For each EDG, IES will use the total countable income of each person included in the EDG, except that there are special rules about:
- Family Health Spenddown, and
- income of a child/stepchild of another person in the EDG or a tax dependent.
See PM 15-06-01-h for policy about whether to count the income of a child/stepchild (of any age) of another person in the EDG and for policy about whether to count income of a tax dependent.
Special Policy for Family Health Spenddown
Federal guidelines allow states to use MAGI budgeting for Family Health spenddown EDGs with the following budgeting difference: if the EDG goes into spenddown, we could only use the income of responsible relatives to determine the spenddown obligation amount.
For purposes of this rule, a responsible relative is defined as:
- a spouse, or
- a biological or adoptive parent of a child under age 19.
If the only income is that of a non-responsible relative (such as a stepparent or sibling), the result is a spenddown case with a zero spenddown amount. With a '0' SPD obligation, the family does not need to submit any medical expenses. In this situation, spenddown is met.
Note: Since All Kids Share and Premium is always prospective, IES will determine SPD eligibility for the months before the Share/Premium eligibility (which may or may not include backdate months).