Meeting Consumers Where They Are: What We’re Learning from ICHRA

Alan Silver, President of ICHRA, Ambetter Health Solutions

 

By Alan Silver, President of ICHRA, Ambetter Health Solutions

What people expect from healthcare coverage is changing. Healthcare is becoming more consumer-driven, with individuals expecting greater choice, personalization and control over how they select and experience coverage.

For many, traditional group coverage has not kept up with those expectations. Employees may have limited plan options, face uncertainty around what is covered and struggle to compare costs or provider access in a way that feels clear and useful.

What we’re seeing across the market is a clear shift toward more individualized expectations. People want coverage that reflects how they live, not a one-size-fits-all model. At Centene, we are responding to that shift by rethinking how coverage is offered and how people experience it. Health innovation models like Individual Coverage Health Reimbursement Arrangements (ICHRAs) are one example of how that shift toward greater choice and individualized coverage is taking shape.

Rethinking Coverage Through ICHRA

ICHRA introduces a different approach to employer-sponsored insurance (ESI). Instead of offering a single group plan, employers provide a set contribution amount, similar to a defined contribution approach, and employees select the coverage that works best for them and their families.

ICHRA allows individuals to choose the coverage that works best for them and their families, with options designed to meet a wide range of needs and preferences. Through Ambetter Health Solutions, our ICHRA offering provides access to flexible, personalized coverage options with plan designs that emphasize affordability, simplicity and usability. This flexibility also allows individuals within the same household to select different levels of coverage based on their unique healthcare needs. Centene launched ICHRA through Ambetter Health Solutions in 2025 and has since expanded to 13 states, with continued growth planned.

Making Choice Easier to Navigate

One of the things we’ve learned since rolling out ICHRA in 2025 is that offering more options alone is not enough. As more choices become available, the experience around how people evaluate and select coverage becomes increasingly important.

Centene is focused on making that experience easier to navigate. That includes:

• Designing plans with clearer benefit details and cost structures.
• Providing tools and resources that help individuals understand and compare options.
• Connecting individuals to support teams that guide them through plan selection and use.
• Partnering with benefits administrators to support employees as they evaluate and select coverage.

This reflects how we are refining ICHRA to better support consumer needs. It helps people compare options, make informed decisions, and use their coverage with confidence. Centene is continuing to strengthen the experience by expanding education and improving clarity around how coverage works.

Flexibility for Individuals, Predictability for Employers

In addition to providing flexibility for employees, ICHRA also presents benefits for employers. Rising healthcare costs continue to challenge small and large businesses alike, with projections pointing to some of the largest cost increases in more than a decade. However, employers are increasingly looking for more predictable and stable ways to manage those costs.

With ICHRA, employers set a fixed amount they contribute toward coverage, instead of managing the changing costs of a traditional group plan. That can help employers better manage costs over time while giving employees more choice in how they select coverage.

This balance allows employers to step away from rigid plan structures without stepping away from offering coverage. At the same time, individuals gain more control over how they select and use their benefits. That alignment between employer needs and individual expectations is one of the reasons ICHRA continues to gain traction.

What Centene Is Doing Differently

Alan Silver speaking at the 2026 ICHRA Conference, where industry leaders explored how greater choice, personalization and flexibility are reshaping healthcare coverage.

Our approach to ICHRA is grounded in experience. As a national Marketplace carrier, Centene has spent more than a decade developing plan designs and coverage approaches tailored to the communities we serve. That experience shapes how we are building ICHRA today. Through Ambetter Health Solutions, we are focused on:

• Expanding access to affordable coverage across a broad range of markets.
• Supporting continuity of coverage as individuals move between jobs or coverage situations.
• Designing plans that reflect how people use coverage, with options that support a range of healthcare needs and preferences.

By closely tracking member needs and market trends, we continue improving plan design and making coverage easier to understand and use. This allows us to respond more quickly as needs change and gaps become clear.

Looking Ahead: The Future of ICHRA and Coverage

ICHRA is here to stay, and the direction from consumers is clear. People want more choice, personalization and stability in how they access and manage healthcare coverage as they move through different life transitions. Healthcare is moving toward a model that gives individuals more control and better visibility into their options.

This shift toward more consumer-driven coverage is reshaping how benefits are designed and experienced, with a stronger focus on choice, personalization and stability. ICHRA reflects this broader move toward coverage that is more flexible and more responsive to how people live.