Odds on the impending battle over healthcare legislation shifted this month when Wal-Mart Stores–the largest private employer in the United States–came out in support of healthcare reform. In a letter to President Barack Obama, the giant retailer argued that healthcare costs are a "burden that is crushing America's businesses." Wal-Mart said changes to healthcare should center on "payment reform and efficiency initiatives," and it called for an employer mandate that is "fair and broad in its coverage," adding, "Not every business can make the same contribution, but everyone must make some contribution."

Meanwhile, a survey of 329 companies by human resources consultancy Mercer confirms the likely sticking points: 52% oppose requiring employers to offer coverage, and 59% oppose placing limits on the current tax exclusion for employer-provided health benefits. Just 11% of the companies say they are in favor of enacting comprehensive healthcare reform this year, while 67% prefer phasing in changes to the healthcare system.

The survey respondents did echo Wal-Mart's interest in improving the healthcare system, though. Sixty percent say their highest priority is "to improve health care quality and efficiency," and 50% favor insurance market reforms like requiring insurers to offer individual coverage and eliminating policy features such as exclusions of pre-existing conditions."