The Consumer Becomes the Payor: How ICHRA Unlocks a New Era in Healthcare

In this episode, Julie Yoo and Jay Rughani are joined by Thatch cofounders Chris Ellis and Adam Stevenson to explore why ICHRA—a more recent policy innovation—might quietly revolutionize employer-sponsored health benefits. Unpacking the surprising history of how U.S. healthcare became entangled with employment, they make the case for a defined-contribution future that mirrors the rise of the 401(k) and HSA. Tailored especially for today’s distributed and fast-moving workforce, ICHRA allows employers to offer tax-free health dollars employees can spend how—and where—they choose.

For healthcare entrepreneurs, the conversation provides a blueprint for navigating a rapidly shifting payer landscape, including insight into how fintech infrastructure, policy tailwinds, and carrier ecosystem integrations unlock market readiness.

This episode was originally published in October of 2024. The conversation remains relevant today.