Florida Advances State-Run Individual Health Insurance Exchange Linked to ICHRAs

The Florida House Health Care Facilities & Systems Subcommittee has approved a bill (HB 141) to create the Florida Employee Health Choices Program, an online exchange for purchasing individual health insurance. This program centers around individual coverage health reimbursement arrangements (ICHRAs), allowing employees to select coverage and receive tax-advantaged reimbursements from employers. The bill aims to address concerns over rising insurance costs and limited options for both businesses and employees. Bill sponsor Representative Taylor Yarkosky framed the proposal as a market-driven solution anticipating significant health-care system changes. However, some legislators questioned the necessity of a state-run exchange given existing private exchanges. Federal guidance clarifies that ICHRAs enable employers to reimburse employees tax-free for individual insurance premiums and medical expenses without offering traditional group coverage. National debates over extending Affordable Care Act (ACA) subsidies have intensified recently, influencing state-level health insurance policy considerations. The Florida bill, along with a parallel Senate version (SB 440), is slated for review in the upcoming legislative session beginning in January 2026. The state anticipates initial costs exceeding $1.25 million for exchange development and operation. Florida previously instituted a health coverage exchange for small employers in 2008, which did not sustain itself due to low enrollment and limited product diversity. The subsequent emergence of the federal ACA marketplace contributed to the obsolescence of that state program. The current proposal attempts to reintroduce a state-managed platform designed around ICHRAs, leveraging tax benefits and consumer choice. This legislative move reflects ongoing efforts to innovate health insurance delivery at the state level amidst fluctuating federal policy and market dynamics, potentially influencing employer-sponsored coverage models in Florida and possibly beyond. Insurance professionals should monitor this development for insights on regulatory compliance, market adaptation, and integration of ICHRA-based solutions.