Georgetown's ICHRA study is useful for identifying what an employer should investigate before changing benefits. Its stakeholder interviews describe employer budget predictability alongside varied employee experiences. They do not establish a national savings rate or prove that one benefit model works better for every workforce. source
Who contributed to the study?
JoAnn Volk, Kevin Lucia and Sloane Daly of Georgetown University's Center on Health Insurance Reforms published their issue brief in September 2026; the university announced it on September 30. The research combined a literature and legal review with 32 structured stakeholder interviews conducted from November 2025 through February 2026. Participants included employers, employees, benefit advisers, brokers, administrators and state-based Marketplaces. Funding came from the National Institute for Health Care Reform. source
This is qualitative research: accounts help explain decisions and identify problems to investigate. Thirty-two stakeholders does not mean 32 employees, and the interviews do not provide representative percentages for all ICHRA participants. The interview period also predates the publication date.
What did Georgetown find?
The university's summary describes an expanding support ecosystem but limited employer uptake, concentrated among smaller businesses. Cost and predictable employer spending are central motivations. More individual-plan options can accompany uneven coverage and financial effects for employees, while administrative barriers and rising individual-market premiums may constrain adoption. These are the researchers' findings from the reviewed evidence and stakeholder accounts. source
Our practical interpretation is to evaluate the employer's financing decision and the employee's insurance experience together. A contribution amount is one input; it cannot describe the complete result for everyone who receives it.
Separate budget predictability from the employee's bill
Consider a fictional premium-only arrangement with a $500 monthly allowance. One employee selects a $650 policy and has $150 of premium remaining. Another selects a $900 policy and has $400 remaining. The employer's stated allowance is identical, but the two employee budgets differ. Neither subtraction evaluates deductibles, prescriptions, household coverage or legal affordability.
The federal framework separately considers affordability and its consequences for Marketplace tax credits. Use the actual employer offer and applicable reference premium rather than this illustration to assess that question. source Our 2027 affordability guide distinguishes the employee's Marketplace calculation from an employer's compliance analysis. The beyond-premiums analysis addresses the cost of using coverage after enrollment.
Compare the circumstances within your workforce
The following is our suggested evaluation worksheet, not a set of measured outcomes from Georgetown. Test a proposed arrangement against the situations that matter to your employees before relying on a company-wide average.
| Decision | Information to obtain |
|---|---|
| Coverage available locally | Plans offered for the employee's address and plan year; confirm availability with the insurer or Marketplace. |
| Continuing care | The exact policy's doctor, hospital, prescription and authorization requirements. |
| Household coverage | Who is included in the employer offer and how the household's coverage options interact. |
| Money and timing | Premium remaining after the allowance, required initial payments, reimbursement timing and costs when receiving care. |
For a treatment or prescription that matters, a carrier name or a favorable average is insufficient. Follow the doctor and prescription checklist using the exact plan. Employees can use the employee guide to collect questions without sharing medical details with their employer.
Make operational promises specific
An evaluation should identify who submits the application, makes the first payment, confirms active coverage and resolves a failed payment. Ask the administrator to demonstrate the workflow for the carriers employees may actually choose, including the process when a status feed is unavailable.
Require a clear handoff: an unresolved case needs an owner, a deadline and a route for the employee to get help. Keep a completed application separate from insurer-confirmed coverage. Our activation guide provides the milestones; the provider-selection framework helps turn them into proposal questions.
Define success before the first renewal
Write down the employer's objective, the employees eligible to participate, the comparison period and the expected service responsibilities before launch. At renewal, compare those expectations with actual spending, participation, confirmed coverage and unresolved support cases. Record employee feedback alongside the number invited and the number responding.
A useful review can identify a successful budget decision and a payment problem in the same arrangement. Those observations should lead to different actions: maintain the effective contribution design, resolve the failed workflow, or reconsider the benefit where coverage does not meet the workforce's needs. The first-renewal scorecard sets out a practical review.
Use each kind of evidence for the question it can answer
Read Georgetown's interviews alongside the EBRI employer-interest survey and a documented employer transition. They describe different things: reported experiences, stated intentions and one company's disclosed arrangement. None substitutes for a comparison of your workforce's actual options.
Start with our evaluation brief, assign the unanswered coverage and operating questions, and bring the same requirements to every candidate. That is a useful application of this study without turning its interviews into a prediction of your employees' outcomes.
Sources and evidence
Review dates are recorded for each source above. Company pages are useful for confirming how a product is described, but they do not prove service quality or customer results.
Suggested citation
Cite this page for our analysis. Georgetown University's Center on Health Insurance Reforms conducted the underlying stakeholder study; cite its linked report for the original findings.
ICHRA Report. Georgetown's ICHRA study: employer and employee experiences. Published October 30, 2026. https://ichrareport.com/research/georgetown-ichra-stakeholder-study-2026/