Yes, the expense to a company like Wal-Mart is staggering. The hardest hit companies for additional expense b/c of ACA are the 15 industries that use minimum to low wage labor to deliver their product or service. First in many of these firms the employees were never eligible for the insurance before ACA ( Fast Food, Janitorial, Security Guard, Landscaping, Retail, Home Health Care Etc.) To look at the economics of the situation say a janitorial contractor has 1,000 janitors that previously were not qualified for insurance. An average single POS plan in the US is $389.00 per month. The most you can charge a janitor is 9.5% of lets say 8.00 / hour for 130 hours a month ( ACA Safe harbor ) or $98.80 per month leaving the company to pay 290.20 for each janitor that chooses to but the insurance. Even at 8.00 an hour wage 25% of the newly eligible janitors will but the insurance so 290.20 * 250 = $72,550 per month or$870,600 a year of new expense to the janitorial firm. This is a huge problem b/c a company with 1,000 janitors doesn't make $870,600 profit a year ( I am in the business, I know that ). There is one company that we found that figured out a solution, it is called Speyer Meridian. Somehow they found a way to write a "gold" plan for minimum to low wage employees at 9.5% of the state minimum wage and they charge the employer an administration fee only. We though it was BS and impossible but we fully investigated it and put it in for our janitors and it is legit. CIGNA is the claims payer and it is exactly as it was represented. I am the HR manager of the company and don't have all of the details but somehow the company came up with a privatized Medicare system that works. Our lawyers checked it out - it met all qualifications of ACA and our company is now compliant and our janitors love the insurance product. If you are interested I'm sure you can find them on the web. Hope this helps - this issue drove me nuts for 2 years.