Under PPACA, cost-sharing reductions (CSR) that lower deductibles and copays are available to eligible marketplace enrollees with household income between:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Cost-sharing reductions (CSR) lower the deductibles, copays, and coinsurance that a marketplace enrollee pays, and they apply only to enrollees who select a Silver-tier plan. CSR is available to eligible households with income between 138% and 250% of the federal poverty level. Below 138% FPL, most adults qualify for Medi-Cal instead, and above 250% FPL the CSR subsidy phases out. The 138-250% band is a core PPACA number tested on the A&H exam. CSR applies only to Silver-tier plans because the reduction is built into the plan's cost-sharing design, and the federal government compensates the insurer for the lowered member cost shares.
Why the other options are wrong
- B) Income at or below 100% FPL routes most adults to Medi-Cal rather than to marketplace coverage with CSR.
- C) The 400-500% FPL range is far above the CSR ceiling; enrollees above 250% FPL receive no cost-sharing reductions.
- D) The 300-400% FPL range exceeds the CSR threshold; in that band only premium subsidies, not CSR, may apply.
Memory hook
CSR lives in the 138-250% band — the sweet spot where help with deductibles and copays kicks in.