When the law was written, advocates hoped the employer requirement would help reduce the ranks of the uninsured. Some employers have indeed said they would offer insurance to additional workers, but others have gone in the opposite direction.
Virginia's situation provides a good lens on why. The state has more than 37,000 part-time, hourly wage employees, with as many as 10,000 working more than 30 hours a week. Offering coverage to those workers, who include nurses, park rangers and adjunct professors, would have been prohibitively expensive, state officials said, costing as much as $110 million.
"It was all about the money," said Sara Redding Wilson, director of Virginia's Department of Human Resources Management. "If we could cover everyone, we would."