On March 9, Health Affairs published a brief by the Robert Wood Johnson Foundation (RWJF), examining health reform’s employer insurance mandate.  Health reform requires employers with 50 or more employees to pay the federal government if they do not offer comprehensive and affordable health coverage.  The brief explains the measure and explores potential scenarios resulting from its implementation.  Beginning in 2014, affected employers that do not offer coverage must pay the federal government.  The law does not require payment for the first 30 employees; however, employers must pay $2,000 for each subsequent employee.  In addition to offering coverage, affected employers must pay at least 60 percent of employees’ health care costs and ensure that employees' costs do not exceed 9.5 percent of their household income.  Employers whose coverage does not meet these standards must pay the federal government $3,000 for each employee that opts out of employer-sponsored coverage to purchase coverage through a health exchange.  The brief also explores the possibility that Congress will repeal the measure, examining current legislation (S. 20) as well as other potential changes.

From the report: 

To expand access and strengthen the employment-based health system, the Affordable Care Act of 2010 will require midsize and large companies to make payments to the federal government if they do not offer health insurance to their employees and dependents starting in 2014. This employer requirement is a controversial and high-profile element in the law.

Supporters maintain that the "play or pay" requirement will help strengthen the existing employment-based system by giving more workers access to improved health coverage. Critics say that the requirement will drive up businesses' costs, and a handful of large employers have said that making the extra tax payments would be less expensive than continuing to provide health coverage to workers.

Full Report: Employers and Health Care Reform 

Health Affairs. (2011). Employers and health care reform.