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Top Democrat Urges Swift Action on ICHRAs to Stop Threat of Health Discrimination


Ranking Member Doggett highlights alarming issues with Trump-era policy and House GOP effort to codify rule in new letter to Biden Administration


Thursday, July 20, 2023


WASHINGTON, D.C. – Keep US Covered (KUC), joined by its seven campaign partners representing patients, health care providers, and businesses, today applauded Representative Lloyd Doggett’s effort to protect American workers from health discrimination.  Doggett, the ranking member on the House Ways and Means Health Subcommittee, sent a letter to President Biden, HHS Secretary Xavier Becerra, and Treasury Secretary Janet Yellen highlighting the need for an increased sense of urgency to repeal the Trump-era policy that established Individual Coverage Health Reimbursement Arrangements (ICHRAs) following House passage of H.R. 3799, a GOP-led bill to codify the dangerous policy.


Ranking Member Doggett notes in the letter that ICHRAs are “a convoluted and discriminatory policy that threatens to leave millions of vulnerable Americans underinsured and unprotected” and underscores that he is “concerned that this is yet another effort by Republicans to undermine the ACA and codify a bad policy that encourages workplace discrimination.”


“ICHRAs allow discrimination in the workplace, risk damage to the ACA marketplace, and weaken workers’ coverage options,” stated Keep US Covered Senior Advisor Sonja Nesbit. “We are thrilled that Ranking Member Doggett sent a letter to the President, Secretary Becerra, and Secretary Yellen about the urgent need to roll back this dangerous policy. Rescinding ICHRAs will help reduce disparities and protect the ACA from yet another Republican attack. We thank Ranking Member Doggett for taking a stand on this important issue for the sake of millions of vulnerable Americans.”


An excerpt from the letter states,


As you know, ICHRAs permit an employer to stop offering health coverage and instead provide a voucher to their employees to go shop around for their own insurance. Forcing those with the least to find affordable and comprehensive coverage in a sea of junk plans and misleading marketing, ICHRAs leave workers vulnerable to ending up with inadequate coverage. With no oversight to ensure workers are not misled into junk coverage, employees merely have to self-attest that they purchased ACA-compliant insurance, even though they may not understand the fine print and caveats of their plan.


Further, employers are permitted to risk shift and discriminate against low wage and vulnerable employees. Under this Trump-era policy, employers may pick and choose classes of workers who will be offered an ICHRA and provide comprehensive employer-sponsored coverage to other classes of employees. One survey found that 60% of large firms intended to offer ICHRAs only to low wage workers. The Joint Committee on Taxation and Congressional Budget Office recently estimated that 95% of the likely 2 million workers who will be placed in an ICHRA by 2032, would have otherwise been enrolled in employer-provided coverage with Affordable Care Act (ACA) protections.


Following the Biden Administration’s recent action to crack down on junk insurance, the President continues to have the opportunity to strengthen that effort by abolishing ICHRAs. More than two years ago, through Executive Order 14009, President Biden made a promise to review and potentially rescind Short-Term Limited Duration Health Insurance (STLDI), which was recently acted on, as well as the deeply flawed ICHRA policy. Regretfully, the ICHRA policy remains in place today and continues to be antithetical to President Biden’s health equity and coverage goals. Without swift executive action, the policy allowing health discrimination will remain in place at the expense of American workers and their families.


A copy of Ranking Member Doggett’s letter can be found here.

To learn more about KUC and its partners’ work to educate policymakers on ICHRAs, STLDI, and the social determinants of health, visit or follow the campaign on Twitter and Facebook.








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