Regardless of outcome, this presidential election will reshape our country. There are significant differences in how Kamala Harris and the Democrats or Donald Trump and the Republicans plan to tackle a range of issues — including health care.

The health care market has changed dramatically over the past two Presidential administrations due to the introduction of the individual coverage health reimbursement arrangements (ICHRAs). ICHRAs, which launched on January 1st, 2020, allow employers to provide employees with a monthly, tax-free allowance to purchase health insurance on the individual market.

Healthcare policy remains a highly partisan issue. But ICHRAs — built off President Obama's 21st Century Cures Act but expanded by President Trump — are reliably bipartisan. However, the broader health care policies implemented under a second Trump administration or a Harris administration could have a profound impact. It's worth examining how these candidates and their party platforms might influence the ICHRA market going forward.

How would a Kamala Harris administration impact ICHRA?

In general, Democrats support ICHRAs because every new member of the ACA marketplace increases the risk pool and the competitiveness of plans. The party's platform for this election aims to achieve "universal" health care by backing a public option in the ACA market. That public option could take many forms, but in essence would create a government-run plan that competes alongside private insurers in the public marketplaces.

If the ACA marketplace remains competitive, the introduction of a public option could be beneficial for ICHRAs. Such a move would give employees more options, particularly in parts of the country where there's not much private competition. Keep in mind, any policy that moves away from a marketplace structure would have to involve a complete overhaul of health care in the U.S. as we know it today.

A Harris administration should be good for the continued expansion of ICHRAs. However, there are special interest groups to the left of Harris challenging ICHRAs as a Trump-era policy; these groups fail to recognize that ICHRA evolved out of the Obama administration's lesser-known QSEHRA policies for small businesses. These activists may be able to grab the attention of a Democratic president, but sweeping changes are unlikely.

Instant Insights /

How the presidential election will impact ICHRAs and the health insurance market

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