CSR (Cost-Sharing Reduction)

A Cost-Sharing Reduction (CSR) is an extra federal subsidy that lowers the out-of-pocket costs of a Silver-tier Marketplace plan: the deductible, copays, coinsurance, and the out-of-pocket maximum. It does not lower your monthly premium, for that, see APTC.

Who qualifies

CSRs are tied to your household income as a percentage of the federal poverty level (FPL):

Household income	CSR tier	What it does
Up to 150% FPL	CSR 94	Plan covers ~94% of average costs (Platinum-equivalent)
150–200% FPL	CSR 87	Plan covers ~87% of average costs (Gold-equivalent)
200–250% FPL	CSR 73	Plan covers ~73% of average costs (slightly better than standard Silver)
Above 250% FPL	No CSR	Standard Silver plan applies

There is one important catch: you must enroll in a Silver plan. CSRs do not apply to Bronze, Gold, or Platinum plans, and they do not transfer if you switch mid-year.

Example

A family of 3 in Florida with household income of $40,000 (about 169% FPL for 2026, household size 3):

• Standard Silver plan: $7,000 deductible, $9,400 OOP max
• With CSR 87: deductible drops to ~$1,500, OOP max to ~$4,000
• The premium is the same; the out-of-pocket protection is dramatically better

For a family with regular medical needs, that difference is the difference between affordable care and skipped care.

Why Silver?

This is one of the quirks of ACA design. To get CSR, you must buy a Silver plan because the federal government compensates insurers for the extra coverage on Silver tier specifically. Many people who would otherwise pick a Bronze plan (lower premium) should run the math: with CSR, a Silver plan often delivers far more value because the deductible alone might be 80% lower.

CSR and Native Americans / Alaska Natives

Members of federally recognized tribes have separate, more generous CSR rules — many qualify for $0 or near-$0 cost-sharing on any Marketplace plan, not just Silver. If you have tribal membership, mention it on your application.

What changed for 2026

CSR rules themselves are unchanged. What changed is the broader subsidy landscape: with APTC cut back to the original 2.10–9.96% schedule (IRS Rev. Proc. 2025-25), CSR-eligible households below 250% FPL still pay relatively little for premiums — making “enhanced Silver” plans (Silver + APTC + CSR) the highest-value option for most lower-income enrollees.

Related terms

• Deductible
• Out-of-Pocket Maximum
• APTC
• Federal Poverty Level

Run the calculator, see whether your income qualifies for CSR.