Claim: The possibility that employers could push sicker employees onto exchanges would also make those exchanges more expensive for everyone.
Fact: The Departments of Health and Human Services, Labor, and the Treasury properly structured the ICHRA rules to prevent high-claim employees from being directed to the individual market. The HRA rule should improve the individual market and lead to more insurer participation. Early data from the initial adopters of ICHRAs suggests that the rule is encouraging enrollees who are much younger than traditional ACA enrollees to sign up for coverage, improving the overall individual market.
The ICHRA rules strike the right balance between employer flexibility and guardrails to protect the individual market from adverse selection. To prevent behavior that could lead to employers steering unhealthy employees into the individual market, the rule provides that employers may offer either an ICHRA or a traditional group health plan within an employee class but may not offer employees a choice between the two. Moreover, employers that provide an ICHRA must do so on the same terms for all employees in a class of employees, except that they may increase the HRA amount for older employees and employees with more dependents.