We talk a lot about what drives economic growth: investment, innovation, infrastructure. But there's a variable that doesn't show up on enough balance sheets: the health of the American worker. When people are healthy, they work. They produce. They build. And when they're not, the entire economy feels it.
That's why the U.S. Chamber strongly supports Individual Coverage Health Reimbursement Arrangements (ICHRAs).
What Is an ICHRA?
ICHRAs allow employers of any size to reimburse employees tax-free for individual health insurance premiums and qualified medical expenses. Instead of offering a one-size-fits-all group plan, employers set a contribution amount, and employees choose the coverage that works best for them and their families.
A Healthier Workforce Is a More Productive Workforce
Absenteeism, presenteeism, and chronic disease management drain productivity and increase costs across every sector.
ICHRAs expand access to coverage for all workers, including part-time employees, seasonal workers, and those at small businesses that can't afford more traditional group plans. More coverage means a healthier workforce and a stronger economy.
Building on Congressional Momentum
In 2025, the U.S. House passed the Custom Health Option and Individual Care Expense (CHOICE) Arrangement framework as part of the One Big Beautiful Bill Act, signaling strong bipartisan interest in giving employers greater flexibility to offer portable, individualized health benefits. Although the CHOICE Act provisions were stripped out in the Senate version, House passage marked an important milestone in advancing long-term certainty for employers and employees alike.
Making It Permanent
Good policy is permanent policy. ICHRAs were established by executive order, which means they can be undone the same way. Congress must act to codify ICHRAs into law, giving employers and employees the certainty they need to plan, invest, and build healthier workforces for the long term.
America’s business community wants to invest in its workforce.
Codifying ICHRAs sends a clear signal: America is serious about expanding access to healthcare, empowering workers, and building the kind of healthy, productive workforce that keeps our economy competitive.
Bottom Line
America's health advantage isn't guaranteed. It’s built. ICHRAs are one of the most powerful tools we have to expand coverage, reduce costs, and put health decisions where they belong: with the people who live with those decisions every day.
Congress must act to make ICHRAs permanent. The health of our workforce and the strength of our economy depend on it.
