Cost-sharing reductions (CSR) under the ACA are available to eligible enrollees whose household income is between:
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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, including deductibles, copays, and coinsurance, of eligible enrollees who choose a Silver plan through the exchange. They are income-tested for households between 138% and 250% of the federal poverty level, with the reduction amount decreasing as income rises within that band. CSR does not change the premium itself, which is addressed separately by the premium tax credit, and it applies only to Silver-tier plans. These thresholds are an exact exam fact and must not be confused with the APTC ceiling of 400% FPL or the Medi-Cal thresholds.
Why the other options are wrong
- B) Households below 100% FPL are generally eligible for Medicaid or Medi-Cal rather than exchange cost-sharing reductions, so the CSR band does not begin at zero income.
- C) Enrollees above 250% FPL do not qualify for CSR. They may still receive premium tax credits up to 400% FPL, but their cost-sharing is not reduced.
- D) Households above 400% FPL are above the premium tax credit ceiling entirely and receive no income-based cost-sharing reductions on the exchange.
Memory hook
CSR lives between 138 and 250: the Silver-plan sweet spot for lower out-of-pocket costs.