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Reversing Harmful ICHRA Policy

Workers have earned their health benefits, but a Trump-era policy threatens that insurance coverage, opens the door to discrimination, and would raise the cost of plans on the Affordable Care Act (ACA) marketplace. 

 

Typically, a worker with health benefits is provided quality coverage directly from their employer. A rule enacted by the previous administration, however, encourages the system to force workers to find insurance on their own. 

 

Under this so-called Individual Coverage Health Reimbursement Arrangement (ICHRA), workers can be divided into different classes, with some staying on the employer-sponsored plan and others forced onto the individual market to fend for themselves with only a stipend. Not only would this leave some workers with lower-quality coverage, but health experts have warned that it invites discrimination in the workplace. 

 

At a time when health care is so important, ICHRAs take us a step in the wrong direction – away from health equity. For struggling families, vulnerable populations, and those with pre-existing conditions, ICHRAs represent a harmful precedent and could result in a higher number of underinsured people. The ACA marketplace was meant to provide choice and options. But if ICHRAs become commonplace, more affordable options might leave the marketplace entirely, reducing choice for everyone. ICHRAs jeopardize the health coverage that workers have earned and so many families depend on. Together we can restore fairness and protect quality coverage for working Americans.   

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What We're Fighting For

 
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Rolling Back STLD Rules

When you pay for health insurance, you should feel protected. But a Trump-era policy has helped flood the market with low-quality insurance that can leave Americans facing huge medical bills. Under the Affordable Care Act (ACA), health insurance is generally supposed to cover a minimum set of services and costs. A certain type of coverage, however, called “short-term, limited duration” insurance is exempted from those rules. These plans exist, in theory, to fill gaps in coverage, such as when a person is in between jobs. But the rules were rewritten to make these plans a regular part of the health care market to make these plans a regular part of the health care market. “Short-term” can now be as long as three years.

 

Consumers are often drawn to them because they have lower monthly premiums but are unaware of how hollow the coverage actually is. These short-term plans often do not cover things like prescription drugs, maternity care, mental health, or free preventive care. And they typically come with strict limits on how much care they will pay for, far below what’s adequate.  People, often those with lower incomes, think they are covered, but these plans provide little protection. The Biden administration should reverse this rule and help prevent people from falling prey to these plans. By taking action, Americans will have the peace of mind that their coverage will be there for them when they need it.

 
 
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Promoting Social Determinants of Health

A person’s health is influenced by dozens of societal factors ranging from where they live to what they eat. Whether someone lives in a house or an apartment, if they live near outdoor activities or if they are far from medical care, tells us things about how likely they are to face health risks. Factors also include a person’s educational options and if they have access to healthy food. These social determinants of health have a major impact on well-being and health outcomes. To promote health equity and reduce disparities, health policy and health care coverage options should more fully account for these issues. For example, quality health coverage could help patients coordinate various elements of their lives such as connecting patients with childcare, housing options or facilitating access to medical care, whether through transportation to appointments or telemedicine.

 

As we improve the health care system, we must refine what we mean by quality care. We can deliver better coverage, reverse potentially discriminatory policies and reduce disparities in care based on geography, income, race and other determinative factors. Keep US Covered seeks to broaden the focus of health policy and improve health and health equity by ensuring policymakers account for a broad set of factors, both inside and outside the doctor’s office.

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