other forms of public assistance health coverage, and provided they do not have access to affordable coverage (no more than 9.86% of income for the employee's coverage) through their own or a family member's employer. Households below the federal poverty level are not eligible to receive these subsidies. Lawfully present immigrants whose household income is below 100% FPL and are not otherwise eligible for Medicaid are eligible for subsidies if they meet all other eligibility requirements.) Married individuals must file taxes jointly in order to receive subsidies. Enrollees must have U.S. citizenship or proof of legal residency to obtain a subsidy. Subsidies are provided as an advanceable, refundable tax credit. The amount of subsidy is sufficient to reduce the premium for the second lowest cost silver plan (SCLSP) on an exchange cost a sliding-scale percentage of income. The percentage is based on the percent of Federal Poverty Level (FPL) for the household, and varies slightly from year to year. In 2019, it ranged from 2.08% of income (100%-133% FPL) to 9.86% of income (300%-400% FPL). The subsidy can be used towards any plan available on the exchange, but not catastrophic plans. The subsidy may not exceed the premium for the purchased plan. (In this section, the term "income" refers to Modified Adjusted Gross Income.) Small businesses are eligible for a tax credit provided that they enroll in the SHOP Marketplace. Exchanges PPACA mandated that health insurance exchanges be provided for each state. The exchanges are regulated, largely online marketplaces, administered by either federal or state governments, where individuals, families and small businesses can purchase private insurance plans. Exchanges first offered insurance for 2014. Some exchanges also provide access to Medicaid. States that set up their own exchanges gives them some discretion on standards and prices. For example, states approve plans for sale, and thereby influence (through negotiations) prices. They can impose additional coverage requirements—such as abortion. Alternatively, states can make the federal government responsible for operating their exchanges. Cost-sharing reduction subsidies As written PPACA mandated that insurers reduce copayments and deductibles for PPACA exchange enrollees earning less than 250% of the FPL. Medicaid recipients were not eligible for the reductions. So-called cost-sharing reduction (CSR) subsidies were to be paid to insurance companies to fund the reductions. During 2017, approximately $7 billion in CSR subsidies were to be paid, versus $34 billion for premium tax credits. The latter were defined as mandatory spending that does not require an annual Congressional appropriation. CSR payments were not explicitly defined as mandatory. This led to litigation and disruption later. Risk management PPACA implemented multiple approaches to helping mitigate the disruptions to insurers that came with its many changes. Risk corridors The risk-corridor program was a temporary risk management device. It was intended to encourage reluctant insurers into PPACA insurance market from 2014–2016. For those years the Department of Health and Human Services (DHHS) Loss-making insurers would receive payments paid for in part by profit-making insurers. Similar risk corridors had been established for the Medicare prescription drug benefit. Many insurers initially offered exchange plans. However, the program did not pay for itself as planned, losing up to $8.3 billion for 2014 and 2015. Authorization had to be given so that DHHS could pay insurers from "general government revenues". However, the Consolidated Appropriations Act, 2014 (H.R. 3547) stated that no funds "could be used for risk-corridor payments". leaving the government in a potential breach of contract with insurers who offered qualified health plans. On February 10, 2017, in Moda Health v the United States, Moda, one of the insurers that struggled financially because of the missing