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

Cost-sharing reductions (CSR) that lower deductibles, copayments, and coinsurance for Marketplace enrollees are available to households with incomes between:

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

Why A is correct

The ACA provides cost-sharing reductions to eligible Marketplace enrollees whose household income is between 138% and 250% of the federal poverty level. These enrollees receive enhanced plan benefits with lower deductibles, copayments, and coinsurance, and the reductions are available only on Silver-tier plans sold through the Exchange. The 138% to 250% FPL band is the defined CSR eligibility range, distinct from the higher APTC band, so A correctly identifies the income window for cost-sharing reductions. The CSR program is specifically designed to make Silver plan coverage more affordable for lower-income enrollees who are above the Medi-Cal threshold but still struggle with out-of-pocket costs.

Why the other options are wrong

  • B) Households in the 250% to 400% FPL range may receive premium tax credits but are above the CSR threshold and therefore receive no cost-sharing reductions. Those households may qualify for premium tax credits but are above the CSR income band.
  • C) Households below 138% FPL qualify for Medi-Cal rather than Marketplace cost-sharing reductions; there is no CSR eligibility band starting at 50% FPL. No CSR tier exists below 138% FPL, where Medi-Cal coverage takes over.
  • D) Households above 400% FPL receive neither premium tax credits nor cost-sharing reductions under the standard ACA rules, so 400% to 600% FPL is not a CSR band. Households above 400% FPL receive neither CSR nor premium assistance under the standard rules.

Memory hook

CSR lives between 138 and 250. Below is Medi-Cal, above 250 the Silver discounts disappear.

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