What is the maximum income for cost-sharing reductions (CSRs) under the ACA in 2024?
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Executive summary
Cost‑sharing reductions (CSRs) under the Affordable Care Act are limited to people who enroll in a Silver Marketplace plan and whose household income falls at or below 250% of the federal poverty level (FPL) for 2024; for a single person that ceiling was $36,450 and for a family of four $75,000 for 2024 coverage [1] [2]. CSRs are strongest for those at or below 200% FPL and are unavailable to people eligible for Medicaid in expansion states [1] [3].
1. What the rule actually says: the 250% FPL ceiling
Federal guidance and Congressional summaries make clear that CSR eligibility ends at 250% of the federal poverty level for Marketplace enrollees who pick Silver plans; the Congressional Research Service states plainly that an individual with “annual household income no greater than 250% of FPL is eligible for cost‑sharing reductions” [4]. Multiple consumer‑facing explainers repeat the same cap and translate it into dollar examples for 2024 coverage [1] [2].
2. How that ceiling translated into dollars in 2024
Reporting that breaks the FPL percentages into dollar cutoffs shows the 250% threshold for 2024 coverage equaled $36,450 for a single person and $75,000 for a family of four [1]. ValuePenguin and similar outlets use those same 2024 conversion figures when advising consumers about whether they can claim CSRs [2].
3. The lower boundary and the Medicaid interaction
Eligibility for CSRs begins where Marketplace assistance becomes relevant; in states that expanded Medicaid, people below roughly 138% of FPL are generally steered to Medicaid instead of Marketplace subsidies, while in non‑expansion states the lower Marketplace threshold can be as low as 100% of FPL. HealthInsurance.org’s glossary notes that the lower CSR threshold depends on Medicaid expansion status—if you qualify for Medicaid you aren’t eligible for CSRs [3].
4. Who gets bigger vs. smaller CSRs — the income bands
CSRs are tiered. The most generous reduction (often called CSR 94 or CSR 73 depending on the metric) goes to households at the lowest income bands; for 2024 coverage the benefits are strongest at incomes at or below 200% of FPL, with somewhat smaller reductions for those between 200% and 250% FPL [1] [5]. Policy briefs and CMS materials explain that actuarial‑value targets and out‑of‑pocket maxima change by band, so two people both under 250% FPL may experience meaningfully different out‑of‑pocket protections [5] [4].
5. Where confusion comes from: premium credits vs. CSRs
A common source of public confusion is conflating premium tax credits with CSRs. Premium tax credits have been subject to separate temporary enhancements from 2021–2025 that affect how far up the income scale tax credits stretch; those changes do not change the statutory CSR ceiling at 250% FPL for 2024 coverage [6] [7]. Some sites summarize premium credit eligibility differently (e.g., “between 100% and 400%” or expanded through 2025), which can blur distinctions for readers comparing sources [8] [7].
6. Practical implications for consumers
If your 2024 household income exceeded 250% of FPL you could not receive CSRs even if you qualified for premium tax credits; conversely, households below 250% FPL who enroll in a Silver plan should check Marketplace enrollment materials to ensure they receive the CSR benefits they’re entitled to [4] [1]. Consumer calculators and enrollment counselors use the prior‑year poverty guidelines to convert the percentage limits into dollar thresholds—so exact cutoffs vary by household size and by whether you live in Alaska or Hawaii [6] [1].
7. Limitations and what sources do not address
Available sources used here do not detail state‑by‑state variations in outreach or insurer plan designs that can affect the on‑the‑ground size of a CSR; nor do they provide post‑2024 legal or administrative changes that might alter CSR eligibility beyond the timeline covered (not found in current reporting). Readers should consult their state Marketplace or Healthcare.gov for the precise MAGI calculation, Alaska/Hawaii adjustments, and plan‑specific cost‑sharing figures [9].
Sources cited: Congressional Research Service and CMS summaries on CSR eligibility [4] [9], HealthInsurance.org and explanatory guides translating the 250% FPL limit into 2024 dollar cutoffs and context about Medicaid interactions [1] [3], and consumer guides that restate the 250% threshold and dollar examples for 2024 [2] [6].