Sixty-one percent of businesses expect to pay more for their workers’ health coverage when the Affordable Care Act fully takes effect in 2014, according to a survey of 1,203 companies conducted by Mercer. The survey found that 20 percent of respondents said they expect their costs to increase by at least 5 percent.

Under the health reform law, employers with 50 or more full-time employees must offer affordable and qualifying coverage. If an employer fails to offer the benefits or if even one worker is forced to depend on government subsidies to purchase insurance, the employer must pay a penalty.

The Mercer survey reports that 25 percent of respondents expect to make changes to their health benefits plans to avoid the penalty, and 6 percent anticipate potentially dropping health coverage because of the ACA.

About 20 percent of respondents said they would hire workers who would eligible for Medicaid under the law’s expansion. However, many states have yet to make a decision on whether they will participate in the expansion. Although the majority of employers said they are prepared to meet the requirements of the ACA provisions, 11 percent are delaying preparations until after the November elections.