States Looking at Myriad Ways to Get Business to Cover the Uninsured

Well-publicized bills in Massachusetts and Maryland that would force employers to pay part of the cost of coverage for the uninsured are just the tip of the iceberg.

The HR Policy Association, a lobbying group for senior human resources executives, says that bills are pending in 30 states that would require employers to foot at least part of the cost of health-care coverage.

Getting the most attention is a Maryland proposal that has passed the state senate and is expected to become law. It would require large employers to spend at least 8 percent of their payroll on health insurance benefits, or contribute to the state’s health insurance fund for low-income residents. It applies to employers with at least 10,000 employees in Maryland. Wal-Mart employs 15,000 in the state.

According to the Washington Post, Wal-Mart said a year ago that it spent about 5 percent of its payroll on health benefits. Wal-Mart now tells the Post that it spends 7 percent to 8 percent.

Another bill, in Massachusetts, would charge employers who do not provide health benefits the amount that the state is paying to insure the company’s employees, according to Business Insurance.

Variety of possible rules
The HR Policy Association divides the state health insurance proposals into three categories:

Mandates: Like the Massachusetts and Maryland legislation, these would require employers to pay for health care coverage, either directly or indirectly. In some locales, politicians want employers that don’t provide health benefits to pay higher wages to employees. In Nevada, for example, Democratic Assemblywoman Christina Giunchigliani wants to mandate a $6.15 minimum wage for employers who don’t provide health benefits and $5.15 for employers who do provide benefits.

Contract conditions: New Jersey, Texas, Washington and other states are considering bills that would provide preferences to employers that provide health care when the states award government contracts and tax breaks. In Mississippi, for example, Democratic Rep. Percy Watson wants to require employers who would benefit from a state loan program to provide health insurance to their employees within 180 days of receiving the loan.

Reporting: These bills, introduced in some form in at least 20 states, require that a public report be issued showing how many of a company’s employees are receiving Medicaid or similar assistance. These proposals are aimed more at shaming employers than in sticking them with a financial mandate, the HR Policy Association claims.

Marisa Milton, associate general counsel and director, government relations for the HR Policy Association, says employers are fighting these initiatives using in-house lobbying teams as well as state lobbying groups, such as state chambers of commerce. “Employers are very wary of any mandates,” Milton says. Legislation is being proposed frequently, and the association is fielding numerous requests from employers trying to keep up with what’s happening in so many different legislatures. “It is so fragmented,” she says. “There are so many moving pieces.”

U.S. Rep. Chris Van Hollen (D-Maryland) may introduce a bill that would mandate a federal health-spending requirement on businesses, much as Maryland is doing on the local level. With Republicans controlling the presidency and both house of Congress, passage of such a federal law is unlikely.