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Politico
7 days ago
- Health
- Politico
The GOP's Obamacare problem
Presented by With help from Carmen Paun and Erin Schumaker Driving the Day KILLING THE BUZZ? Republicans might unwittingly undermine the growing popularity of a first-term Trump policy that encourages Obamacare sign-ups, Kelly reports. In 2019, the first Trump administration finalized a rule permitting employers to offer their workers a tax credit to purchase health insurance on the Affordable Care Act exchange in lieu of offering them a group plan. Few employers initially took up the offer, but the high costs and administrative burden that come with providing traditional group plans have lately prompted more companies to adopt the arrangements, health insurance brokers told POLITICO. Republicans favor the policy, called Individual Coverage Health Reimbursement Arrangements, because it promotes individual choice in health coverage. Democrats don't mind it either because it bolsters Obamacare. And employers are growing more interested: ICHRA adoption has surged more than 1,000 percent since 2020, according to an HRA Council report. But major obstacles threaten its course. Why it matters: Changes to the ACA in Republicans' recently enacted megabill, the expiration of enhanced federal Obamacare subsidies at year's end and a new Trump administration marketplace rule could lead to fewer young and healthy people in the ACA market and higher premiums. The blend of federal policies could make offering ICHRAs much less attractive for employers, policy experts said. 'For that to be a viable option for the employer to do, the individual market has to be a sustainable, viable market to send your workers to,' said Cori Uccello, a senior health fellow at the American Academy of Actuaries. Key context: Republicans argue the new policies, some of which crack down on ACA enrollment verification, are necessary to address widespread broker and enrollment fraud, even if the changes mean a less stable marketplace with higher premiums. 'I don't think we want a structure where there's millions of people who are receiving subsidies that they don't qualify for,' said Brian Blase, president of the right-leaning Paragon Health Institute and a former Trump adviser who was one of the architects of the ICHRA policy. An earlier version of the GOP megabill that passed the House would have codified the ICHRA policy into statute and offered tax incentives to employers choosing to adopt the arrangements. The provisions were ultimately stripped from the final version of the bill, but Blase and other ICHRA proponents still hope Congress will pass the provisions in a future spending bill or a bipartisan standalone health care package. And state lawmakers nationwide are promoting the policy, too, introducing and passing legislation to incentivize uptake. Even so: Policy experts said the efforts are ill-fated, given the spate of Republican-led policy changes expected to weaken the Obamacare marketplace and increase premium costs over the next few years. 'ICHRAs are only going to be as attractive as the individual market is attractive,' said Ellen Montz, a managing director with advisory firm Manatt Health and a former Centers for Medicare and Medicaid Services official during the Biden administration. WELCOME TO THURSDAY PULSE. President Donald Trump's plans for artificial intelligence include a push to grow AI adoption in health care. Send your tips, scoops and feedback to khooper@ and sgardner@ and follow along @kelhoops and @sophie_gardnerj. MORNING MONEY: CAPITAL RISK — POLITICO's flagship financial newsletter has a new Friday edition built for the economic era we're living in: one shaped by political volatility, disruption and a wave of policy decisions with sector-wide consequences. Each week, Morning Money: Capital Risk brings sharp reporting and analysis on how political risk is moving markets and how investors are adapting. Want to know how health care regulation, tariffs or court rulings could ripple through the economy? Start here. In Congress CHRISTINE GETS A VOTE — A key Senate committee will vote today on whether to advance President Donald Trump's nomination of Dr. Brian Christine to serve as one of the highest-ranking HHS officials. Christine, a men's sexual health doctor and a longtime GOP donor, faced the Senate Health, Education, Labor and Pensions Committee last week for a confirmation hearing to be assistant HHS secretary for health. During the hearing, Christine positioned himself as a 'main street doctor' with a direct link to the patient experience, noting his alignment with the Make America Healthy Again movement to combat chronic disease and his opposition to gender-affirming care. He received little pushback from Republicans on the HELP Committee and endured an expected probe from Democrats — who tried to make him answer for HHS Secretary Robert F. Kennedy Jr.'s fringe views or Trump's Medicaid cuts. Why it matters: If confirmed by the full Senate, Christine would be charged with overseeing the uniformed public health service and helping carry out Kennedy's public health agenda. The assistant secretary for health advises the HHS secretary and recommends policy related to public health matters like disease prevention, vaccine programs and health disparities. What's next: If the committee approves Christine's nomination today, it will advance to the full Senate floor for a vote. PUBLIC OPINION ON THE BBB — Nearly half of Americans believe the GOP's recently enacted 'big, beautiful bill' will hurt them, according to a new poll from health policy think tank KFF. About a quarter of adults — including more than half of Republicans — believe the law will help them, according to the poll. People identifying as supporters of President Donald Trump's Make America Great Again movement were over five times more likely to say the law will help their families than hurt them. The remaining quarter said they don't expect to be affected by the law. Background: The One Big Beautiful Bill Act includes key components of Trump's domestic agenda, like tax cuts and border security, and is estimated to reduce health care spending by more than $1 trillion, with most of those cuts coming from Medicaid, the health insurance program serving more than 70 million low-income Americans. The Congressional Budget Office has estimated that about 10 million people could lose health insurance as a result of the changes in the megabill, which also includes changes to the Affordable Care Act. Two-thirds of Medicaid enrollees said the law will hurt their families, according to the poll. The survey was conducted from July 8 to 14, online and by telephone, among a nationally representative sample of 1,283 U.S. adults. In the States 'MAHA WINS' IN IDAHO — Health Secretary Robert F. Kennedy Jr. held an event with Idaho's Republican Gov. Brad Little on Wednesday to celebrate new initiatives in the state his office dubbed 'MAHA wins,' Carmen reports. The measures include the Agriculture Department approving the state's waiver to allow Idaho to exclude soda and candy from items that can be purchased with Supplemental Nutrition Assistance Program benefits. They also touted a bill the governor signed into law in April barring businesses, schools and other entities from restricting entry, services or employment based on requirements to be vaccinated or undergo certain medical tests or treatments. 'I'm very happy to be here in Idaho, which is the home of medical freedom, home of good health,' Kennedy said. Why it matters: The Idaho visit is part of a tour Kennedy has embarked on across Republican-led states to highlight state legislation in line with his Make America Healthy Again movement. Today, he'll visit the Nez Perce Tribe in Lenore, Idaho, where he'll discuss with tribe leaders 'the importance of preserving traditional foods and the role they play in combating chronic disease,' according to HHS. At the Agencies MICROSOFT HACK HITS NIH — The National Institutes of Health is among the victims of a breach of Microsoft's SharePoint collaboration software, HHS confirmed to POLITICO on Wednesday, Erin reports. 'The Department and its security teams are actively engaged in monitoring, identifying and mitigating all risks to our IT systems posed by the Microsoft SharePoint vulnerability,' HHS spokesperson Andrew Nixon said in a statement. 'At present, we have no indication that any information was breached as a result of this vulnerability,' Nixon said. 'HHS takes the protection of our information, systems and networks seriously, and are handling this issue with the utmost diligence and care.' Big picture: Microsoft first reported the widespread cyberattack, which has impacted dozens of organizations globally, on Saturday. On Tuesday, the company confirmed in a blog post that three Chinese hacking groups, known as Violet Typhoon, Linen Typhoon and Storm-2603, were among those behind the attack. Multiple federal agencies are believed to have been breached, while more have yet to be fully investigated. The SharePoint breach is considered severe because it lets hackers remotely access Microsoft users' self-hosted versions of the service. Once inside, hackers can go deeper into the users' networks to access sensitive material. Versions of the software hosted on the cloud are not vulnerable to the attack. The Washington Post first reported that NIH was involved in the breach. OZ ON THE HILL — Centers for Medicare and Medicaid Services Administrator Mehmet Oz defended the One Big Beautiful Bill Act's steep Medicaid cuts during a closed-door meeting with House Ways and Means Democrats and Republicans today, framing them as efforts to curb 'waste, fraud and abuse,' POLITICO's Robert King reports. The $1 trillion in health spending reductions projected by the CBO — mostly cuts from Medicaid — sparked skepticism from Democrats, who warned of coverage losses, especially under new work requirements for some able-bodied adults. Oz argued that those losing Medicaid could shift to other insurance, while critics said most affected already work and predicted enrollment drops tied to red tape. CMS did not return a request for comment on the roundtable. Names in the News Tony Dieste has been named chief marketing officer at health care technology company Dieste is the founder and chair of Dieste, Inc. WHAT WE'RE READING POLITICO's Kimberly Leonard and Arek Sarkissian report on the abortion rights fight at the center of the Florida Democratic governor primary. POLITICO's Katherine Tully-McManus reports on the House Appropriations Committee approving a bill that cuts funding for the State Department and foreign-aid programs by 22 percent. The New York Times' Stephanie Nolen reports on the U.S. quietly drafting plans to end a federal program that saved millions from AIDS.
Business Wire
22-07-2025
- Business
- Business Wire
W3LL Named Inaugural Platinum Sponsor for the HRA Council Continuing Education Program for Health Insurance Brokers and Agents
WASHINGTON--(BUSINESS WIRE)--The HRA Council today announced that W3LL, an ICHRA integrator and health benefits technology company powered by Softheon, has joined as the inaugural Platinum Sponsor of HRACademy, the Council's premier Individual Coverage Health Reimbursement Arrangement (ICHRA) and Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) continuing education (CE) initiative for licensed health insurance brokers and agents. "HRA Council thought leaders are at the forefront of ICHRA adoption and ACA marketplace optimization." W3LL's sponsorship reinforces the HRA Council's mission to expand knowledge and understanding of Health Reimbursement Arrangements (HRAs) through high-quality, accessible education. HRACademy offers structured training courses with Continuing Education (CE) Credits focused on individual coverage HRAs (ICHRAs), qualified small employer HRAs (QSEHRAs), and related innovations that are reshaping how American workers and their families access health coverage. 'Education is the HRA Council's core mission,' said Robin Paoli, executive director of the HRA Council. 'HRA Council members across our ecosystem of brokers, carriers, administrators, advisors, and employers, contributed to this highly sought-after new curriculum and we are grateful to W3LL's leadership as our inaugural platinum sponsor.' 'At W3LL, we believe that technology is only as powerful as the people who use it,' said Eugene Sayan, CEO of W3LL. 'Brokers are essential advisors for employers navigating the rapidly evolving health benefits landscape, and all licensed insurance agents need the up-to-date CE Credits HRA Council members have created. Supporting HRACademy aligns perfectly with our commitment to education, innovation, and access.' Building on its existing member-driven educational programs, the HRA Council launched HRACademy in 2025 to provide licensed health insurance professionals with ongoing, in-depth training on HRAs and the broader individual market. HRACademy's growing roster of CE courses is approved in all 50 states for CE credits approved by state Departments of Insurance. 'HRA Council thought leaders are at the forefront of ICHRA adoption and ACA marketplace optimization,' said Robin Paoli. 'Our members are building the HRACademy to share their learning and equip agents with the knowledge and tools they need to empower employers and employees to use these new health coverage options effectively.' For more information on HRACademy and upcoming CE courses, visit For more information on W3LL, visit About the HRA Council The HRA Council is the nation's leading nonprofit coalition dedicated to advancing health reimbursement arrangements (HRAs). Through research, education, and advocacy, the Council supports the expansion of affordable, flexible health coverage for millions of Americans. Learn more at About W3LL W3LL is a partner to brokers, administrators, and benefit technology companies, offering tools that help simplify complex processes. As an ICHRA integrator, W3LL connects brokers and agents directly to health plans through intuitive platforms that simplify enrollment, allow interoperability, and streamline the payments process. Backed by the expertise and success of our parent company, Softheon, W3LL redefines healthcare administration, unlocking new opportunities for growth. Find out more at
Yahoo
19-06-2025
- Health
- Yahoo
ICHRA adoption grows as Congress mulls codifying the coverage into law
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. A nascent form of health coverage that creates an alternative gateway for employers to offer Affordable Care Act coverage to their workers is seeing rising uptake, especially among midsize to large employers. Adoption of individual coverage health reimbursement arrangements, or ICHRA plans, rose 34% from 2024 to 2025 among employers with 50 or more full-time employees, according to a new report from trade association the HRA Council. Still, the vast majority of ICHRA users remain companies with fewer than 20 employees, most of which are providing health coverage for the first time through the arrangements, the HRA Council said. ICHRA allows employees to shop and choose between plans on the ACA exchanges and have some or all of the cost offset by their employer through a stipend. Unlike in traditional group health plans, businesses can set a fixed amount to help their workers cover healthcare costs, defraying some financial risk from offering insurance. ICHRAs were first available as a coverage option in 2020, and have grown rapidly since, according to research. However, the lack of industry-wide data collection makes it difficult to get a clear picture of adoption nationwide — market experts estimate about 500,000 to one million Americans are covered in ICHRA arrangements. About 450,000 U.S. employees and their dependents were offered ICHRA or a qualified small employer HRA for the 2025 plan year, according to the new report. However, that estimate should be taken as a floor for the larger overall market, which could encompass one million people or more, the HRA Council said. Proponents of ICHRAs argue they create an avenue for employers to offer benefits that they may not be able to otherwise afford. The share of small businesses offering health insurance has dropped significantly over the past two decades, from upwards of 47% in 2000 to about 30% in 2023, according to an analysis by health software company TakeCommand. That decline has coincided with an increase in the cost of providing employer-sponsored insurance. As for employees, ICHRAs give them freedom to choose from a variety of plans based on their needs, instead of from a smaller range of choices set up by their employer. People who enroll in ACA plans via ICHRA tend to be younger as well, a population that's usually healthier — so, their enrollment helps stabilize the risk pools and keep marketplace plans affordable, ICHRA advocates say. The coverage arrangements were expanded by President Donald Trump during his first term in rulemaking in 2019, as the president promoted policy alternatives to traditional ACA coverage. However, unlike many of the Trump administration's healthcare priorities, ICHRAs enjoy relatively bipartisan support. Democrats generally approve of ICHRAs because they add new members to the ACA marketplaces, while Republicans support the expanded choices they provide employees. Though ICHRAs are backed by regulation, the plans have never been backed by law. However, that could soon change. Republicans in Congress are currently considering codifying ICHRAs as 'Custom Health Option and Individual Care Expense' or 'CHOICE' plans. Massive reconciliation legislation passed by the House in June would also provide small employers offering ICHRAs with a tax credit. However, the Senate Finance Committee stripped the ICHRA provisions from the upper house's version of the bill released on Monday. To date, Indiana is the only state that's established a tax credit for ICHRA adoption, though a handful of others — including Ohio, Texas and Georgia — are considering the legislation that would create incentives for small employers to offer the arrangements, according to the HRA Council. The legislative uncertainty hasn't stopped private equity, venture capital and some major insurance companies from investing heavily into ICHRAs, betting that the market for the products will continue to grow. Investors have funneled millions of dollars into companies providing ICHRA administration and health benefits technology. Funding rounds this year alone include upwards of $100 million for Remodel Health, $40 million for Thatch and $20 million for Venteur, for example. Meanwhile Centene, the largest marketplace carrier in the U.S., is embarking on a full-court press to introduce more employees to its ICHRA plans. The insurer recently created a division wholly dedicated to promoting ICHRA and launched the arrangements in six states during open enrollment for 2025. 'Large-scale ICHRA adoption will be a journey of several years ... but considering the small group health insurance market covers 62 million Americans and the full commercial group market covers 170 million, we see a healthy addressable market over the long term,' Centene CEO Sarah London said during the payer's investor day in December. 'Aggressively pursuing this line of business is an easy choice,' London added. Similarly, Oscar Health has worked to expand its ICHRA membership, viewing it as a valuable alternative for smaller businesses to provide insurance as medical costs continue to rise, CEO Mark Bertolini said during an Axios event in Washington, D.C. in May. Recommended Reading Centene appoints first head of ICHRA products
