It has led universities to bludgeon the largest part of their work force so that they don't have to provide them health care.
Over the last thirty years all colleges have largely morphed from a tenure model to the model used by for-profit colleges: high churn through the use of adjunct instructors.
Consequently, almost every college in America has cut or will cut the hours of non-tenure track or tenure-track faculty so that they don't have to provide them with health care.
That said, cutting someone's hours to deny them coverage that should be a right anyway is not a flaw of the law itself, but of universities treating themselves like corporations.
A great shot is when you pull it off. A smart shot is when you don't have the guts to try.