Health care costs and the Affordable Care Act are top concerns for midsize businesses, according to a survey conducted by ADP Research Institute. Sixty-nine percent of the 756 businesses surveyed are “very concerned” or “extremely concerned” regarding the cost of health care and other benefits.

The recently released Midsized Business Owners Study, which surveyed owners and executives at companies with 50 to 999 employees in July and August, found that 54% are concerned about the ACA — a 5% drop from last year. However, comprehension is a major problem for employers. The study found that less than 25% “are confident that they have the tools and information needed to make the decisions about the best health and benefits strategies for their companies.”

Proposed changes

Meanwhile, a massive number of proposed changes doesn’t make understanding the ACA any easier — there were 19,000 just last year, according the study, now in its third year. Advisers who have not done so already would do well to position themselves as health reform experts, particularly as the study found a majority of companies remain idle with respect to the health care law. “Two years after the U.S. Supreme Court upheld the constitutionality of the ACA, more than half of midsized businesses still don’t have plans in place to manage it,” the study said.

The level of government regulation was another concern for just over half of the midsized businesses surveyed. One third of businesses say they paid fines for failing to comply with government regulations, but half of those owners don’t know the total penalties they paid. This year, business owners were fined four times on average, the study said.

The study also found a wide discrepancy when it comes to our economic future — 51% surveyed expect their specific industry to improve in the next year, while just 15% believe the overall economy will improve during that time. 

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