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After 18 months of waiting for health care reform to play out, employers find themselves in a very challenging cost position for 2011,” said Ken, Hewitt’s health care practice leader. “Reform creates opportunities for meaningful change in how health care is delivered in the U.S., but most of these positive effects won't be felt for a few years. In the meantime, employers continue to struggle to balance the significant health care needs of an aging workforce with the economic realities of a difficult business environment. While health care reform cannot be blamed entirely for employers’ increasing cost, the incremental expense of complying with the new law adds fuel to the fire, at least for the short term.