Top 5 Affordable Care Act Concerns for Small Businesses Small businesses spend an average of 13 hours, or $1275, a month in order to keep up with Affordable Care Act (ACA) compliance. Unfortunately, even with this solid investment, small employers are still coming up short on compliance delivery.Read more … Posted on November 2, 2015 by Compliagent and tagged Compliance Healthcare ACA OIG California Medicare Skilled Nursing Long Term Care small businesses healthcare compliance news. Comment