The CSR Program is a cost-sharing reduction resource available to qualifying enrollees in Affordable Care Act insurance plans. The ACA requires insurers to reduce cost-sharing amounts (deductibles, copayments, and out-of-pocket limits) for Premium Tax Credit recipients enrolled in silver plans whose income is below 250 percent of the federal poverty level (FPL). The CSR program thus results in a plan where the insurer pays a greater percentage of the expenses with the generosity varying by household income.
By lowering out-of-pocket costs, the CSR Program increases a silver plan’s actuarial value (AV) above 70 percent. Below are silver plan AVs corresponding to the different subsidy qualifications within the CSR Program.
- 94 percent AV, when the enrollee’s household income is below 150 percent of the federal poverty level
- 87 percent AV, when the enrollee’s household income is between 150 and 200 percent of the federal poverty level
- 73 percent AV, when the enrollee’s household income is between 200 and 250 percent of the federal poverty level
Over five million lower income households received benefits from the CSR program in 2020.
Additional Resources