Trump Administration Health Reimbursement Arrangements Put ACA Subsidies at Risk for Low-Income Workers

The associated press release can be found here.

Individual coverage health reimbursement arrangements, or ICHRAs, are a small-scale initiative from the Trump administration with some appeal as a way to help workers access health coverage when it’s not available on the job. However, they pose significant risks for New York consumers, particularly lower-income enrollees.

These risks include higher individual market premiums due to adverse selection; the loss of employer-sponsored insurance; higher costs for lower-income consumers by ending their access to the Essential Plan and federal subsidies for health care insurance premiums; and new logistical and administrative burdens.

This brief explains the workings of ICHRAs and examines their risks and benefits for New Yorkers; it also suggests several ways ICHRAs could be improved for New Yorkers, helping establish ICHRAs as a tool to help address shortcomings in the employer-sponsored insurance market and the Affordable Care Act—rather than undermining them.