Abstract
The Affordable Care Act (ACA) was the signature accomplishment of President Barack Obama in 2010. The ACA was officially launched as active in 2014. The primary objectives of this law is threefold: (1) to reform the private insurance market—especially for individuals and small-group purchasers, (2) to expand Medicaid to the working poor with income up to 133% of the federal poverty level, and (3) to change the way that medical decisions are made. Embedded in the 1296-page ACA are mandates, tax credits, provisions, exemptions, and requirements. Small businesses under 50 employees are affected by the ACA if they approach and eventually breach 50 employees, but there are many more aspects involved when discussing the ACA and small businesses. Specifically, the decision for organizations under 50 employees to offer or not offer health care benefits to its employees is complicated and dependent upon various factors such as cost, regulations, benefits (ROI), and acting upon what is expected as employers. The ACA has challenged employers and employees to examine their respective roles and positions related to providing and receiving health care benefits. Assisting with these discussions is the federal government and the free market. Adding to the decision-making process is the 111th through the 116th United States Congress which is designed to be focused on the best interests of the employee and employer in a free market society. The reactions, organizational implications and responses to the new health care law (ACA) on companies with fewer than 50 employees is interesting and worth learning more about through reading this study.