October 27, 2017
American Health Policy Institute CEO Tevi Troy writes in AXIOS' "Expert Voices" that an underreported yet significant part of President Trump's executive order on health care is its direction "to increase the usability of Health Reimbursement Arrangements (HRAs), to expand employers' ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage." Dr. Troy says that if done right, an expansion of tax-preferred HRAs could strengthen the individual market by adding healthy customers and expanding the risk pools. He cites a recent Mercer survey, which found that 16 percent of employers said they would consider a standalone HRA for all eligible employees if there were no penalty, and 21 percent said they might consider it depending on the strength of the individual market. Prior to implementation of the Affordable Care Act, HRAs were used by some employers to reimburse their employees' health care premium expenses rather than offer their own plans. However, in 2013 the Obama administration decided that standalone HRAs violated the ACA. Dr. Troy argues that loosening or reversing the restrictions on HRAs could transform how employers provide health care benefits in the future and improve the operations of the individual market, something that should merit bipartisan support.