Reports of the death of the so-called “Wal-Mart” health care bills may have been somewhat exaggerated, health policy experts say.
Although advocates of the bills have suffered setbacks in recent weeks, lawmakers may continue to introduce and reintroduce new versions of the bills for years to come, says Janice Kupiec, director of state affairs at the National Association of Health Underwriters, Arlington, Va.
“People may keep at it,” Kupiec says.
The Wal-Mart bills are bills that would require all large employers in a state to provide health coverage to all employees, or else pay the state a tax or fee.
Unions, consumer groups and other advocates are calling the bills “fair share” bills and employer groups are calling the bills “employer mandate” bills.
But Wake-Up Wal-Mart, a group affiliated with the United Food and Commercial Workers International Union, Washington, that is helping to spearhead a campaign to introduce the large-employer coverage bills in more than 30 states, is focusing on Wal-Mart Stores Inc., Bentonville, Ark., on its website. And the labor market in some states, such as Maryland, is structured in such a way that the large-employer mandate bills apply only to Wal-Mart.
Bill advocates frightened the employer groups in January, by persuading Maryland lawmakers to pass the Maryland large-employer coverage bill, H.B. 1284, over the veto of Gov. Robert Ehrlich.
Since then, employer groups such as the Retail Industry Leaders Association, Washington, and the National Federation of Independent Business, Nashville, Tenn., seem to have succeeded at killing the large-employer coverage bills in Colorado, New Hampshire and Washington.
RILA has sued to block the Maryland large-employer coverage law in the U.S. District Court in Baltimore. RILA is arguing the law violates the Employee Retirement Income Security Act, which preempts state regulation of employee benefit plans.
“The tide is beginning to turn in this debate,” RILA President Sandy Kennedy says in a statement. “State policymakers are seeing through the union smokescreen and recognize these laws for what they: Terrible public policy that does nothing to address real health care challenges.”
But Maryland lawmakers now are debating H.B. 1510, a bill that would require all employers with more than 1,000 employees to spend at least 4.5% of payroll on health care.
At press time, Florida, New Jersey and New York had just started considering their large-employer coverage bills, and large-employer coverage measures could surface as ballot initiatives in Oregon and Washington, Kupiec says.
Even if all or most of the remaining large-employer coverage bills die, lawmakers could keep resurrecting them for years to come, she says.
Kupiec says she is keeping an especially close eye on states’ efforts to count the number of Medicaid and Children’s Health Insurance Program plan members in households with at least one adult who works for a large employer.
Unions got the idea of attacking Wal-Mart in part because it showed up at or near the top of some states’ rankings of employers of employed beneficiaries of Medicaid and CHIP plans.
In Massachusetts, for example, a state study shows that 6,146 Wal-Mart workers and Wal-Mart worker dependents get health coverage from Medicaid and CHIP plans. Wal-Mart is the employer of more working Medicaid and CHIP plan members than any other employer in the state.
The New Jersey Senate voted 36-0 in February for S. 539, a bill that would require the New Jersey human services commissioner to identify companies that employ large numbers of residents who get coverage through NJ FamilyCare, New Jersey’s CHIP plan.
The state rankings could be misleading: Some residents may have had Medicaid coverage early in the year and lost it later in the year when they began working for the employers listed. Other residents may be in transitional programs for recent welfare alumni or other special groups.
But state lawmakers’ interest in identifying employers with large number of employees receiving public health benefits bears close attention, Kupiec says. “I don’t think that’s going to go away.”
The UFCW and other groups promoting the large-employer coverage bills, such as the AFL-CIO and the Service Employees International Union, both of Washington, say giant employers should provide health coverage for employees because it’s the right thing to do.
“In our America, corporations live up to their responsibility and provide their employees with adequate and affordable health care coverage,” says Wake-Up Wal-Mart.
Roughly 7% of workers at employers with more than 100 employees have no health coverage at all, according to a study cited by Wake-Up Wal-Mart.
The UFCW and the SEIU recently broke away from the AFL-CIO.
Edmund Haislmaier, a health policy lobbyist, has speculated in an analysis for the Heritage Foundation, Washington, a conservative think thank, that unions may be trying to use the large-employer coverage campaign to show that they can outlobby one another.
A Wal-Mart spokesman declined to be interviewed for this article.