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Politico: Why the Biden Administration Might Like a Trump Era Health Policy

May 30, 2024 8:36 AM | Robin Paoli (Administrator)

HRA Council's Executive Director Robin Paoli spoke with Politico's Kelly Hooper for a story about ICHRA and QSEHRA as successful, bipartisan public policies.

Excerpt for HRAC Members:

BIDEN POISED TO KEEP ICHRA — Progressive groups for three years pleaded with the Biden administration to kill a Trump-era health insurance policy they say allows companies to discriminate against older, sicker employees, POLITICO’s Kelly Hooper reports.

In the end, Biden officials kept the rule in place — a win for the policy’s proponents, including several business groups and an advocacy group aided by a former Trump White House adviser.

Background: The 2019 rule expands individual coverage health reimbursement arrangements, or ICHRAs, which allow employers to provide tax-exempt subsidies to their workers to purchase H.R. 3590 (111) plans.

The arrangements offer an alternative for companies that find group health insurance plans too expensive, the policy’s supporters say. But some liberal groups argue that ICHRAs provide an incentive for companies to discriminate against older, sicker workers and push them into the Affordable Care Act’s marketplace, which could raise premiums for everyone.

HHS hasn’t indicated whether it plans to rescind the rule before the end of President Joe Biden’s term, said Sonja Nesbit, a senior HHS official during the Obama administration who is now senior policy adviser for Keep US Covered, an advocacy group that’s been pushing the Biden White House to scrap the rule.

“In a situation where [former President] Donald Trump becomes president again, a big concern here is seeing the immediate codification of this policy,” Nesbit said. “This could be a very fatal blow for folks hoping to ensure equity in private health care coverage.”

Even so: The White House might see the policy as a way to boost its efforts to enroll more people in Obamacare, for which record enrollment has become a campaign talking point.

An HHS spokesperson declined to say whether the administration is looking to reverse the rule but said in a statement that expanding and lowering the cost of health coverage “will continue to be this Administration’s north star.”

Proponents of the ICHRA rule say it has bolstered Obamacare, and fears among Democrats that the policy would allow companies to discriminate against their employees haven’t materialized.

“You’re bringing in younger folks, bringing in folks who’ve never been covered in their adult lives with health insurance. This is a big win,” said Robin Paoli, executive director of the HRA Council, a group that’s provided the Biden administration with data to demonstrate the arrangement’s benefits. “It’s expanding coverage, more Americans are being covered, and so it’s satisfying all of its goals as public policy.”

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