And that has been intensified by several changes that have been made to the law's requirements. For instance, the deadline for employers with 50 or more full-time workers to begin offering affordable coverage has been pushed back and tweaked a few times. That buys companies time but also forces some to revisit and adjust their plans.
"Nothing about this law is simple," said Don Susswein, a principal at McGladrey LLP, which does benefits consulting for medium-sized employers.
The overhaul hasn't fazed many companies, especially those in industries that must provide attractive benefits to attract and keep highly skilled workers. Tech giant Google Inc., which ranks among the nation's best places to work, said it hasn't had to make any significant changes to its health benefits to adhere to the law.
The law requires that employer-sponsored plans cover at least a certain percentage of expected health care costs, and more than 80 percent of companies surveyed by Mercer said they already meet that threshold.
But while the overhaul hasn't had much of an impact on the coverage now offered by many companies, that could change. Some will have to adjust their plans in the next few years to avoid a tax on expensive plans that starts in 2018. That means they may raise out-of-pocket costs for employees to lower the plan's overall cost.
HELPED BY THE LAW
Companies with fewer than 50 employees can send their workers to insurance exchanges to find coverage and, in some cases, receive tax credits for doing so. This can be a recruitment or retention benefit for companies that can't afford to offer coverage.
The 1-800-Got-Junk? franchisee said rates for coverage he was providing were scheduled to jump 65 percent this year. So he sent employees to exchanges to find coverage and offered to continue paying half the premium, or coverage cost. He projects savings of $3,000 to $4,000 annually — significant for a company with $500,000 to $1 million in annual revenue, he said.
Bigger companies also can save by sending employees to exchanges. Western Communications Inc. dropped coverage for its 280 employees this the year after the newspaper publisher had more than $2 million in health care claims last year. Employees can go to exchanges, where they may be eligible for subsidies to help pay for care.
President Gordon Black said the decision was made even though a company of Western's size likely will face a fine — which can total $2,000 per employee for most workers — for not offering coverage.
"We'll cross that bridge when we come to it," he said.
AP writers Joyce Rosenberg and Anne D'Innocenzio in New York and Michael Liedtke in San Francisco contributed to this report. Murphy reported from Indianapolis.