When Sandy Beall founded Ruby Tuesday 40 years ago, the restaurateur made the decision to provide health benefits to all of his employees, even as the chain has grown to some 35,000 workers worldwide."That's one thing that sets us apart from others. Sandy has always believed everybody should take care of their own, so we always have. But we think all companies should be on an even playing field," said Belinda Sharp, vice president of human resources for Ruby Tuesday.

Under sweeping changes to the nation's health care system through the Patient Protection and Affordable Care Act, companies with 50 or more full-time employees will be required to join in the game beginning in 2014, when they'll have to provide coverage or face penalties. Part-time employees must be offered benefits if they work 30 or more hours per week.

While some businesses like Maryville-based Ruby Tuesday say they don't expect to see much impact, others are bracing for changes that will be mandated over the next two years.

Businesses varying from restaurants and indoor tanning salons to medical device companies and a craft hobby chain have come out nationally against the legislation, which mandates new tax and regulatory requirements.

They argue that the health care overhaul will stifle business and economic growth by discouraging expansion, cutting worker hours and raising prices to cover additional costs.

But there is one thing on which businesses agree many unresolved questions remain.

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Russell's Pest Control employee J.P. Wellens performs a quarterly service call on a customer's home in Knoxville on Jan. 11. The small, family-owned business doesn't meet the employer mandate that requires it to offer health benefits, but owner Mark Nadolski said he feels that he must to stay competitive. AMY SMOTHERMAN BURGESS/ NEWS SENTINEL

For the restaurant industry, such uncertainty creates zero job growth, said Greg Adkins, president and CEO of the Tennessee Hospitality Association.

A vast majority of the statewide trade organization's more than 1,000 members have concerns with the law, he said. The restaurant industry operates under low profit margins and with a high number of part-time employees.

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Health care reform: Knox area businesses bracing for health care changes