Cost-sharing reductions (CSR) under PPACA are available to individuals with household income between 138% and 250% of the federal poverty level who:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Cost-sharing reductions lower the out-of-pocket costs — deductibles, copays, and coinsurance — of exchange enrollees with household income between 138% and 250% of the FPL, but the subsidy attaches only to Silver-level marketplace plans. The reduction is built into the plan's cost-sharing design, effectively raising the actuarial value of the Silver plan for eligible enrollees. Because eligibility and delivery both run through the exchange, off-exchange purchases and non-Silver tiers do not carry the CSR benefit. This Silver-plus-exchange linkage is the precise point the exam tests.
Why the other options are wrong
- B) CSR applies only to Silver plans; other tiers and catastrophic coverage do not carry the cost-sharing reduction, so this answer overgeneralizes the eligibility rule.
- C) CSR is delivered through exchange enrollment; off-exchange Silver plans generally do not include the benefit, so buying outside the marketplace forfeits the subsidy.
- D) Bronze plans carry lower premiums but higher cost-sharing and are not the vehicle for the CSR subsidy, so this answer mistakes premium level for the CSR mechanism.
Memory hook
CSR = Silver-only cost-sharing discount for the 138-250% FPL band. Bronze buys a cheap ticket, not a discount on care.