Republican lawmakers are reviving proposals that failed to make it into the sweeping One Big Beautiful Bill Act, turning their focus to a trio of measures that could reshape how employers offer health benefits through Individual Coverage Health Reimbursement Arrangements, or ICHRA.
Four notes:
1. The CHOICE Arrangement Act
Introduced Sept. 18 by House Republicans, the bill would rename ICHRAs as Custom Health Option and Individual Care Expense (CHOICE) arrangements and grant them the same legal designation as traditional group health plans. The proposal also provides a two-year federal tax credit of up to $100 per month per employee for small businesses adopting CHOICE.
2. Senate Companion to the CHOICE Arrangement Act
The Senate bill mirrors the House legislation and codifies the same framework within the tax code. The CHOICE Act clarifies that employer-funded reimbursement accounts integrated with ACA-compliant individual coverage satisfy group health plan requirements under the Public Health Service Act.
Like the House version, the Senate bill allows employees participating in CHOICE arrangements to purchase on-exchange plans using pre-tax cafeteria plan dollars. It also creates a small business credit to incentivize adoption.
3. Small Business Health Options Awareness Act
The bill would direct the Small Business Administration to conduct outreach and education on ICHRAs through its district offices and Small Business Development Centers. It would also require the SBA to publish ICHRA resources online in coordination with the Treasury, HHS and Labor departments.
4. “Centene supports the CHOICE Arrangement Act, which codifies Individual Coverage Health Reimbursement Arrangements (ICHRA) and introduces a new employer tax credit to encourage adoption,” Alan Silver, President of ICHRA at Ambetter Health Solutions, told Becker’s in a statement. “The statutory clarity this legislation provides could ultimately expand access to affordable, portable coverage options. ICHRA provides employers the opportunity to define their financial contribution to employee healthcare, while allowing individuals to choose plans that best meet their needs.”
