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Health Care Reform

Health Care Reform

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Support Workforce Investment

The NRF Retail Opportunity Index encourages Congress to support workforce investment by supporting jobs and economic growth rather than union organizers and expensive new regulations and mandates. Learn more.

The Issue

With insurance premiums skyrocketing for years, NRF has long advocated reform that would make health care more accessible by making it more affordable. Instead, the Affordable Care Act does little to reduce costs and emphasizes mandates that will drive up expenses for employers. Since the beginning of 2015, businesses with 100 or more workers have been required to provide insurance to full-time employees at coverage levels determined by the government, and the requirement will apply to businesses with 50 or more employees beginning in 2016. The costs of the mandates are so high that some retailers could be forced to stay under the 50-employee threshold in order to avoid being covered; others could have to cut workers’ hours so they won’t count as full-time.

Why It Matters to Retailers

While retailers will see the same added payroll costs as other industries, compliance will be particularly complicated because of the nature of retail’s workforce. Retailers employ not just permanent, full-time workers, but also a large number of part-time, seasonal and temporary workers. Certain provisions of the law, such as its 30-hour definition of full-time and a requirement that insurance be provided within 90 days of being hired, could prove problematic under those conditions. As an industry with extremely tight profit margins, retailers will not be able to absorb the added costs, and could be forced to lay off workers.

NRF Advocates for True Health Care Reform

NRF has long been committed to helping find a solution, and proposed a comprehensive health care reform plan in 2008. While some elements supported by NRF can be seen in the Affordable Care Act, NRF opposed passage because of the law’s failure to adequately address health care costs and its job-killing employer mandate. NRF has worked to repeal the most onerous provisions of the health care law, such as the employer mandate, but those efforts have not yet succeeded. In the meantime, NRF leads a number of coalitions on health care reform and is focusing on efforts to smooth implementation and help retailers with compliance. Among other measures, NRF supports legislation that would define full-time as 40 hours rather than 30, and a bill that would have the law apply to businesses with 100 or more employees rather than 50.

Additional Resources

  • The infamous portal to the Federal Fallback Marketplace (exchange). Online marketplace for individuals and businesses with 50 or fewer employees.


Affordable Health Benefits Coalition – NRF-chaired coalition of allied business interests focused on the cost of medical care and health insurance coverage.

Employers for Flexibility in Health Care Coalition

Coalition letter to the IRS on ACA employer reporting mandates  

Washington Council Ernst & Young’s reference deck on ACA employer requirements

The Affordable Coverage Project – Coalition working to repeal the ACA health insurance tax

Diverse viewpoints

Alliance for Health Reform’s Employer Mandate of the Patient Protection Affordable Care Act Toolkit 

The Galen Institute 

The Brookings Institute