Starting in January, the Affordable Care Act will require businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it. For some business owners on the edge of the cutoff, the mandate is forcing them to weigh very carefully the price of growing bigger.

According to a new Mercer study of 134 large employers (5,000 or more employees), 15% say that their onsite or near-site worker clinics will push them into the bracket where they will be required to pay the Cadillac Tax. But most of the respondents, 46%, either didn’t know how the clinics will affect their Cadillac tax status or didn’t think there would be an effect (28%).

From November 15 to December 15, a small business that purchases a plan in the Obamacare-created Small Business Options Program marketplace does not have to meet participation requirements, which require that businesses with up to 50 employees ensure that at least 75 percent of their employees enroll. The annual window comes at a time when small businesses haven’t taken to the Small Business Health Options Program, or SHOP, created to offer more plans for small businesses.

Yesterday’s post discussed what we know about Obamacare as its third open enrollment season commences. Here are four major questions about the future of Obamacare that remain unanswered.

Longtime opponents of the ObamaCare “Cadillac tax” met with lawmakers this week with a new message: We’re willing to compromise. In a fly-in visit with key members and committee staff, employer benefits lobbyists went in seeking a more politically viable solution than full repeal. Rather than eliminating the tax entirely, they pitched exempting the contributions that are made to employers’ health savings accounts, which could otherwise be subject to the 40 percent excise tax.

It’s crunch time for thousands of small business owners who must comply with requirements of the health care law for the first time.

Companies with 50 to 99 full-time employees must offer affordable insurance to employees and their dependents starting Jan. 1. They must also file tax forms with the government by Jan. 31 detailing the cost of their coverage and the names and Social Security numbers of employees and their dependents. While companies of all sizes are subject to the law must file the forms, smaller businesses without big staffs to handle the paperwork may have to hire someone to do it — at a cost of hundreds or thousands of dollars.

President Obama signed a small but significant bill this week that rolls back a requirement in his signature health law, the Affordable Care Act. Last week, Congress voted on bipartisan lines to repeal a small group insurance markets rule that was slated to go into effect in 2016. Many business groups said that without the change, premiums would have gone up for millions of workers.

Enactment of the bill was a small victory for Obamacare critics, but it could also pave the way for new, piecemeal approach to repealing Obamacare.

Ike Brannon is offering a full-throated defense of the Cadillac tax over at The Weekly Standard. He fully concedes that Obamacare is “replete with bad policies.” But he would have us believe “the so-called Cadillac tax is not one of them.”

“A different health care issue has emerged for Democrats, in sync with the party’s pitch to … middle-class voters … high out-of-pocket costs for people already covered. Democrats call it ‘underinsurance.’ After paying premiums, many low- and middle-income patients still face high costs when trying to use their coverage. … [T]he value of a health insurance card is being eaten away by rising deductibles … Several liberal-leaning organizations have recently focused on the issue.”

Obamacare has enmeshed many Americans in a bureaucratic nightmare. True, the law has helped some uninsured people obtain coverage. But millions of people have seen their health-insurance plans canceled, because the plans did not meet the requirements of the Affordable Care Act. Others, particularly young Americans, have seen premiums rise to pay for the roster of newly added benefits. Tommy Groves (not his real name), a young professional working at a small firm in Washington, D.C., was among the nearly 5 million Americans who received termination-of-coverage letters from their health-insurance providers because their plans did not comply with the ACA’s requirements. While about half the states offered to extend canceled plans for another year, later increased to two years, the District of Columbia required its residents to get new insurance.

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