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3/19/2020

U.S. Departments of Treasury, Health and Human Services and Labor Expand Access to Quality, Affordable Health Coverage Through H…

U.S. Departments of Treasury, Health and Human Services and
Labor Expand Access to Quality, Affordable Health Coverage
Through Health Reimbursement Arrangements
June 13, 2019

WASHINGTON — Today, the U.S. Departments of Health and Human Services, Labor, and the
Treasury issued a new policy that will provide hundreds of thousands of employers, including
small businesses, a better way to provide health insurance coverage, and millions of American
workers more options for health insurance coverage. The Departments issued a final regulation
that will expand the use of health reimbursement arrangements (HRAs). When employers have
fully adjusted to the rule, it is estimated this expansion of HRAs will benefit approximately
800,000 employers, including small businesses, and more than 11 million employees and family
members, including an estimated 800,000 Americans who were previously uninsured.
“Too many Americans today have little say in how their healthcare is financed,” said HHS
Secretary Alex Azar. “President Trump has promised Americans that he will put them in control
of their healthcare, and this expansion of health reimbursement arrangements will help deliver
on that promise by providing Americans with more options that better meet their needs. This
rule and other Administration e orts are projected to provide almost 2 million more Americans
with health insurance.”
“By continuing to o er diverse health coverage choices, the Trump Administration ensures
America has a healthy workforce,” said Labor Secretary Alex Acosta. “The HRA final rule o ers
millions of American workers more health coverage choices and portability. HRAs create a great
opportunity for job creators to support their employees and for those employees to be
empowered to make the best healthcare decisions for their families.”
“President Trump is delivering on his promise to o er Americans more health coverage choices
and lower healthcare costs. This new rule gives businesses a better way to o er health insurance
to employees and allows workers to select coverage that best fits their and their families’
needs,” said Treasury Secretary Steven T. Mnuchin. “I am proud of this Administration’s e orts to
curb the cost of healthcare for American workers and small businesses by expanding coverage
options and spurring competition.”
https://home.treasury.gov/news/press-releases/sm708

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3/19/2020

U.S. Departments of Treasury, Health and Human Services and Labor Expand Access to Quality, Affordable Health Coverage Through H…

Under the rule, starting in January 2020, employers will be able to use what are referred to as
individual coverage HRAs to provide their workers with tax-preferred funds to pay for the cost of
health insurance coverage that workers purchase in the individual market, subject to certain
conditions. These conditions strike the right balance between employer flexibility and
guardrails meant to protect the individual market against adverse selection, and include a
notice requirement to ensure employees understand the benefit. Individual coverage HRAs are
designed to give working Americans and their families greater control over their healthcare by
providing an additional way for employers to finance health insurance.
This regulation is in response to President Donald J. Trump’s Executive Order on “Promoting
Healthcare Choice and Competition Across the United States,” and is part of the Trump
Administration’s work to deliver more health coverage choices and lower healthcare costs for
Americans. Full implementation of the HRA rule, the Association Health Plan rule, and the shortterm, limited-duration insurance rule is projected to provide insurance to nearly 2 million
people, on net, who would otherwise be uninsured.
Many businesses have struggled with the high costs and complex bureaucracy of providing
health insurance coverage, leading to less coverage for workers. Over the last decade, a
significant number of small businesses have stopped o ering any health insurance to their
employees. As a result, a smaller percentage of Americans working in small businesses are
being covered by employer health benefits, and many are le uninsured. Moreover, 80 percent
of employers that provide coverage only o er one type of health plan to their employees,
leaving workers and their families with no choices and plans that may not meet their needs.
The HRA rule makes it easier for small businesses to compete with larger businesses by creating
another option for financing worker health insurance coverage. The rule enables businesses to
better focus on serving their customers and growing their businesses—and not on navigating
and managing complex health benefit designs.
The HRA rule also increases workers’ choice of coverage, increases the portability of coverage,
and will generally improve worker economic well-being. This rule will also allow workers to
shop for plans in the individual market and select coverage that best meets their needs.
Because HRAs are tax-preferred, workers who buy an individual market plan with an HRA
receive the same tax advantages as workers with traditional employer-sponsored coverage.
Further, by increasing employee options and empowering more people to shop for health plans
in the individual market, the final rule should spur a more competitive individual market that
drives health insurers to deliver better coverage options to consumers.
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3/19/2020

U.S. Departments of Treasury, Health and Human Services and Labor Expand Access to Quality, Affordable Health Coverage Through H…

In addition to allowing individual coverage HRAs, the HRA rule creates an excepted benefit HRA.
In general, this aspect of the rule permits employers that o er traditional group health plans to
provide an excepted benefit HRA of up to $1,800 per year (indexed to inflation a er 2020), even if
the employee doesn’t enroll in the traditional group health plan, and to reimburse an employee
for certain qualified medical expenses, including premiums for vision, dental, and short-term,
limited-duration insurance. This provision will also benefit employees who have been opting
out of their employer’s traditional group health plan because the employee share of premiums
is too expensive.
The final rule can be found here.
FAQs can be found here.

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https://home.treasury.gov/news/press-releases/sm708

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