Talk of some kind of “national solution” for small business health coverage costs surfaced here recently at a hearing on state efforts to require employers to provide health coverage.

The employer-employee relations subcommittee at the House Education and the Workforce Committee organized the hearing to review whether the Maryland “fair share” bill, which requires companies with more than 10,000 employees to spend at least 8% of payroll on health coverage or pay a similar amount to the state, makes sense.

Rep. Sam Johnson, R-Texas, the subcommittee chairman, and other Republicans at the hearing criticized Maryland’s fair share bill.

“In Maryland, some believe that employers must be forced, not only to provide health coverage to their employees, but to provide a specific level of benefits,” Johnson said. “Mandating certain health benefits on one company from a state capital is not freedom and free enterprise, and I’m very concerned about what that would mean for people in the future.”

Rep. Patrick Tiberi, R-Ohio, pointed out that the new Maryland law includes an exemption for state and local governments. Many of Maryland’s government employees have no health coverage, Tiberi said.

Rep. Donald Payne, D-N.J., the most senior Democrat, said Maryland and other states are simply trying to fill the vacuum left by congressional inaction.

“I would love to see Congress do something to really address the rising cost of health care, and find creative ways to cover those people who can’t afford it,” Payne said. “But until that happens, we must not stand in the way of the states that are working hard to come up with ways to provide their citizens with quality, affordable health care.”

New Jersey is considering legislation similar to Maryland’s, Payne noted.

One witness, Mila Kaufman, a researcher from the Georgetown University Health Policy Institute, said letting some companies rely on taxpayers to pay for employees’ health care is anticompetitive.

“It is very unfair for some employers to send their workers to government programs and not pay for it,” she said.

But Paul Kelly, senior vice president of federal and state government affairs at the Retail Industry Leaders Association, Arlington, Va., said the new Maryland law “doesn’t do anything to reduce health care costs” or do much to help those without coverage.

The law requires employers to pay more for the coverage they already sell and gives state lawmakers “a convenient way to say they’re doing something,” Kelly said.

Lawmakers found retail and small business witnesses were open to hearing about proposals for a “national solution” to rising health coverage costs.

Kelly said he would not endorse such an expansion, but he said the idea “ought to be explored.”

Larry Drombetta, president of HR Stores Inc., Owings Mills, Md., a chain of shoe stores, said in response to a question that the government might consider expanding Medicare to provide coverage for workers.