HR-5498-119
Supplemental report filed by the Committee on Small Business, H. Rept. 119-716, Part II.
Sponsored by Beth Van Duyne (R-TX)
What it does
This bill would require the Administrator of the Small Business Administration (SBA) to distribute information about Individual Coverage Health Reimbursement Arrangements (ICHRAs) to small businesses. The SBA would deliver this information through Small Business Development Centers and its district offices, and would also publish it via social media, press releases, and its website. The information itself would be developed by relevant federal agencies, including the Departments of Treasury, Health and Human Services, and Labor.
Who benefits
Small business owners who are currently unaware of ICHRAs as an option for providing health benefits to employees. Employees of small businesses whose employers may adopt ICHRAs after learning about them, potentially gaining access to health coverage they did not previously have. Insurance brokers and carriers who sell individual market plans, since ICHRAs direct employees to purchase individual coverage. Small Business Development Centers, which would receive a clearer outreach mandate. Health insurers operating on the individual market, who could see increased enrollment.
Who is hurt
Traditional group health insurance carriers and brokers who compete with the individual market plans that ICHRAs fund, and who may lose small-group market business if employers shift to ICHRAs. Small business employees who prefer employer-sponsored group plans, which may offer broader networks or lower premiums than individual market alternatives in some regions. Taxpayers who fund SBA operations would bear the modest administrative cost of the outreach effort. Small businesses in states with thin individual insurance markets, where ICHRA-funded individual plans may offer fewer options.
Supporters argue
Supporters argue that ICHRAs, established by a 2019 federal rule, give small businesses a flexible, defined-contribution alternative to traditional group health insurance — but that many small employers remain unaware the option exists. They contend that leveraging the SBA's existing outreach infrastructure (including roughly 1,000 Small Business Development Centers nationwide) is a low-cost way to close an information gap, potentially expanding health coverage access for the millions of Americans employed by small businesses that currently offer no health benefits.
Opponents argue
Opponents argue that directing small businesses toward ICHRAs steers employees away from employer-sponsored group coverage and into the individual market, where plans may carry higher out-of-pocket costs or narrower networks — particularly in rural or less competitive insurance markets. They contend that using federal agency resources to promote one specific health benefit vehicle over others amounts to a policy preference embedded in an outreach mandate, and that Congress should address the underlying affordability and coverage gaps in small-group markets rather than promoting a workaround.