My startup is still under 50 employees and the ACA has significantly increased our costs. We already offer generous healthcare benefits so the only thing that has changed is that we spend a lot more money under the new laws. The other option was to pass the steep cost hike on to the employees. This is not unique to my startup either.
For all the talk about how this law is supposedly great for startups, everyone I know has had the opposite experience in practice.
Traditionally, i was under the impression that it was a company intending to have an IPO that has yet to do so.
I'm aware that modern understandings differ.
In the past, you could sometimes defer some of your healthcare costs by offering only high-deductible plans. You could offer policy choices with higher copays. You could even incentivize employees to drop coverage altogether.
Is any of that untrue, or bad for a company to do? Absolutely not. If I say to an employee, "Which would you rather have - a $70,000 salary with a $5,000 deductible health plan, or a $60,000 salary with a no deductible plan?", which one will they choose? Hell if I know in advance - that's up to each employee. I've offered them the same basic thing and let them choose what fits them the best. I fail to see how that's "bad".
Get off your high horse.