NASE Statement on Passage of 21st Century Cures Act

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NASE Statement on Passage of 21st Century Cures Act

Measure Will to Ensure the Health Care System Works for America’s Small Business Community by Eliminating HRA Penalty


WASHINGTON, D.C. – With the “21st Century Cures Act” signed into law, the National Association for the Self-Employed (NASE), the nation’s leading advocate and resource for the self-employed and micro-business community, applauded the inclusion of a provision that allows small businesses with less than 50 employees to offer Health Reimbursement Accounts (HRAs) without penalty.

“The American small business community applauds this new law allowing small employers to offer Health Reimbursement Accounts to their employees without penalty,” said Katie Vlietstra, NASE Vice President for Government Relations and Public Affairs.  “We must incentivize health care; not punish those who proactively offer health care resources to their employees. It is essential that we have a health care system that works for all Americans.  This relief has been long in the making and we look forward to strengthening the health care system for all Americans.”

NASE has been part of a coalition of small business groups leading the effort to change this unintended consequence of the Affordable Care Act (ACA), which negatively impacted small employers with 49 or less employees that are under no legal obligation to provide a qualified healthcare plan under the employer mandate of the ACA.  However, HRAs are a key health care tool that has long-been used to help small business owners provide some level of financial support for their employees.

In 2015, the Treasury Department announced that it was delaying the enforcement of the technical guidance issued in September 2013 regarding Health Reimbursement Accounts (HRAs).  When the technical guidance was issued, NASE submitted a draft response illustrating its affect on the small business community. At that time, Vlietstra also penned an op-ed on this healthcare situation for The Hill’s Congress Blog.


The National Association for the Self-Employed (NASE) is the nation's leading resource for the self-employed and micro-businesses, bringing a broad range of benefits to help entrepreneurs succeed and to drive the continued growth of this vital segment of the American economy. The NASE Small Business Locator helps identify and connect our nation’s smallest businesses. In addition, NASE’s new health care portal helps small business owners navigate the nation’s health care marketplace. The NASE is a 501(c) (6) nonprofit organization and provides big-business advantages to hundreds of thousands of micro-businesses across the United States. For more information, visit the association's website at

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