Most of us don't walk into an HVAC business. They come to our home and keep us cool in the summer. But like a lot of other family businesses, you will find the coffee pot on and people coming and going to keep the business running.
Mark is the proud owner of one of those types of HVAC companies in San Antonio. His technicians are loyal and hardworking, and Mark tries his best to take care of them like family. A couple of years ago, he set up Individual Coverage Health Reimbursement Accounts for each of them. They are better known as an ICHRA.
The point was to let his employees buy their own health care plan that fits their needs. Most people use their ICHRA dollars to buy Affordable Care Act health insurance plans. Post COVID, many were able to leverage subsidies that made those plans significantly more affordable through premium tax credits.
Now the story is different.
Mark is reading headlines about Obamacare plan premiums in Texas going up by 75 percent or more for many families. Also, the federal government shutdown has turned into a debate about whether the enhanced healthcare subsidies will continue or not.
Mark does not want his employees stuck with sky-high premiums. He also does not want to lose them to a competitor offering more traditional benefits. This has led him to wonder if there is a better way to provide coverage without depending on government funded assistance.
The Debate Over ACA Subsidies
When the pandemic hit, the federal government made ACA health plans more affordable with expanded subsidies through the American Rescue Plan Act. Many Texans, including employees supported by ICHRAs, relied on that extra help to make health insurance premiums more manageable.
Those premium subsidies are expiring headed into the 2026 Open Enrollment period. And as part of the current government shutdown, the future of new funding for these healthcare subsidies is one of the most debated issues.
The problem for small businesses like Mark’s is simple. Premium payments are set to jump. Employees who have been using ACA coverage will feel the impact in their wallets. Some will start questioning whether their employer is really helping them at all.
Mark sees the news stories and knows uncertainty is not a benefit. His employees want answers. He wants stability.
Why Employers Using ICHRAs Are at Risk
At first, Mark thought the ICHRA model was the perfect solution. He set a budget, gave employees the funds, and let them shop for their own health plans. It worked.
Now those same employees are facing massive premium increases. A plan that was once affordable can quickly cost hundreds more every month and the out of pocket health care costs are going up as well. Employees who once felt supported may now feel abandoned.
That frustration can lead to disengagement. Or worse, it can lead to losing good workers to companies that offer employer sponsored health plans that provide better health coverage and lower out of pocket costs.
Mark built his business on keeping the right people by doing the right thing. The last thing he wants is to see them leave over something he thought was helping.
Shifting ICHRA Dollars into Smarter Alternatives
Mark is not about to give up. He begins asking better questions. Particularly, how can he use the same dollars in a smarter way?
That is when he calls us and learns about alternatives that do not depend on subsidies or government funding bill debates. We helped him narrow in on three specific health plan options.
- Catastrophic Health Plans paired with Direct Primary Care: This option protects employees from large medical bills while also giving them unlimited access to everyday care through a primary care practice. It removes the fear of a huge expense and gives peace of mind for routine health care needs.
- Limited Benefit Plans like Accident, Critical Illness, and Hospital Indemnity: While these plans are not traditional health insurance, they give support when unexpected costs pop up by putting dollars directly into the employee's pocket. These health plans are especially valuable for employees who may already be on a spouse’s plan but still want coverage for emergencies.
- True Small Group Health Plans: With the right structure, these can be predictable, competitive, and a better fit than an ACA plan that keeps shifting with political winds. Whether it is a self-insured plans or a traditional plan with a major insurance company, they make health care costs predictable and provide tax deductions for the business.
For Mark, seeing these health coverage options means he is no longer stuck waiting on federal health agencies for clarity. He can give his employees something that works today and tomorrow.
A Better Path Forward for Texas Small Businesses
Mark’s story is not unique. All over Texas, small business owners are reading the same headlines about ACA premium support and the shutdown. They see the debate over the health insurance marketplace subsidies, and they also see the impact on their employees in real time.
The truth is that government shutdown standoffs and political debates will always come and go. What does not change is the need for small businesses to protect their people so that they can thrive as they are meant to.
That is where Insurance For Texans steps in. We work with business owners across the state to evaluate their current setup, show them what alternatives exist, and build smarter employer-sponsored coverage benefits that make sense regardless of politics.
You do not have to wait and hope that Washington figures it out. You can take action today.
Click the button below to talk with a Texas health insurance expert about turning uncertainty into a better plan for your business.