ICHRA

An interesting article via Jamil Ragland of CT News Junkie:

Six Democratic lawmakers went on the offensive today against what they believe is a better alternative to Association Health Plans.

(Note: The phasing of this lede is confusing...it makes it sound like the lawmakers oppose the better alternative, which the article makes clear is not the case.)

Association Health Plans, which are not currently allowed in Connecticut, would allow small businesses to form a group and purchase health insurance in bulk. However, that health insurance doesn’t come with the protections of the Patient and Affordable Care Act. 

It's been quite awhile since I've written about the "Ass" part of #ShortAssPlans; here's a few basics via Robert Pear of the New York Times:

Note: The first portion of this is a rehash of the explainer I first posted back in June, but it's necessary in order to understand the context of how ICHRA is growing.

Individual Coverage Health Reimbursement Arrangements, or the unfortunate-sounding ICHRA for short, are a type of health insurance arrangements which were created via Trump administration-era regulations back in 2019.

Louise Norris, as always, offers the best explanation of how ICHRA's work:

Last week, I reported that the Republican-controlled House Ways & Means Committee had passed a bill which would codify Individual Coverage Health Reimbursement Arrangements, or ICHRA for short. As Louise Norris explains:

An individual coverage health reimbursement arrangement (ICHRA) is a new type of health reimbursement arrangement in which employers of any size can reimburse employees for some or all of the premiums that the employees pay for health insurance that they purchase on their own...ICHRAs represent a departure from previous ACA implementation rules that forbid employers from reimbursing employees for individual market premiums....

Individual Coverage Health Reimbursement Arrangements, or the unfortunate-sounding ICHRA for short, are a type of health insurance arrangements which were created via Trump administration-era regulations back in 2019.

Louise Norris, as always, offers the best explanation of how ICHRA's work:

An individual coverage health reimbursement arrangement (ICHRA) is a new type of health reimbursement arrangement in which employers of any size can reimburse employees for some or all of the premiums that the employees pay for health insurance that they purchase on their own...ICHRAs represent a departure from previous ACA implementation rules that forbid employers from reimbursing employees for individual market premiums....

As longtime readers know, every summer/fall I run analyses of the annual premium rate change filings for both the individual and small group health insurance markets for all 50 states +DC. However, I tend to put most of my focus on the individual market, since that tends to have a lot more interest and activity surrounding it.

The individual market has been rocked by both economic and policy changes from year to year (in both good and bad ways) far more than the small group market, which hasn't been in the news nearly as much. You tend to read a lot of stories about the Individual Market (both ACA-compliant as well as so-called "junk plans" like Short Term, Sharing Ministries, Farm Bureau and the like), and of course the Large Group market is massive (something like 40% of the U.S. population), so even minor changes to that are big news...but the Small Group market (which generally includes companies with 50 or fewer full-time employees, though a few states include companies with 100 or fewer) tends to get short shrift in both the news as well as healthcare wonkery.