Employees want more health plan options from their employers, but most are also satisfied with the plan they already have. That tension between wanting choice and being satisfied with existing coverage, surfaced in a new consumer survey released by eHealth, is precisely what has driven ICHRA adoption among employers.
Seventy-seven percent of Americans with employer-sponsored coverage said they wish their employer offered a broader selection of health insurance plans to choose from. The finding comes from eHealth’s October 2026 Open Enrollment Season Spotlight, a survey of 1,000+ adults conducted October 7 to 9 by the online health insurance marketplace, which has a commercial interest in open enrollment activity.
The gap between wanting choice in the abstract and being content with the plan in practice is not a contradiction so much as a market signal. That gap mirrors the dynamic driving ICHRA adoption: employees value having options, even when their plan-switching behaviour is limited.
Forty-three percent of all Americans say they are familiar with CHOICE Arrangements, the Custom Health Option and Individual Care Expense arrangement rebranded by CMS in September 2026 from what the industry has long called individual coverage health reimbursement arrangements (ICHRAs). Under an ICHRA, employers set a defined contribution and employees select individual plans on their own.
That awareness figure arrives when ICHRA adoption is expanding rapidly on the employer side. More than 20,000 US businesses now offer an ICHRA as their primary employee health benefit, representing estimated growth of roughly 53% from 2025, according to the HRA Council’s fifth annual Growth Trends for ICHRA and QSEHRA report, published August 12. More than half of benefits brokers say they are now actively recommending or implementing an ICHRA for at least one client, up from 15% in 2024.
Consumer familiarity catching up to broker adoption matters because ICHRA adoption stalls when employees don’t understand what they’re being offered. An employer moving to a defined contribution model is asking workers to make plan decisions they have not previously had to make. The eHealth data suggests a meaningful share of the workforce now has at least baseline awareness of how such arrangements work.
Thirty-seven percent of ACA plan enrollees say their government premium subsidies were reduced from 2025 to 2026. That figure is consistent with what happened after the enhanced premium tax credits introduced during the pandemic expired at the start of 2026.
ACA marketplace enrollment fell to 23.1 million for the 2026 plan year, down from 24.2 million in 2025, according to final CMS data published March 2026. KFF described the 1.2 million decline as the sharpest single-year drop since the marketplaces launched.
Average deductibles, meanwhile, grew by more than $1,000 per enrollee as shoppers shifted toward lower-premium bronze plans, the steepest single-year increase in marketplace history, according to a separate KFF analysis published May 2026.
Thirty-six percent of ACA plan enrollees in the eHealth survey say their current plan is unaffordable for them, and 68% say they are worried they won’t find affordable coverage for 2027.
Forty-eight percent of survey respondents say they have used an AI tool to review their health insurance options. Among those who did, 85% say they chose their current plan based in full or part on that advice. The same group, however, is clear-eyed about AI’s limits. Sixty-seven percent of those who have used AI for medical advice admit the guidance has sometimes been incorrect, and 82% say they would support a law requiring a human to review any medical claim denied by an AI tool.
The Hartford’s 2026 Future of Benefits Study found that employers are deploying AI-driven recommendation engines to help employees choose coverage during open enrollment, while also finding that employees want human support to remain available where it counts. The eHealth consumer data adds texture to that finding: workers are using AI tools to research coverage, but they are not yet ready to remove humans from consequential decisions.
