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Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 2/5

Under the ACA, cost-sharing reductions (CSR) are available to eligible enrollees who:

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Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

Cost-sharing reductions lower an enrollee's deductibles, copays, and coinsurance — effectively raising the plan's actuarial value — and are available only through Silver-tier marketplace plans. Eligibility is income-based: households between 138% and 250% of the federal poverty level qualify in states that expanded Medicaid (the band differs in non-expansion states, starting at 100% FPL). Below 138% most adults qualify for Medi-Cal, and above 250% CSR phases out entirely. CSR is built into the plan's actuarial value through the Silver tier.

Why the other options are wrong

  • B) CSR attaches only to Silver plans; Bronze plans are not eligible for cost-sharing reductions. The Silver tier is the exclusive home of cost-sharing reductions under the ACA's marketplace rules.
  • C) CSR is a Silver-plan benefit; Platinum plans do not receive it, and households below 100% FPL generally qualify for Medi-Cal rather than marketplace cost-sharing. Platinum plans already carry the highest actuarial value.
  • D) CSR is an ACA marketplace feature; Medicare Advantage has its own benefit structure and is not eligible for CSR. Medicare Advantage has its own separate benefit and subsidy structure entirely.

Memory hook

CSR = the Silver-only secret upgrade: income 138-250% FPL buys a richer Silver plan at no extra premium.

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