Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 3/5
Under the ACA, cost-sharing reductions (CSR) lower out-of-pocket costs for marketplace plan 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 (CSR) reduce deductibles, copayments, and coinsurance for eligible individuals and families who enroll in Silver-tier marketplace plans with income between 138% and 250% of the federal poverty level. CSR is a key ACA mechanism layered on top of the premium tax credit: APTC makes premiums affordable, while CSR makes out-of-pocket costs affordable. The 138%-250% band is a specific exam figure.
Why the other options are wrong
- B) The 100%-138% band is largely the Medi-Cal range; CSR begins at 138% FPL.
- C) Above 250% FPL, income is too high for CSR, although APTC can continue up to 400% FPL.
- D) Households above 400% of the federal poverty level generally receive neither APTC nor cost-sharing reductions; they are expected to pay the full premium for marketplace coverage, so 400%-600% is not a CSR band.
Memory hook
CSR = lower copays for the 138-250% crowd, Silver plans only. Premium help and pocket help are different rungs.