Fortune 500 companies want the health care reform law to give them sustainable costs and healthy employees. How big employers now control costs will depend on the Supreme Court’s ruling on the individual mandate, and how people vote in November if the Court upholds the mandate. A Republican sweep would probably mean the Affordable Care Act’s repeal. If the law survives, employers will have a few options for controlling health care costs. One is to stop providing coverage and let employees but on the new exchanges. Another option would be to maintain coverage but raise co-pays or limit the number of specialists in the network. If many employers choose either option, the ACA finances wouldn’t work as intended, and the program would have to be altered.