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Executives at Oscar Health are counting on the individual health insurance market to be strong enough in 2026 to increase employers' use of individual coverage health reimbursement arrangement programs.
ICHRA programs offer employers a way to provide cash that workers can use to buy their own individual health coverage, either through Affordable Care Act public health insurance exchange programs or in the off-exchange individual market.
Oscar is a health insurer that has focused on the ordinary ACA public exchange market and now hopes to be a big player in the ICHRA market.
The administration of President Donald Trump is toughening ACA exchange enrollment rules Early indications are that Congress will let an increase in ACA exchange plan premium subsidies provided in response to the COVID-19 pandemic expire.
Earlier this year, Oscar was predicting that overall exchange enrollment might fall by 18% in 2026.
Today, Oscar believes exchange plan enrollment will probably fall by more than 18%, Mark Bertolini, Oscar's chief executive officer, told securities analysts Wednesday during a conference call.
"The individual market is experiencing a reset moment," Bertolini said. "But the market is resilient, and we see significant opportunity for long-term growth."
Expanded access to ICHRAs and use of the cash-for-coverage plans should make the individual health insurance risk pool bigger and more stable, Bertolini said.
Related: UnitedHealth, Anthem, Cigna unveil what small employers might pay for 2026 health coverage
Oscar executives said one force that may help expand employers' willingness to consider ICHRA programs is a wave of big increases in rates for fully insured group health coverage and stop-loss insurance.
Oscar held the conference call to go over earnings for the second quarter, which ended June 30. It streamed the call live and posted a recording on its website.
ICHRA strategy: To help support ICHRA program sales, Oscar bought an insurance brokerage firm, IHC Specialty Benefits, and a consumer education website, HealthInsurance.org.
Oscar has also acquired an enrollment technology firm, INSXCloud.
In 2026, Oscar will work with Hy-Vee, a big supermarket chain in the Midwest, to market a Hy-Vee-branded ICHRA program.
"We are initially launching this product for employers and employees in Des Moines, Iowa, for plan year 2026, subject to state approval," Bertolini said.
Hy-Vee: Hy-Vee has a big pharmacy division and has started health insurance distribution arrangements before.
In 2021, Hy-Vee set up a Hy-Vee Medicare Aisle.
This year, the company is using eHealth to help customers sign up for Medicare Advantage plans and Medicare Part D prescription drug coverage.
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