Healthcare policy remains a highly partisan issue. But ICHRAs — built off President Obama's 21st Century Cures Act but expanded by President Trump — are reliably bipartisan. However, the broader health care policies implemented under a second Trump administration or a Harris administration could have a profound impact. It's worth examining how these candidates and their party platforms might influence the ICHRA market going forward.

How would a Kamala Harris administration impact ICHRA?

In general, Democrats support ICHRAs because every new member of the ACA marketplace increases the risk pool and the competitiveness of plans. The party's platform for this election aims to achieve "universal" health care by backing a public option in the ACA market. That public option could take many forms, but in essence would create a government-run plan that competes alongside private insurers in the public marketplaces.

If the ACA marketplace remains competitive, the introduction of a public option could be beneficial for ICHRAs. Such a move would give employees more options, particularly in parts of the country where there's not much private competition. Keep in mind, any policy that moves away from a marketplace structure would have to involve a complete overhaul of health care in the U.S. as we know it today.

A Harris administration should be good for the continued expansion of ICHRAs. However, there are special interest groups to the left of Harris challenging ICHRAs as a Trump-era policy; these groups fail to recognize that ICHRA evolved out of the Obama administration's lesser-known QSEHRA policies for small businesses. These activists may be able to grab the attention of a Democratic president, but sweeping changes are unlikely.

How would a second Trump administration impact ICHRA?

Republicans support ICHRAs because it is market-based and gives employees more choice. The party's platform commits to "promoting choice and competition" — a potential positive for ICHRAs when compared with traditional group plans. Republicans sponsored House Bill 3799 to write the ICHRA regulations into law — the program is currently the result of an executive order and not codified into law — a strong signal about their commitment to the program.

However, a second Trump administration does pose long-term threats to the stability and growth of HRAs. A Trump White House and Republican Congress could renew their efforts to undermine the ACA marketplace, which ICHRA relies on in order to deliver quality plans. A Republican administration may also expand ICHRA rules in ways that go beyond what is currently supported by both parties: allowing ICHRAs to work with non-ACA plans could damage the markets and prompt Democrats to try to undo ICHRAs entirely.

As with a potential Harris administration, ICHRAs should continue to thrive as long as policies in a second Trump Presidency don't move too far in either direction. This also points to the importance of the Congressional races: if the winner of the White House doesn't have the support of both houses of Congress, we're unlikely to see dramatic changes to the health care market.