Cost-sharing reduction eligibility for 2027 marketplace coverage tops out at 250% of the federal poverty level, which works out to about $39,900 in yearly income for a single person and $82,500 for a family of four. That is up modestly from the 2026 threshold of $39,125 and $80,375. The bigger change for 2027 is not who qualifies, it is how much CSR is worth: out-of-pocket maximums for CSR-eligible silver plans are rising alongside the standard ACA limit, which jumps from $10,600 to $12,000 for individual coverage between 2026 and 2027. Below is the full breakdown of income tiers, actuarial value levels, and out-of-pocket caps for 2027, based on CMS's payment parameter guidance issued in January 2026.
What Cost-Sharing Reductions Actually Do
A cost-sharing reduction, or CSR, is a federal subsidy that lowers the deductible, copays, and coinsurance on a marketplace health plan. It is a separate benefit from the premium tax credit, which lowers your monthly bill. CSR only lowers what you pay when you actually use care, and it only attaches to Silver-tier plans. Choose a Bronze, Gold, or Platinum plan instead, and the CSR benefit disappears even if your income qualifies.
CSR eligibility is capped at 250% of the federal poverty level. That is a hard ceiling. Premium tax credits can, in some circumstances, extend well past 400% FPL, but cost-sharing reductions never apply above 250% FPL under current law.
2027 CSR Income Thresholds by Household Size
These figures come from CMS's 2027 Notice of Benefit and Payment Parameters guidance, which locks in the federal poverty guidelines used for 2027 plan year eligibility determinations.
| Household size | 100% FPL (2027) | 150% FPL (2027) | 200% FPL (2027) | 250% FPL (2027, CSR ceiling) |
|---|
| 1 person | $15,960 | $23,940 | $31,920 | $39,900 |
| 2 people | $21,540 | $32,310 | $43,080 | $53,850 |
| 3 people | $27,120 | $40,680 | $54,240 | $67,800 |
| 4 people | $33,000 | $49,500 | $66,000 | $82,500 |
Figures are for the 48 contiguous states and Washington, D.C. Alaska and Hawaii use higher poverty guidelines. Add roughly $5,580 per additional household member above four for continental U.S. figures.
2026 vs 2027 CSR Thresholds
| Metric | 2026 | 2027 | Change |
|---|
| 250% FPL, single person | $39,125 | $39,900 | +$775 |
| 250% FPL, family of four | $80,375 | $82,500 | +$2,125 |
| 100% FPL, single person | $15,650 | $15,960 | +$310 |
| Standard silver OOP max, individual | $10,600 | $12,000 | +$1,400 |
| Standard silver OOP max, family | $21,200 | $24,000 | +$2,800 |
The income thresholds move a small amount each year in line with inflation-adjusted poverty guidelines. The out-of-pocket ceiling is the number to watch. It rose nearly 13% for 2027, following a similar jump the year before, driven by a change in the formula HHS uses to calculate the annual cap.
CSR Actuarial Value Tiers
Your income within the 100% to 250% FPL band determines which version of the Silver plan you are placed into. Insurers call these "cost-sharing variants," and each one carries a different actuarial value (AV), meaning the percentage of your typical medical costs the plan covers in a given year.
| Income (% FPL) | Actuarial value | What it means |
|---|
| 100% to 150% | 94% AV | Plan covers about 94% of costs, comparable to a Platinum plan |
| 150% to 200% | 87% AV | Plan covers about 87% of costs, close to Platinum-level |
| 200% to 250% | 73% AV | Plan covers about 73% of costs, better than a standard 70% Silver plan |
| Any income up to 300% FPL, American Indian/Alaska Native | 100% AV (zero cost-sharing) | No deductibles, copays, or coinsurance for eligible tribal members |
Below 100% FPL, most people in Medicaid expansion states qualify for Medicaid instead of marketplace coverage. In the 10 states that have not expanded Medicaid, some people below 100% FPL fall into a coverage gap where they qualify for neither Medicaid nor marketplace subsidies.
2027 Out-of-Pocket Maximums by CSR Tier
These are the highest annual out-of-pocket amounts a CSR-eligible enrollee can be required to pay on a Silver plan, based on CMS's 2027 parameters.
| Income (% FPL) | 2027 OOP max, individual | 2027 OOP max, family | 2026 OOP max, individual | 2026 OOP max, family |
|---|
| 100% to 200% | $4,000 | $8,000 | $3,500 | $7,000 |
| 200% to 250% | $9,600 | $19,200 | $8,450 | $16,900 |
| Standard Silver, no CSR | $12,000 | $24,000 | $10,600 | $21,200 |
Even with the increase, a household near 150% FPL will have an out-of-pocket cap for 2027 that is $8,000 lower than the standard Silver plan maximum for a family. That gap is the core value of the CSR program, and it widens as income falls further below 250% FPL.
Why the 2027 Forecast Matters More Than Usual
Two things are shifting at once heading into 2027, and they interact in a way that affects who actually captures CSR value.
Enhanced premium tax credits expired at the end of 2025. Marketplace premium payments jumped substantially for 2026, with the Congressional Budget Office and KFF both estimating that subsidized enrollees are paying roughly double what they paid the year before. That pressure carries into 2027. When premiums rise faster than income, some CSR-eligible households respond by downgrading from Silver to Bronze to cut the monthly bill. That decision saves money upfront but forfeits the cost-sharing reduction entirely, since CSR only attaches to Silver plans. Anyone in the 100% to 250% FPL range should run the math both ways before switching metal tiers.
The standard out-of-pocket ceiling keeps climbing faster than the CSR-adjusted ceilings. Since 2026, HHS has used a revised methodology that increases the annual OOP limit more aggressively than in prior years. That makes CSR relatively more valuable for eligible households in 2027 than it was in 2025, because the gap between the CSR maximum and the standard maximum keeps growing.
For anyone near the 250% FPL line, a modest income change, a raise, a spouse returning to work, a dependent aging out, can push a household above or below the CSR ceiling and change what a Silver plan actually costs to use.
How to Apply for Cost-Sharing Reductions
CSR is not a separate application. It is built into the standard marketplace enrollment process.
- Gather income documentation. You will need projected household income for the coverage year, household size, and state of residence.
- Apply through HealthCare.gov or your state marketplace during open enrollment or a qualifying special enrollment period.
- Report accurate projected income. The marketplace uses your estimated 2027 income to determine both premium tax credit and CSR eligibility. If your income falls between 100% and 250% FPL, the system will flag you as CSR-eligible.
- Choose a Silver plan. This is the step people miss. If you select Bronze, Gold, or Platinum, the CSR discount does not apply even if you qualify on income.
- Compare Silver variants within the marketplace. Insurers must offer the CSR-adjusted version of their Silver plans automatically to eligible applicants, so you will see the reduced deductible and out-of-pocket figures reflected in the plan comparison tool before you enroll.
- Update your application if income changes mid-year. A raise, job loss, or change in household size can move you across an FPL threshold and change your CSR tier.
Frequently Asked Questions
What is the income limit for cost-sharing reductions in 2027?
CSR eligibility for 2027 marketplace coverage runs from 100% to 250% of the federal poverty level. For a single person in the continental U.S., that is roughly $15,960 to $39,900. For a family of four, it is roughly $33,000 to $82,500.
Do I have to pick a Silver plan to get CSR?
Yes. Cost-sharing reductions only apply to Silver-tier marketplace plans. If your income qualifies but you choose Bronze, Gold, or Platinum, you will not receive the CSR discount on deductibles, copays, or coinsurance.
How is CSR different from the premium tax credit?
The premium tax credit lowers your monthly premium and can apply at any metal tier. CSR lowers your out-of-pocket costs when you use care, such as deductibles and copays, and only applies to Silver plans. Many households qualify for both at the same time.
Why did out-of-pocket limits go up for 2027 if my income barely changed?
The federal poverty guidelines that set CSR income eligibility move a small amount each year based on inflation. The out-of-pocket maximum is a separate figure set by HHS using a cost-growth formula, and it has increased faster than inflation in both 2026 and 2027 due to a methodology change adopted by the current administration.
Does the expiration of enhanced premium tax credits affect CSR eligibility?
No. CSR income thresholds are set independently at 100% to 250% FPL and were not changed by the expiration of the enhanced premium tax credits at the end of 2025. What did change is the incentive: higher net premiums are pushing some CSR-eligible households toward cheaper Bronze plans, which do not carry the CSR benefit.
What happens if my income falls below 100% FPL?
In states that expanded Medicaid, income below 100% FPL typically qualifies you for Medicaid rather than marketplace subsidies. In the 10 states that have not expanded Medicaid, some people below 100% FPL fall into a coverage gap and do not qualify for either Medicaid or marketplace premium tax credits.
Are American Indian and Alaska Native enrollees eligible for different CSR terms?
Yes. Enrolled members of federally recognized tribes with household income up to 300% FPL can qualify for zero cost-sharing plans, meaning no deductibles, copays, or coinsurance, regardless of which metal tier they choose.
