Cost-sharing reductions (CSRs) lower the deductible, copayments and coinsurance on Silver Marketplace plans for people with income up to 250% of the federal poverty level (FPL). For 2027 coverage, which you can pick from November 1, 2026 through January 15, 2027, the Silver 87 ceiling is 200% FPL, or $31,920 for one person and $66,000 for a family of 4 (2026 poverty guidelines). Silver 94 covers incomes up to 150% FPL ($23,940 for one person in 2027 coverage), and Silver 73 covers incomes above 200% up to 250% FPL ($39,900 for one person). The reduction upgrades the Silver plan you choose; it is not a separate program.
Adults under 65 who choose a Bronze plan to save on the monthly premium can give up this upgrade without knowing it. HealthCare.gov says you must pick a Silver plan to get the savings, and KFF found that in HealthCare.gov states the share of eligible consumers who chose a cost-sharing reduction plan fell from 66% in 2025 to 45% in 2026. This page covers the income lines, the 2027 out-of-pocket limits, the other eligibility rules and how to enroll. For the definition, see the cost-sharing reduction glossary entry, and for the premium side see who qualifies for an ACA subsidy.
Coverage Breakdown
Direct answer: who qualifies for cost-sharing reductions in 2027
Yes. For 2027 coverage, you qualify for cost-sharing reductions when your household income is 100% to 250% of the federal poverty level ($15,960 to $39,900 for one person in 2027), you qualify for the premium tax credit, and you pick a Silver plan. Income up to 150% gets Silver 94, above 150% to 200% gets Silver 87, and above 200% to 250% gets Silver 73.
What Silver 94, Silver 87 and Silver 73 plans change in 2027
Silver 94, Silver 87 and Silver 73 are upgraded versions of the Silver plans sold on HealthCare.gov and state Marketplaces for 2027 coverage. A standard Silver plan pays about 70% of covered costs on average. The cost-sharing reduction versions raise that to 73%, 87% or 94% by cutting deductibles, copayments and coinsurance and by lowering the yearly out-of-pocket limit. The insurer sets each plan's actual deductible, so two Silver 87 plans can differ, but each must stay under the 2027 federal limits: $4,000 for one person ($8,000 for a family) on Silver 94 and Silver 87, and $9,600 ($19,200) on Silver 73, per the CMS 2027 payment parameters guidance of January 29, 2026.
The 2027 base out-of-pocket limit is $12,000 for one person and $24,000 for a family, up from $10,600 and $21,200 in 2026 (CMS). Those are ceilings for every ACA-compliant plan, so the $4,000 ceiling on Silver 94 and Silver 87 is one third of the 2027 base limit. KFF found that the average 2026 Silver deductible for people with income up to 150% of poverty was $80, compared with $5,304 for a standard Silver plan. The monthly premium of a cost-sharing reduction plan is the same as the standard version of that Silver plan, so the upgrade is not an extra charge. Every Silver plan covers the same essential health benefits, and ACA-compliant plans cannot deny coverage or charge more for a preexisting condition.
Silver 87 and 200 FPL: cost-sharing reduction income limits by household size (2027 coverage)
The Silver 87 ceiling is 200% of the federal poverty level (FPL): $31,920 for one person and $66,000 for a family of 4 for 2027 coverage. Marketplace savings for a coverage year use the poverty guidelines in effect when that year's open enrollment began (26 CFR 1.36B-1(h)), so 2027 coverage uses the 2026 guidelines: $15,960 for one person plus $5,680 for each additional person in the 48 states and DC. Alaska ($19,950 plus $7,100) and Hawaii ($18,360 plus $6,530) have higher 2026 guidelines, so multiply those by 1.5, 2 or 2.5 to find their lines.
Anyone still on 2026 coverage, for example through a special enrollment period, is measured against the 2025 guidelines instead. For 2026 coverage, 150% FPL is $23,475 for one person and $48,225 for four, 200% FPL is $31,300 for one and $64,300 for four, and the Silver 73 ceiling of 250% FPL is $39,125 for one and $80,375 for four.
Other rules that decide who gets a cost-sharing reduction plan in 2027
Income is only the first test for cost-sharing reductions in 2027. HealthCare.gov says you must apply through the Marketplace, qualify for the premium tax credit, have an income estimate inside the cost-sharing reduction range, and choose a Silver plan. Catastrophic plans do not qualify. Household income for 2027 coverage counts all Social Security benefits, taxable or not (26 USC 36B(d)(2)(B)(iii)), and your Eligibility Determination Notice shows which plan variant you can choose.
- Medicaid first (2027): in a Medicaid expansion state, adults under 138% of FPL ($22,025 for one person in 2026) are routed to Medicaid, so Silver 94 there mostly serves people from 138% to 150% FPL.
- Coverage gap: below 100% of FPL in a state that did not expand Medicaid (AL, FL, GA, KS, MS, SC, TN, TX, WI, WY) there is no premium tax credit and no cost-sharing reduction (26 USC 36B(c)(1)(A)). Wisconsin covers adults up to 100% FPL through BadgerCare Plus.
- Job-based coverage: an offer of affordable employer coverage (cost of 10.22% of income or less for 2027) blocks the premium tax credit, and with it the cost-sharing reduction.
- Immigration status: from 2027 coverage the premium tax credit is limited to citizens, green card holders, Cuban and Haitian entrants, and citizens of Micronesia, the Marshall Islands and Palau (P.L. 119-21 sec. 71301). Because HealthCare.gov ties cost-sharing reductions to premium tax credit eligibility, read your notice. Refugees, asylees, TPS holders and parolees can still buy a plan at full price, and for 2026 coverage lawfully present immigrants qualify as before.
- DACA: since August 25, 2025, DACA recipients cannot buy a plan through HealthCare.gov or a state Marketplace or get cost-sharing reductions (90 FR 27074).
- American Indians and Alaska Natives: members of federally recognized tribes under 300% of FPL qualify for zero cost-sharing plan variants for 2027 (ACA sec. 1402(d); CMS 2027 guidance).
Why a Bronze plan can cost low-income adults more than a Silver cost-sharing reduction plan in 2027
Consider one adult under 65 with 2027 income of $28,728, which is 180% of the 2026 poverty line of $15,960. That adult qualifies for Silver 87, where the federal out-of-pocket limit is $4,000 for 2027. A Bronze plan pays about 60% of costs on average, gets no cost-sharing reduction, and has a $12,000 base limit for one person in 2027; the final 2027 payment notice also lets some individual-market Bronze plans set an out-of-pocket maximum of up to $15,600 (Federal Register, May 20, 2026). Bronze can carry a lower monthly premium, but a Bronze deductible can run to thousands of dollars before the plan pays for most care.
KFF reports that in HealthCare.gov states the share of cost-sharing reduction eligible consumers who chose a cost-sharing reduction plan fell from 66% in 2025 to 45% in 2026. The premium tax credit can be used on any metal level, but only a Silver plan carries the cost-sharing reduction, so compare the Silver 94, 87 or 73 version against Bronze on deductible and out-of-pocket limit as well as the monthly premium before you pick.
How to enroll in a cost-sharing reduction plan for 2027
Open enrollment for 2027 coverage started November 1, 2026 and runs through January 15, 2027. HealthCare.gov lists December 15, 2026 as the last day to enroll or change plans for coverage that starts January 1, 2027, and January 15, 2027 for coverage that starts February 1, 2027; confirm both dates on HealthCare.gov before you rely on them, because state-based Marketplaces set their own. The official starting point is HealthCare.gov, or your state Marketplace if your state runs its own.
- Estimate your 2027 household income and household size, counting all Social Security benefits.
- Apply at HealthCare.gov or your state Marketplace and enter the income estimate for 2027, not last year's income.
- Read your Eligibility Determination Notice for the line that says you can choose a plan with lower copayments, coinsurance and deductibles.
- Filter to Silver plans and compare deductible, out-of-pocket limit and doctor network, then choose the Silver plan.
- Pay the first premium by the insurer's due date, and report income changes during 2027 so your plan variant stays correct.
Alternatives if you do not qualify for a cost-sharing reduction plan in 2027
Adults under 65 above 250% of FPL or outside the other rules still have several routes to lower costs in 2027. Each option below points to the official place to check it.
- Premium tax credit above 250% FPL: income above 250% and up to 400% of FPL ($39,900 to $63,840 for one person, 2027 coverage) can still earn a credit on any metal level; check HealthCare.gov.
- Medicaid: adults under 138% of FPL in an expansion state, or those who qualify in other ways in any state, apply year-round through HealthCare.gov or the state Medicaid agency.
- Community health centers: if income is under 100% of FPL in a non-expansion state, a health center charges on a sliding scale; find one at findahealthcenter.hrsa.gov.
- Full-price plans above 400% of FPL: income above $63,840 for one person (2027 coverage) has no premium tax credit. Near that line, estimate income carefully, because no repayment cap applies to excess advance credits from tax year 2026.
- Medicare at 65: people 65 and older who have Original Medicare (Part A and Part B) or Medicare Advantage do not get Marketplace savings; see medicare.gov for help.
Frequently Asked Questions
What income qualifies for Silver 87 in 2027?
For 2027 coverage, Silver 87 is for household income above 150% and up to 200% of the federal poverty level. Using the 2026 guidelines, that is $23,941 to $31,920 for one person, $32,461 to $43,280 for two, and $49,501 to $66,000 for four. You must also qualify for the premium tax credit and pick a Silver plan.
What is the difference between Silver 73, 87 and 94?
The number is the share of covered costs the plan pays on average in 2027 coverage. Silver 94 serves income of 100% to 150% FPL, Silver 87 serves above 150% to 200% FPL, and Silver 73 serves above 200% to 250% FPL. Higher numbers mean lower deductibles and copays. A standard Silver plan pays about 70%.
Do I have to choose a Silver plan to get cost-sharing reductions?
Yes. HealthCare.gov says you must pick a plan in the Silver category to get the savings, and catastrophic plans do not qualify. The premium tax credit works on any metal level, but a Bronze or Gold plan gets no cost-sharing reduction in 2027, even if your income is under 250% of FPL.
What are the 2027 out-of-pocket limits on Silver 94, 87 and 73 plans?
For 2027, CMS sets the limit at $4,000 for one person ($8,000 for a family) on Silver 94 and Silver 87, and $9,600 ($19,200) on Silver 73. Without a reduction, the 2027 base limit is $12,000 for one person and $24,000 for a family. Your plan may set lower limits than these ceilings.
Do cost-sharing reductions lower my monthly premium?
No. The premium tax credit lowers the monthly premium, and cost-sharing reductions lower what you pay at the doctor or hospital for 2027 coverage. The monthly premium of a cost-sharing reduction plan matches the standard version of that Silver plan, so you do not pay extra for the upgrade.
Can I get Silver 94 if my income is under 138% of FPL?
It depends on your state. In a Medicaid expansion state, adults under 138% of FPL ($22,025 for one person in 2026) are sent to Medicaid. In a non-expansion state, adults from 100% of FPL can get a premium tax credit and Silver 94, while adults under 100% fall in the coverage gap in 2027.
What if my income changes during 2027?
Report the change at HealthCare.gov or your state Marketplace. Your eligibility is redetermined, and your plan variant can change if your income moves across 150%, 200% or 250% of FPL. HealthCare.gov says that if you have a Silver plan and lose your cost-sharing reductions, you qualify for a special enrollment period.
Do immigrants and DACA recipients qualify for cost-sharing reductions in 2027?
DACA recipients cannot get them, because they cannot enroll through a Marketplace since August 25, 2025. For 2027 coverage, the premium tax credit is limited to citizens, green card holders, Cuban and Haitian entrants, and citizens of Micronesia, the Marshall Islands and Palau, and HealthCare.gov ties cost-sharing reductions to that credit. Check your notice.
