What is a Cost-Sharing Reduction (CSR) on ACA plans?

Cost-Sharing Reductions (CSRs) are a separate ACA subsidy that lowers your deductible, copays, and out-of-pocket maximum on Silver-tier plans for households under 250% of the Federal Poverty Level. They're often more valuable than the premium subsidy (APTC) and are dramatically underutilized.

Two distinct ACA subsidies:

1. Premium Tax Credit (APTC): Reduces your monthly premium. Available for any metal tier (Bronze/Silver/Gold/Platinum). Income range: 100%–400% FPL (or higher under IRA extension).

1. Cost-Sharing Reductions (CSR): Reduces your deductible and out-of-pocket costs. Available ONLY on Silver-tier plans. Income range: 100%–250% FPL.

CSR is automatic — if you qualify by income and choose a Silver plan, you get CSR. You don't apply separately. The Marketplace handles it behind the scenes.

The four CSR levels:

| Income (% FPL) | Plan name | Effective coverage | Typical deductible | Typical OOP max |
|---|---|---|---|---|
| 100–150% | CSR 94 | ~94% (close to Platinum) | $0–$300 | $1,400–$3,300 |
| 150–200% | CSR 87 | ~87% (better than Gold) | $300–$1,000 | $3,000–$5,500 |
| 200–250% | CSR 73 | ~73% (slightly better than standard Silver) | $1,500–$3,500 | $5,500–$7,000 |
| Above 250% | Standard Silver | 70% | $4,000–$8,000 | $7,000–$9,200 |

Specific deductibles vary by carrier and plan; ranges are typical.

How dramatic the difference is:

A standard Silver plan in 2026 typically has:
- Deductible: ~$4,800
- OOP max: ~$9,200
- 30% coinsurance after deductible

The SAME Silver plan with CSR 94 (under 150% FPL):
- Deductible: ~$200
- OOP max: ~$1,400
- 6% coinsurance after deductible

That's a $4,600 deductible reduction and a $7,800 OOP-max reduction — for the same monthly premium. CSR 94 is essentially Platinum-level coverage at Silver-level price.

The widespread mistake — picking Bronze when CSR Silver is better:

Many people under 250% FPL pick Bronze because the monthly premium is lower. This is almost always wrong.

Example: Single 35-year-old, income $25,000 (160% FPL), in a typical metro:

| Plan | Premium after subsidy | Deductible | OOP max | Annual cost if you use $5,000 of care |
|---|---|---|---|---|
| Bronze | $0/month | $7,500 | $9,200 | $5,000 |
| CSR 87 Silver | $30/month | $300 | $3,000 | $360 (premium) + $300 (deductible) + small copays = ~$1,000 |
| Gold | $130/month | $1,500 | $7,500 | $1,560 + $1,500 + copays = ~$3,500 |

CSR Silver wins by $4,000 vs Bronze and $2,500 vs Gold for moderate utilization. The benefit is even bigger if you use more healthcare.

The ONLY scenario where Bronze beats CSR Silver:
- You have ZERO healthcare needs all year (no doctor visits, no prescriptions, no preventive care)
- AND you want the absolute cheapest premium

For anyone with even modest healthcare use (1–2 doctor visits, any prescriptions), CSR Silver is dramatically better.

Who qualifies for CSR (2026 estimates):

CSR 94 (~94% coverage) — household income at or below 150% FPL:
- 1 person: $23,475
- 2 people: $31,725
- 4 people: $48,225

CSR 87 (~87% coverage) — 150–200% FPL:
- 1 person: $23,475–$31,300
- 2 people: $31,725–$42,300
- 4 people: $48,225–$64,300

CSR 73 (~73% coverage) — 200–250% FPL:
- 1 person: $31,300–$39,125
- 2 people: $42,300–$52,875
- 4 people: $64,300–$80,375

Special CSR for American Indians/Alaska Natives:

Members of federally-recognized tribes get CSR 100 (zero cost-sharing) on any plan tier if income is under 300% FPL — even Bronze, Gold, Platinum. This is a major underused benefit for Native Americans.

How to actually get CSR:

1. Apply through HealthCare.gov or your state Marketplace. Report your projected annual income accurately.

1. Pick a Silver-tier plan. This is critical. CSR is ONLY available on Silver. Picking Bronze or Gold loses the CSR benefit even if you qualify.

1. Confirm the CSR variant. When you see a Silver plan, the displayed deductible and copays should reflect your CSR level. The plan name often includes "73," "87," or "94" in the description.

1. Re-shop annually. During Open Enrollment, re-check CSR eligibility based on next year's income projection. Marketplace will recalculate.

What if your income changes mid-year:

• Income drops below 250% FPL mid-year → you become CSR-eligible. Update your application; you can switch to a CSR Silver plan via the qualifying income change SEP.
• Income rises above 250% FPL mid-year → you lose CSR eligibility. The Marketplace will adjust at year-end via tax reconciliation; in some cases you may owe back a portion.
• Income rises above 400% FPL → you may also lose APTC entirely (especially if subsidy cliff returns in 2026). Update immediately.

Common mistakes:

• Not knowing CSR exists. Most people only know about premium subsidies; CSR is the bigger benefit at moderate income.
• Picking Bronze for the lower premium. Math almost always favors CSR Silver under 250% FPL.
• Not updating income. If income changes, CSR eligibility changes — failing to update means wrong coverage.
• Off-Marketplace enrollment. CSR is ONLY available on plans purchased through the Marketplace, not direct from the carrier. Off-Marketplace enrollment forfeits CSR.

What to do next: Call (866) 534-1886. We confirm your CSR eligibility, calculate which CSR variant Silver plan beats Bronze AND Gold for your specific situation, and enroll you correctly to maximize the subsidy. Free.