School administrators in Dothan, Ala., aren’t sure whether health act rules taking effect next year will require them to offer medical coverage to substitute teachers, who lack it now.

But they aren't waiting to find out. The system has decided to hire subs through Kelly Services, a temporary staffing agency, to avoid any health-cost obligations that might come as their direct employer.

The district pays about $700 per month per full-time teacher for medical insurance. "You multiply that times 300 [substitutes] and you've got a big expense," said Dell Goodwin, personnel director for Dothan City Schools.

The rush to implement the Affordable Care Act, which is generating billions for insurers, hospitals and technology vendors, also looks like a boon for staffing companies, whose share prices have soared. But some suggest that exceptions for temporary employees could leave holes in the health law’s expanded coverage.

"That could lead to an increase in part-time workers" who lack insurance, said Susan Houseman, an economist at the Upjohn Institute for Employment Research who studies staffing companies. "You regulate something and people will always try to find a way around the regulation."

Starting in January, employers with at least 50 workers must offer affordable coverage or pay a penalty. Some are considering outsourcing jobs to specialists such as Kelly, Manpower, Robert Half and Randstad to stay under this limit.

"We are already getting inquiries from our client base for companies in and around 50, asking us to help them understand this legislation, and to inquire as to how we might be helpful," Keith Waddell, Robert Half's president, told investors on a conference call a few weeks ago. "Our response is that we can legally help them remain under 50."

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