Oscar Health’s insurance president, Janet Liang, identifies industry complacency as the primary obstacle to growth in the Individual Coverage Health Reimbursement Arrangement (ICHRA) market. Despite being introduced in 2019, ICHRA enrollment remains relatively low\u2014between 200,000 and 500,000 participants\u2014largely because customers tend to stick with familiar insurance options rather than exploring new alternatives.<\/p>\n
“There’s a little bit of complacency in the industry,” Liang explained. “We’re investing in education with brokers, education with state regulators, chambers and trade associations to really understand this option.”<\/p>\n
The slow adoption of ICHRA represents a missed opportunity for both employers and employees who could benefit from its flexible approach to health insurance coverage.<\/p>\n
As part of its plan to double membership by 2027, Oscar Health is positioning itself as the “market maker” for ICHRA. This arrangement enables small employers to provide funds directly to employees for purchasing plans on the individual market, which aligns perfectly with Oscar’s strategy to expand exchange participation.<\/p>\n
The company has made significant investments in platforms that make ICHRA more accessible and user-friendly for employers. This focus on technological infrastructure reflects Oscar’s commitment to removing barriers to adoption and streamlining implementation.<\/p>\n
By championing ICHRA, Oscar Health is creating a pathway for small businesses that have traditionally struggled to offer competitive health benefits to attract and retain talent in today’s challenging labor market.<\/p>\n
Oscar Health projects substantial growth in exchange enrollees\u2014estimating between 24 and 31 million by 2027. The ICHRA model supports this growth by bringing more individuals into the marketplace while providing continuity of coverage even when employees change jobs.<\/p>\n
“Not only is it good for small employers as an option and for employees to have choices, it will also help to strengthen the exchange itself by bringing in more lives with more continuity,” Liang noted.<\/p>\n
This approach addresses one of the longstanding challenges in American healthcare: maintaining continuous coverage when changing employment. With ICHRA, employees can keep their selected plans even when moving between jobs that offer this arrangement, reducing coverage gaps and improving health outcomes.<\/p>\n
Liang, who joined Oscar as insurance president in February after serving as group president and COO of care delivery for Kaiser Foundation Health Plan and Hospitals, was attracted to Oscar’s technological focus.<\/p>\n
“We’re really interested in how technology can ease member experience, and we use it to help navigate care and create efficiencies within the system,” she said. “One of our advantages is that we’re able to apply AI, large language models for insights and incorporate that into our transactional systems and our digital app.”<\/p>\n
Oscar’s investment in technology extends beyond administrative efficiency. The company leverages data analytics to identify care gaps, improve member engagement, and facilitate more personalized healthcare experiences. This tech-forward approach distinguishes Oscar from traditional insurers who may be slower to adopt emerging technologies.<\/p>\n
For small businesses, ICHRA offers a predictable cost structure and administrative simplicity compared to traditional group plans. Employers can set contribution amounts based on employee classes, providing flexibility while controlling costs.<\/p>\n
Employees benefit from greater plan choice, selecting coverage that best meets their specific healthcare needs rather than accepting a one-size-fits-all group plan. This personalization can lead to higher satisfaction and better utilization of health benefits.<\/p>\n
Liang joins Oscar during a pivotal period\u2014the company reported its first-ever profitable year in 2024, but faces potential challenges in the individual market. While increased tax subsidies have driven record enrollment, these subsidies are set to expire at the end of 2025 without congressional action.<\/p>\n
Despite this uncertainty, Oscar executives remain optimistic, citing bipartisan support for extending the credits. Even if the credits aren’t extended, they believe the marketplace will remain viable.<\/p>\n
“There’s never been a period where we’re not navigating [uncertainty] in healthcare. This is a dynamic industry, with a lot of passionate public leaders at the federal and state level. Fortunately, I’ve seen lots of changes, and I think, overall, in the U.S., we’re on a good trajectory to address the uninsured in our communities,” Liang concluded.<\/p>\n
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