The federal government delayed a mandate that applies to employers who have 50 to 99 employees until 2016, Field said, explaining that the requirement aims to discourage employers from dropping coverage. 

Field said, however, that some employers have converted some full-time employees to part-time status in an effort to evade the law’s requirement to provide health insurance to full-time workers. 

“That is perhaps the most vulnerable point, the Achilles heel of the whole law,” Field said, noting that police departments and school districts have put employees on part-time status in order to get around the mandate. 

Field and University of Pennsylvania Perelman School of Medicine Professor David Grande discussed efforts in Pennsylvania and other states to implement the law in ways that challenge the federal law’s aspirations. 

Grande said Pennsylvania Gov. Tom Corbett’s proposal to require Medicaid recipients to seek insurance through the private sector has been implemented in Arkansas and other states, while his bid to force Medicaid recipients to prove that they are seeking employment is unprecedented. 

“Corbett could be putting a poison pill in it, knowing that the feds are not going to approve the work requirement,” Field said.  “He’s certainly pushing the limits here, and there will be intense bargaining over it.” 

Pennsylvania and some other states are pushing back against the law’s policy objectives in order to pacify conservatives, Field said.  

“It’s an ideological battle,” Field added, “between wanting to take the money and not wanting to expand the government’s direct involvement.”