GUEST EDITORIAL: Healthcare Costs Squeeze Main Street. CHOICE Arrangements Can Help.

Across America, small business owners are working every day to grow their companies and take care of the employees who make their success possible. From manufacturers and retailers to restaurants and service businesses, quality health coverage can help employers recruit talent, retain skilled workers, and support working families.

But small employers often face a health care system that was not built with Main Street in mind. Large corporations can rely on human-resources departments, outside consultants, and benefits teams to manage complicated plans and annual renewals. Small business owners are busy running the restaurant, managing the job site, serving customers, and making payroll while operating on tight margins. As health care costs continue to rise, small businesses need benefit options that are straightforward, flexible, and affordable.

Costs have risen sharply. Average annual premiums for employer-sponsored family coverage have more than doubled since 2008, rising from $12,680 to $26,993. For a small business owner, rising premiums can mean delaying a new hire, postponing an equipment purchase, limiting wage increases, or shifting more costs to employees. For families, they mean less money for groceries, housing, childcare, transportation, and savings. Small businesses need more options, not fewer.

That is why the Trump Administration is highlighting CHOICE Arrangements, previously known as Individual Coverage Health Reimbursement Arrangements, or ICHRAs. CHOICE Arrangements give small businesses another way to offer health coverage: instead of selecting one group plan for every employee, an employer can provide a fixed tax-favored contribution for qualifying individual coverage.

For employers, CHOICE Arrangements offer more predictability and control. A small business can set its contribution instead of absorbing unpredictable group-plan premium increases. This flexibility can help businesses that have struggled to offer health benefits for the first time, support employees in multiple states, and compete for talent without sacrificing resources needed to invest in their business. Qualified reimbursements are generally tax-deductible business expenses and generally are not subject to payroll tax.

For employees and their families, CHOICE Arrangements provide more choice and flexibility. Workers can use their employer’s contribution toward qualifying individual coverage through HealthCare.gov, a state marketplace, a private insurer, or an off-exchange platform. That gives workers more ability to select coverage that fits their doctors, prescriptions, family needs, and budget. It is employer-supported health care with more consumer control: employers gain greater certainty over what they spend, while employees have a greater say in the coverage they choose.

CHOICE Arrangements are part of President Trump’s broader agenda to lower health care costs, increase competition, and put more control in the hands of the American people. The administration’s Most-Favored-Nation agreements with 26 pharmaceutical manufacturers cover nearly 90 percent of the branded U.S. drug market and seek to align U.S. prices with the lowest prices in comparable developed nations.

Through TrumpRx, Americans have another way to access lower negotiated prescription-drug prices; the platform has delivered more than $700 million in savings and covers more than 1,000 branded and generic medicines. The administration has also made a historic $50 billion commitment through the Center for Medicare and Medicaid Services (CMS) Rural Health Transformation Program to strengthen access to care, the health care workforce, and modernized delivery systems in rural America.

Small business owners can visit CMS.gov/choicearrangements to learn the basics, see if CHOICE Arrangements makes sense for their business, estimate costs, and connect with brokers or third-party administrators that can help evaluate and administer an arrangement. The goal is clear: health care should work for the American people, not special interests and Washington bureaucracy. CHOICE Arrangements bring that principle to Main Street by helping business owners manage rising costs while allowing workers to choose coverage that better serves their families.