HRAs continue to deliver high-quality, personalized health care to more American workers: In one year, coverage tripled for ICHRA; doubled for QSEHRA

Tax-advantaged accounts strengthen ACA market, labor market competitiveness and access to employer-funded health coverage

WASHINGTON, June 28, 2023 /PRNewswire/ — Today, the HRA Council released its 2023 data report on the state of health reimbursement arrangements, including HRAs for Small Qualified Employers (QSEHRA) and Individually Covered HRAs (ICHRA). The report shows that between 2022 and 2023, the number of American workers who offered insurance through an ICHRA tripled; QSEHRA offers, available only to small employers with fewer than 50 employees, are doubled.

“ICHRA and QSEHRA cover workers with quality ACA health insurance that they select based on their health needs,” he said Robin Paul, Executive Director of the HRA Board. “Employers enable employees to secure the coverage and care they need within predictable health care budgets. Choosing their own health coverage allows employees to select trusted providers and be confident in compliant insurance to the ACA which protects them from discriminatory practices such as pre-existing gender conditions and rewards”.

The report adds more detail and context to the rise in popularity of HRAs, described as 401(k)s for health coverage, including their effectiveness as a viable benefits solution and their critical role in shaping bipartisan health policy poised to create a more affordable and accessible healthcare system.

HRA Council members report that HRAs are a ramp to benefits for companies that have never been able to offer health insurance, thereby reducing the number of people without coverage. The report highlights how HRAs help small and medium-sized businesses attract and retain talent in a competitive job market.

Small businesses aren’t the only ones reimbursing employees for health care coverage. Adoption of ICHRA among Large Applicable Employers (ALEs) more than doubled between 2022 and 2023 and has grown by a factor of 25 since 2020.

Other highlights from the report include:

  • The market and its risk pool are strengthened by the younger workers offered by HRA; 61% of those offered an ICHRA are under the age of 44.
  • ICHRA-funded health plan selections are split nearly evenly between the Gold, Silver and Bronze tiers with employees becoming wise consumers choosing the coverage that is best for them and/or their families.
  • As ALE growth continues to ramp up, small businesses with fewer than 20 employees currently make up 88% of employers offering ICHRA and QSEHRA.

“QSEHRA and ICHRA are a bipartisan success in advancing health equity and connecting more American workers with Affordable Care Act plans that offer access to mental, behavioral and physical care,” Paoli said. “HRAs provide the choice and portability American workers deserve, providing employers with a modern, well-regulated solution to cover more workers, including remote, hybrid, part-time, seasonal, and dependent workers across multiple American regions.”

The report is available for download here and is based on data from the administrators and enrollment platforms that make up the Council, including Alegeus, Flyte HCM, HealthSherpa, HRASimple, nexben, OneBridge Benefits, PeopleKeep, Remodel Health, Stride Health, Take Command and zizzl salute.

About the HRA Council
The HRA Council is a non-profit, non-partisan advocacy organization of HRA administrators, carriers, membership societies and professionals who work together to facilitate the ability of employers to offer HRA and the ability of employees to use an HRA to sign up for coverage. With a shared mission, the Council educates employers and policymakers, works towards industry standards, shares collective industry research, and advocates for HRA-friendly regulations.

Contact with the media

First name: Karen CampbellHRA Board
E-mail: [email protected]

SOURCE HRA Council

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