How to Get Free or Low-Cost Health Insurance

Cost-Sharing Reductions

If your income is between 100% and 250% of the federal poverty level (and you're not eligible for Medicaid), you may get more help to pay your deductible, copays, and coinsurance when you use your health insurance.This is known as a cost-sharing reduction (CSR) subsidy.

CSR benefits are part of the ACA. For eligible applicants, CSR is built into Silver-level plans in the exchange/marketplace.

The federal government used to reimburse insurers for the cost of providing this benefit, but that ended in late 2017, under the Trump administration. Since then, insurers in most states have added the cost of CSR to premiums of on-exchange Silver-level plans. This results in higher Silver premiums, which in turn results in larger premium subsidies. But nothing has changed about the CSR benefits themselves, or eligibility for these benefits.