Health Insurance

Cost-Sharing Reduction (CSR)

CSRs reduce out-of-pocket costs for Silver plan enrollees with household incomes between 100% and 250% of the federal poverty level.

Last reviewed: May 2026 · Editorial methodology

Definition

Cost-Sharing Reductions (CSRs) are federal subsidies that reduce the deductibles, copays, coinsurance, and out-of-pocket maximum amounts on Silver-tier marketplace plans for eligible enrollees. To receive a CSR, a person must enroll in a Silver plan and have a household income between 100% and 250% of the federal poverty level (FPL). CSRs are layered: those earning 100–150% FPL receive the most generous reduction, typically bringing the Silver plan's actuarial value close to a Platinum plan; those at 150–200% FPL receive a moderate reduction; and those at 200–250% FPL receive a smaller reduction. Critically, CSRs are available only on Silver plans — choosing a Bronze or Gold plan makes you ineligible even if you qualify by income. Because insurers must fund CSRs regardless of whether the federal government appropriates reimbursement funds, they have embedded CSR costs into Silver plan premiums in many states, sometimes inflating Silver premiums relative to other tiers — a strategy called 'Silver loading.' When Silver loading occurs, it can increase premium tax credit amounts and make Gold plans unexpectedly cheaper than Silver.

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Tip

Glossary definitions are educational. Always check your own policy language — insurers can define common terms differently from one another. When in doubt, request a written explanation from your agent.

Related terms

Premium Tax CreditThe premium tax credit (PTC) makes marketplace coverage affordable by offsetting a portion of your monthly premium based on your income and the cost of the benchmark Silver plan.Metal Tier (Bronze/Silver/Gold/Platinum)Metal tiers signal how a plan splits costs with you: higher tiers mean higher premiums but lower out-of-pocket costs when you need care.Health Insurance MarketplaceThe marketplace, also called the exchange, is where most people shop for ACA plans and access premium tax credits to reduce their monthly premium.ACA (Affordable Care Act)The ACA established consumer protections including guaranteed issue, coverage of preexisting conditions, and subsidized marketplace insurance for millions of Americans.MAGI (Modified Adjusted Gross Income)MAGI is your adjusted gross income plus certain additions like tax-exempt interest and foreign income, used to assess marketplace and Medicaid subsidy eligibility.

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Source: Cover Forge USA editorial team|Last verified: May 2026|Methodology
Definitions are educational and may be simplified. Always refer to your policy contract and consult a licensed agent for terms that affect coverage decisions.
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Cover Forge USA Editorial Team

Editorial Lead

This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.

Reviewed June 2026

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