The first Trump administration sought to stem that decline while improving insurance competition and portability. In 2019 officials finalized a rule allowing employers to fund employees’ individual health coverage through health reimbursement arrangements. HRAs differ from traditional employer-sponsored coverage because the employee, not the employer, selects and owns the insurance policy. Crucially, however, employers and employees can still make premium contributions on a pretax basis.

ObamaCare attempted to solve a real problem: Previously only individuals buying health coverage through an employer could do so on a pretax basis. The law’s exchanges subsidize many without an offer of “affordable” employer coverage. But its regulations also force families to buy coverage they don’t need and may not want, causing premiums to soar. Rates more than doubled in the law’s first four years, and continue to rise more sharply than employer plan premiums. The enhanced subsidies Congress enacted beginning in 2021, which make premiums “free” for nearly half of enrollees, have encouraged massive fraud, as the Congressional Budget Office and others have documented.

The Trump administration’s HRA option provides a better way forward for many stuck in the ObamaCare morass. Workers whose businesses offer HRAs receive a free choice of insurance plans, a portable policy they can take with them from job to job, and a total tax savings (federal, state and payroll) that I estimate at 25% to 35% of the premium.

Those tax savings could come in handy if the enhanced ObamaCare subsidies expire as scheduled on Dec. 31. As I noted in these pages, while most households will face a modest financial impact of roughly $50 to $100 a month, households with incomes exceeding four times poverty will no longer qualify for subsidies, and families making just above that threshold could face thousands of dollars in heightened costs. Yet a recent survey found that fewer than 1 in 5 small firms not offering health coverage are likely to offer an HRA option in the next two years.

Conservatives rightly concerned about the cost and fraud associated with extending the enhanced ObamaCare subsidies should embrace HRAs as a better alternative. President Trump should work with the National Federation of Independent Business and other small-business groups to promote greater awareness about HRAs among their membership. Republican lawmakers should do the same in their districts. Lawmakers could also consider whether to codify the 2019 HRA rule or incorporate HRA-related tax incentives in a possible second budget reconciliation bill.

The Gospel of Matthew advises Christians to not hide their light under a bushel basket. Yet rather than trumpeting a major healthcare achievement, many congressional Republicans have run away from discussing the issue. In health reimbursement arrangements, the first Trump administration gave conservatives a tool to expand portability and affordability in ways superior to another ObamaCare bailout. They should do far more to promote it.

This post was originally published at The Wall Street Journal.