HB 6708, the ICHRA Permanency Act, codifies the June 20, 2019 final rule on health reimbursement arrangements (HRAs) and other account-based group health plans as binding federal law. The rule—issued by the Treasury, Labor, and Health and Human Services—governs how HRAs interact with traditional group health coverage and other account-based arrangements.
The bill’s effect is not to create new policy elements but to convert an existing regulatory framework into statutory certainty.
In practical terms, the act preserves the current HRA framework by placing it on solid legal footing. That permanency reduces regulatory risk for employers and plan sponsors, ensuring that the current approach to HRAs remains enforceable even as broader health policy landscapes evolve.
The bill therefore functions as a codification instrument rather than a policy lever to expand or restrict benefits on its own.
At a Glance
What It Does
The final rule on HRAs and account-based group health plans is codified, giving it the full force of federal law.
Who It Affects
Employers and plan sponsors who offer HRAs, account-based plans, and their administrators; health plans and insurers involved in administering HRAs.
Why It Matters
It provides regulatory certainty and continuity for employer-sponsored benefits, ensuring a stable framework for account-based health coverage across agencies.
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What This Bill Actually Does
The ICHRA Permanency Act is a straightforward statutory codification of an existing regulatory framework. Section 2 codifies the 2019 final rule that governs HRAs and other account-based group health plans, making that rule binding federal law across relevant agencies.
Section 1 establishes the act’s short title. The net effect is to lock in the current policy architecture around HRAs, rather than to create new coverage mandates or tax changes.
For compliance professionals, this means a durable reference point: HRAs and associated account-based structures operate under a codified rule that remains enforceable. Employers, plan sponsors, and administrators can plan with greater certainty about how HRAs interact with other group health coverage and the protections the rule provides.
The act also clarifies that the rule’s cross-agency origin—Treasury, Labor, and HHS—remains the governing framework for these arrangements.
The Five Things You Need to Know
The bill codifies the June 20, 2019 final rule on HRAs and account-based group health plans.
The codification gives the final rule full force and effect of federal law.
The rule is anchored in guidance issued by Treasury, Labor, and HHS.
The act carries the short title: ICHRA Permanency Act.
There are no new policy elements; the bill preserves the existing rule.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Short title
This section designates the act as the ICHRA Permanency Act and provides the official shorthand reference to be used in federal law and policy discussions.
Codification of HRAs rules
This section codifies the June 20, 2019 final rule on health reimbursement arrangements and other account-based group health plans, giving the rule full force and effect of law. It preserves the cross-agency framework established by the rule (Treasury, Labor, and HHS) and makes no new substantive policy changes beyond codification.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Employers that offer HRAs to employees; they gain regulatory certainty and a stable framework for plan design.
- Plan sponsors and administrators who implement account-based health plans; clarity reduces ambiguity in compliance and reporting.
- Employees enrolled in HRA-based coverage, who benefit from a predictable regulatory environment and access to account-based benefits.
- Health insurers and third-party administrators that administer HRAs; consistent federal standards streamline operations.
- Benefits compliance professionals who manage employer-sponsored plans; a stable rule set simplifies governance.
Who Bears the Cost
- Employers may incur ongoing administrative and compliance costs to align with the codified rule.
- Plan sponsors and administrators may need to adjust documentation and reporting to align with the codified framework.
- HRAs and account-based plan providers may bear costs associated with maintaining alignment with the statutory codification.
- Regulators and agencies may incur administrative costs to monitor and enforce the codified rule.
Key Issues
The Core Tension
The central tension is between making the HRAs framework durable and uniform (benefiting predictability and compliance) and preserving regulatory flexibility to adjust policy in response to changing health-care costs, market dynamics, or new evidence.
Codifying an existing rule reduces regulatory uncertainty, but it also locks in a static policy framework. The bill does not address how the HRA rule will be updated in response to evolving health policy needs, nor does it resolve potential tensions between HRAs and other ACA-related requirements.
Practitioners will want to watch for future amendments or guidance that clarify enforcement expectations, transition provisions, or state-law interactions.
A central question is whether codification restricts agile policy responses to market changes or administrative priorities. While permanency can stabilize benefits design, it may also limit the government’s ability to adapt the rule to new cost pressures, coverage gaps, or discrimination concerns as health markets evolve.
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