HealthCare.gov hopes to profit from ICHRA boom
Licensing for small-group producers is starting off more than three times as fast as in 2023.
This could be the year when the Centers for Medicare and Medicaid Services finally turns HealthCare.gov into a serious health benefits player.
HealthCare.gov began opening up for agent and broker registration last week, and 831 producers got their registrations within their first four days.
That compares with just 231 registrations during the first four days in 2023.
HealthCare.gov has been highlighting a potentially hot service: the fact that producers and employers can use the relatively new qualified small employer health reimbursement program and the individual coverage health reimbursement arrangement program to give workers cash they can use to buy their own guarantee-issue, community-rated health coverage through HealthCare.gov.
While employers are trying to wrap their brains around the new QSEHERA and ICHRA “give workers cash they can use to buy their own coverage” options, the employers could also look at the ordinary, potentially subsidized small-group plans available through HealthCare.gov’s SHOP arm.
Related: 10 FAQs about ICHRA
HealthCare.gov has posted a QSEHRA, ICHRA and SHOP plan guide to help employers and producers compare the options.
More players
One of the companies poised to benefit from a flowering of QSEHRA, ICHRA and SHOP interest is HealthSherpa, which acts like an independent marketing organization for HealthCare.gov.
HealthSherpa helped about 30% of the 21 million who now have ACA exchange plan coverage get covered, is also hoping to benefit from employers, and brokers’ search for new ideas: It’s posted its own QSEHRA and ICHRA guide.
Some of the other companies about to get a moment in the sun include ICHRA.com, PeopleKeep, Take Command, Thatch and Venteur.
The history
Congress developed the Affordable Care Act public exchange system in an effort to serve as a middle ground between a health savings account-only system and a single-payer, government-run health care system.
The system is supposed to create a way for Americans to shop for health coverage from private insurers the way they shop for clothes or books, by eliminating most of the kinds of underwriting problems and sales application friction that once hindered online sales.
Some states and the District of Columbia run their own ACA exchange programs.
This year, HealthCare.gov provides ACA exchange services for 32 states.
Based on the current market value of companies like eHealth, which was the leading pioneer in the Amazon for health insurance sector, HealthCare.gov’s account support relationships might give it a market value of more than $1 billion.
Related: Why ICHRAs are the future of large-group health insurance
Glitches slowed HealthCare.gov managers’ efforts to building up the Small Business Health Options Program side of the Affordable Care Act public exchange system back when the system came to life, in late 2013.
Due in part to an ACA provision requiring members of Congress and top staffers to get their own health coverage through the ACA public exchange system, many of them have been getting their own health benefits through the District of Columbia’s locally run exchange program for almost a decade.
Califonia and Colorado are other examples of states with locally exchange programs and aggressive SHOP outreach teams.
In recent years, indifference from the administration of President Donald Trump and the COVID-19 pandemic held back SHOP sales, but the work the Trump administration did on the QSEHRA and ICHRA may have given HealthCare.gov infrastructure it can use to the group market, now that COVID-era upheaval is receding.