PPACA is the Obama-care for those who don't know.
Now consider this -- the PPACA sets forth a "fine" (tax) of $2,000 per employee for a business that has 50 or more and does not provide "at least" the minimum "insurance" to all.
There is no health care plan I'm aware of that a business can buy today that costs less than $2,000 per employee per year, and which also meets the requirements in the law. None. That was almost impossible to meet back in 1995 for a healthy, 18 year old insured single male. It's flatly impossible now and it's doubly-so if your workforce has other than 18-year old single, healthy males in it. I know this to be factual because I was responsible for buying it for our employees as a CEO of a company.
Therefore the incentive is for all businesses to drop health care.
Second, your choice is to either (1) buy and have said plan (whether through employment or individually) or pay a "fine" (tax) of 1% of income (increasing to 2.5% of AGI in 2016.) The minimum "fine" is $95 starting in 2013, rising to $695 in 2016. The average family income is about $50,000/year, which means that the fine (tax) will be $1,250 in 2016. It's less now.
You cannot buy health insurance at their "minimum level" for anything approaching $1,250 a year no matter how healthy you are at any age.
The law prohibits insurance companies from charging you more if you're sick, or refusing to cover you at all. They must accept everyone on equal terms.
will drop coverage; it's cheaper (by far) for them to pay the fine and,
for those under 133% of the federal poverty level, those employees can go onto Medicaid. This is a "family of four" income of $31,900 (as of today; it will go up of course.) That's roughly the second quintile.
- Individuals will drop coverage and pay the fine, since it's far cheaper than to buy the "insurance."
The cost of "insurance" will thus skyrocket to 10x or more what it costs now, just as it would if you bought auto insurance only after you wrecked or homeowners insurance only after you had a fire.
At the higher price nobody will be able to afford to buy the insurance at all, since that will be indistinguishable from just paying for whatever is wrong with you, plus the insurance company markup.
In very short order the entire medical system and health insurance scheme will collapse, leaving only two choices -- either a return to free market principles (including all I've argued for since this debate began) or a single-payer, fully-socialized system ala Canada.
You can bet the government will continue to try to change the terms of the deal -- including ramping up the tax/fine and other games, to prevent this outcome, but they will fail.