Small Business Health Options Awareness Act (2026 Report)
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Summary
House Report 119–716 of the 119th Congress, 2d Session, on the Small Business Health Options Awareness Act of 2026, submitted June 29, 2026 by Mr. WILLIAMS of Texas from the Committee on Small Business to accompany H.R. 5498. The committee reports the bill favorably with an amendment that directs the Small Business Administration to disseminate federal agency information on individual coverage health reimbursement arrangements (ICHRAs) through small business development centers, district offices and agency communications. The report states the committee ordered the bill reported on May 20, 2026 by a roll call vote of 13 ayes to 11 nos. It includes a section-by-section analysis and procedural statements. Minority views signed by Ranking Member Nydia M. Velázquez state concerns that ICHRAs could raise marketplace premiums and that the bill omits ACA Marketplace information.
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119TH CONGRESS REPORT
" HOUSE OF REPRESENTATIVES !
2d Session 119–716
SMALL BUSINESS HEALTH OPTIONS AWARENESS
ACT OF 2026
JUNE 29, 2026.—Committed to the Committee of the Whole House on the State of
the Union and ordered to be printed
Mr. WILLIAMS of Texas, from the Committee on Small Business,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 5498]
The Committee on Small Business, to whom was referred the bill
(H.R. 5498) to require the Administrator of the Small Business Ad-
ministration to provide information to small business concerns on
individual coverage health reimbursement arrangements, and for
other purposes, having considered the same, reports favorably
thereon with an amendment and recommends that the bill as
amended do pass.
CONTENTS
Page
I. Purpose and Bill Summary ........................................................................ 2
II. Need for Legislation .................................................................................... 2
III. Hearings ....................................................................................................... 2
IV. Committee Consideration ........................................................................... 3
V. Committee Votes ......................................................................................... 3
VI. Section-by-Section of H.R. 5498 ................................................................. 5
VII. Congressional Budget Office Cost Estimate ............................................. 5
VIII. New Budget Authority, Entitlement Authority, and Tax Expenditures 5
IX. Oversight Findings & Recommendations .................................................. 5
X. Performance Goals and Objectives ............................................................ 5
XI. Statement of Duplication of Federal Programs ........................................ 6
XII. Congressional Earmarks, Limited Tax Benefits, and Limited Tariff
Benefits ..................................................................................................... 6
XIII. Federal Mandates Statement ..................................................................... 6
XIV. Federal Advisory Committee Statement ................................................... 6
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XV. Applicability to Legislative Branch ........................................................... 6
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XVI. Statement of Constitutional Authority ...................................................... 6
XVII. Minority Views ............................................................................................ 7
The amendment is as follows:
Strike all after the enacting clause and insert the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Small Business Health Options Awareness Act of
2026’’.
SEC. 2. OUTREACH TO SMALL BUSINESS CONCERNS ON INDIVIDUAL COVERAGE HEALTH RE-
IMBURSEMENT ARRANGEMENTS.
(a) DISSEMINATION.—The Administrator of the Small Business Administration
shall disseminate information developed by appropriate Federal agencies on indi-
vidual coverage health reimbursement arrangements to small business concerns
through—
(1) small business development centers; and
(2) district offices of the Administration.
(b) PUBLICATION.—The Administrator shall include the information described in
subsection (a) in outreach and communications of the Small Business Administra-
tion, including social media, press releases, and publication on a website of the Ad-
ministration.
(c) DEFINITIONS.—In this section:
(1) APPROPRIATE FEDERAL AGENCY.—The term ‘‘appropriate Federal agency’’
means a Federal agency, as determined by the Administrator of the Small Busi-
ness Administration, and includes the Department of the Treasury, the Depart-
ment of Health and Human Services, and the Department of Labor.
(2) INDIVIDUAL COVERAGE HEALTH REIMBURSEMENT ARRANGEMENT.—The term
‘‘individual coverage health reimbursement arrangement’’ has the meaning
given by the rule entitled ‘‘Health Reimbursement Arrangements and Other Ac-
count-Based Group Health Plans’’ (84 Fed. Reg. 28888; June 20, 2019).
(3) SMALL BUSINESS ACT DEFINITIONS.—The terms ‘‘small business concern’’
and ‘‘small business development center’’ have the meanings given, respectively,
under section 3 of the Small Business Act (15 U.S.C. 632).
I. PURPOSE AND BILL SUMMARY
On September 18, 2025, Rep. Beth Van Duyne (R–TX), intro-
duced H.R. 5498, the Small Business Health Options Awareness Act
of 2025. H.R. 5498 directs the U.S. Small Business Administration
(SBA) to disseminate information regarding individual coverage
health reimbursement arrangements (ICHRAs), developed by rel-
evant federal agencies, to small businesses through small business
development centers (SBDCs), district offices, and SBA communica-
tion channels.
II. NEED FOR LEGISLATION
ICHRAs were created through agency rulemakings under the
Trump Administration in 2019 and became available to employees
in 2020. ICHRAs offer employers a flexible and tax-advantaged
way to reimburse employees for health insurance they purchase on
their own. However, low awareness of this option has prevented
broader adoption. ICHRAs remain an innovative way for employers
to have more affordable health coverage for their employees. This
legislation leverages SBA’s existing outreach programs to educate
small businesses about ICHRAs as a flexible, tax-advantaged way
to help employees pay for individual health coverage. H.R. 5498 en-
sures small businesses have the tools they need to offer competitive
benefits, retain employees, and reduce costs.
III. HEARINGS
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The Committee on Small Business held the following hearings
examining matters related to H.R. 5498:
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• On February 5, 2025, the Committee held a hearing titled
‘‘Hope on the Horizon: Prioritizing Small Business Growth in
the 119th Congress.’’
IV. COMMITTEE CONSIDERATION
The Committee on Small Business met in open session, with a
quorum being present, on May 20, 2026, and ordered H.R. 5498, as
amended, to be reported favorably to the House of Representatives
by a roll call vote of 13 ayes to 11 nos.
V. COMMITTEE VOTES
Clause 3(b) of rule XIII of the Rules of the House of Representa-
tives requires the Committee to list the recorded votes on the mo-
tion to report legislation and amendments thereto. The Committee
voted to favorably report H.R. 5498, as amended to the House of
Representatives at 4:19 PM.
The Committee considered the follow amendments to H.R. 5498:
• Chairman Williams offered an amendment in the nature of
a substitute to H.R. 5498. This amendment was adopted by
voice vote.
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VI. SECTION-BY-SECTION OF H.R. 5498
Section 1—Short title
This Act may be cited as the ‘‘Small Business Health Options
Awareness Act of 2026.’’
Section 2—Outreach to small business concerns on individual cov-
erage health reimbursement arrangements
This section requires the SBA to disseminate information devel-
oped by federal agencies, including the Department of Treasury,
Department of Health and Human Services, and the Department
of Labor, regarding ICHRAs to small businesses through SBDCs
and SBA district offices.
This section directs the SBA to include information on ICHRAs
in agency outreach and communication efforts, including social
media, press releases, and publications on the SBA’s website.
This section defines the terms ‘‘appropriate federal agency,’’ ‘‘in-
dividual coverage health reimbursement arrangement,’’ and incor-
porates the existing Small Business Act definitions for ‘‘small busi-
ness concern’’ and ‘‘small business development center.’’
VII. CONGRESSIONAL BUDGET OFFICE COST ESTIMATE
Pursuant to 3(c)(3) of rule XIII of the Rules of the House of Rep-
resentatives, the Committee adopts as its own the cost estimate
prepared by the Director of the Congressional Budget Office pursu-
ant to section 402 of the Congressional Budget Act of 1974. At the
time this report was filed, the Committee has requested but not re-
ceived a cost estimate from the Director of the Congressional Budg-
et Office.
VIII. NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND
TAX EXPENDITURES
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House
of Representatives and section 308(a)(I) of the Congressional Budg-
et Act of 1974, the Committee provides the following opinion and
estimate with respect to new budget authority, entitlement author-
ity, and tax expenditures. While the Committee has not received an
estimate of new budget authority contained in the cost estimate
prepared by the Director of the Congressional Budget Office pursu-
ant to section 402 of the Congressional Budget Act of 1974, the
Committee does not believe that there will be any new or increased
costs attributable to this legislation.
IX. OVERSIGHT FINDINGS & RECOMMENDATIONS
In accordance with clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the over-
sight findings and recommendations of the Committee on Small
Business with respect to the subject matter contained in H.R. 5498,
as amended, are incorporated into the descriptive portions of this
report.
X. PERFORMANCE GOALS AND OBJECTIVES
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With respect to the requirements of clause 3(c)(4) of rule XIII of
the Rules of the House of Representatives, the goal of H.R. 5498
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is to increase small business awareness of ICHRAs as a flexible,
tax-advantaged health coverage option.
XI. STATEMENT OF DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the House
of Representatives, no provision of H.R. 5498 is known to be dupli-
cative of another Federal program, including any program that was
included in a report to Congress pursuant to section 21 of Public
Law 111–139 or the most recent Catalog of Federal Domestic As-
sistance.
XII. CONGRESSIONAL EARMARKS, LIMITED TAX BENEFITS, AND
LIMITED TARIFF BENEFITS
With respect to clause 9 of rule XXI of the Rules of the House
of Representatives, the Committee finds that the bill does not con-
tain any congressional earmarks, limited tax benefits, or limited
tariff benefits as defined in clause 9(e), 9(f), or 9(g) of rule XXI of
the Rules of the House of Representatives.
XIII. FEDERAL MANDATES STATEMENT
The Committee will adopt as its own the estimate of the Federal
mandates prepared by the Director of the Congressional Budget Of-
fice pursuant to section 423 of the Unfunded Mandates Reform Act.
XIV. FEDERAL ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b) of the
Federal Advisory Committee Act were created by this legislation.
XV. APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to the
terms and conditions of employment or access to public services or
accommodations within the meaning of section 102(b)(3) of the Con-
gressional Accountability Act.
XVI. STATEMENT OF CONSTITUTIONAL AUTHORITY
Pursuant to clause 7 of rule XII of the Rules of the House, the
Committee finds that the authority for this legislation in Art. I, § 8,
cl.1 of the Constitution of the United States.
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XVII. MINORITY VIEWS
H.R. 5498 would require the Small Business Administration
(SBA) to distribute materials on Individual Coverage Health Reim-
bursement Accounts (ICHRAs).
It is important to provide information to small businesses so they
can better meet the health care needs of their workers. However,
small businesses should have a complete view of all options avail-
able to them, not just ICHRAs. Over half of all the Affordable Care
Act (ACA) Marketplace enrollees are small businesses owners, em-
ployees, or self-employed. By directing SBA to provide information
only on ICHRAs, without requiring information on the ACA Mar-
ketplace, creates a significant gap in the guidance available to
small businesses.
With that said, ICHRAs are problematic in that they lead to
health care discrimination against certain classes of workers. While
nondiscrimination provisions were included in the original rule to
protect employees from being targeted based on age, health status,
or other features, ICHRAs could be offered to specific classes of
workers to reduce group health plan costs, and better coverage
could be offered to top executives.
ICHRAs will also make the marketplace risk pool sicker and in-
crease premiums. A Brookings Institution analysis found that al-
lowing employers to offer ICHRAs alongside a traditional group
health insurance plan could increase marketplace premiums by
16% to 93%. If employers shift high-cost or high-risk workers onto
the individual market, the adverse selection will drive up pre-
miums in the individual market.
ICHRAs leave small business employees worse off for healthcare
coverage. If an employee is offered an ICHRA, the employee is not
eligible for subsidized marketplace coverage, unless their share of
the premium is more than 9.96 percent of household income. For
many low-wage workers, they may be better off without an ICHRA
and use the marketplace premium tax credits for more generous
and affordable coverage.
Aside from the underlying policy concerns, it makes little sense
at this time to require the Small Business Development Centers
(SBDCs) to disseminate information about them while President
Trump’s budget eliminates their funding, and the SBA is with-
holding funds. Expanding responsibilities while reducing resources
is not only unsustainable, but it is the textbook definition of an un-
funded mandate. Moreover, several agencies are already required
to educate individuals and employers about ICHRAs, making addi-
tional SBDC dissemination on ICHRAs duplicative.
Small businesses—already squeezed by Trump’s tariffs—are get-
ting squeezed by Republicans’ health plan. Get less, pay more. And
it means higher costs and worse health for working Americans. To
help with the affordability crisis, we should ensure small busi-
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nesses and their employees have a comprehensive slate of health
care information to make informed decisions. Doing so would mean
the very survival of the operation. That is why Democrats sup-
ported an amendment offered by Rep. Hillary Scholten (D–MI),
which would require the SBA to publicly post information about all
health care plans, and supported an amendment offered by Rep.
Kelly Morrison (D–MN) requiring a notice that ICHRAs could limit
an individual’s eligibility for the ACA premium tax credits. The
amendments were defeated by Republicans.
NYDIA M. VELÁZQUEZ,
Ranking Member.
Æ
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