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Some benefits specialists are still skeptical about the future of individual coverage health reimbursement arrangements.
Employers can use ICHRAs to achieve a long-sought goal: being able to give workers cash the workers can use to buy their own health coverage.
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But panelists who spoke last week at an Employee Benefit Research Institute policy forum argued that the individual market policy options and customer service standards are too weak to please a worker who is used to the health benefits big and midsize employers typically offer.
Even some strong ICHRA concept supporters have suggested that making cash-for-coverage programs a success will require health insurers and the Affordable Care Act public exchange system to improve the quality of the policies available through the exchange system.
Tracy Watts, U.S. leader for health policy at Mercer, scoffed at the idea that shopping on HealthCare.gov or another ACA public exchange is a good substitute for an employer-sponsored health plan.
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"It's not as easy as you think" Watts said. "Go and try it on your own and see what's available to you. See how much it costs. Type your doctor names into the tool that you're given to see if they're in network."
The difficulty of shopping, the high cost of unsubsidized coverage and the weak provider networks are what have kept employers from switching to ICHRas, Watts said.
Garrett Hohimer, a vice president at the Business Group on Health, said ICHRA advocates seem to be assuming, incorrectly, that "coverage is coverage is coverage."
"I don't think that's the reality," Hohimer said. "The employee or the patient or the member experience of going to the ACA marketplaces alone and trying to make a decision, versus the curation and quality insurance that employers put into their programs, are wildly different experiences... I think a lot of people maybe don't realize how valuable that employer engagement is in making sure that people can get care and get coverage that works for them."
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
