The Patient Protection and Affordable Care Act comprehensively reforms health care financing and delivery in the United States. Because the law relies on existing market structures, such as private sector health insurance carriers and employer-sponsored group health plan coverage, employers are particularly concerned with the act’s “employer shared responsibility” (aka “pay-or-play”) rules. In December 2012, the IRS issued comprehensive proposed regulations on the subject. Consistent with its prior practice, the IRS held a public hearing on April 23 to hear firsthand the concerns of interested parties. While the act imposes many new requirements on employers that sponsor group health plans, none is more important or costly than the employer shared responsibility rules.

Testimony provided at the April 23 hearing, along with more than 100 public comment letters filed to date, will inform the content of final regulations that will have significant, long-term consequences for employers (whether or not they offer group health plan coverage).