Bill would require all Md. employers to offer their workers health coverage

February 05, 1994|By John W. Frece | John W. Frece,Sun Staff Writer

General Assembly leaders are drafting a bill that could require all employers in Maryland to offer their employees health insurance.

Under the proposal, which has not received the full support of Gov. William Donald Schaefer and is expected to be controversial, employers would not be asked to pay for the insurance or administer it.

The idea, backers in both houses say, is to make insurance more available to an estimated half-million people who are now uninsured and, possibly, to make it more affordable.

The proposal also is intended to position Maryland so that its health care laws have a better chance of surviving if Congress passes a national health care reform bill.

The emerging legislation has the backing of House Speaker Casper R. Taylor Jr., D-Allegany, Senate Finance Committee Chairman Thomas P. O'Reilly, D-Prince George's, and Nelson J. Sabatini, the state health secretary.

It does not go as far as President Clinton's proposal, which would require employers not only to offer insurance, but also to pay 80 percent of the premiums. The plan is more like one being pushed by U.S. Rep. Jim Cooper, D-Tenn., which would require employers to offer their workers insurance, but not necessarily pay for it. That also is consistent with the position of the National Governors' Association.

"The whole name of the game is universal access and cost-containment," said Mr. Taylor, who was the primary mover behind a major health care reform law enacted by Maryland's General Assembly last year.

This year's legislation would also expand on last year's law by extending many of the reforms affecting small businesses to individuals who are self-employed or whose employers do not offer insurance coverage.

Details of the legislation have not been ironed out, and Mr. Sabatini said that Mr. Schaefer has not yet approved a final bill. He said the governor had agreed that last year's reforms -- such as guarantees that policies will be issued to any applicant and that such coverage will be renewed upon expiration regardless of the health of the insured -- should be extended to the "individual market."

But he said it was not clear whether Mr. Schaefer would go along with mandating that employers offer insurance or whether he prefers setting up four regional insurance purchasing cooperatives that would serve as intermediaries between insurers and the insured.

"It's one or the other," Mr. Sabatini said. "You don't need both."

The health secretary said that he did not know what businesses would say about such a new mandate, even if there was no financial or administrative requirement attached.

Miles Cole, a spokesman for the Maryland Chamber of Commerce, said he could not suggest how businesses might respond to the bill until he and they see the details of any proposed legislation.

According to a January 1994 study by the Employee Benefits Research Institute in Washington, 14 percent of Marylanders, about 585,000 people, are uninsured, ranking the state about 30th in the nation.

Ever since the state's new Health Care Access and Cost Commission proposed a new set of reforms late last month, lobbyists for insurers and health care providers have been scrambling to head off any changes that might hurt their clients.

The lobbyists have quietly pointed out that last year's reforms xTC are not in effect yet, that key legislative leaders had promised they would not substantively tamper with last year's reforms this year, and that there is no assurance that Congress will pass anything. Even if it does, they say, no one can predict what that will be.

Partly in reaction to the concerns raised by interest groups, General Assembly leaders agreed yesterday to abandon two of the commission's original recommendations.

One was a study, initially sought by the Maryland Hospital Association, of emerging health care networks. Lawmakers said the commission did not need a law to conduct a study.

The other was an attempt to resolve a dispute between doctors and "managed care" networks, such as health maintenance organizations, over whether such networks should be required to accept any doctor who wants to join. That issue, they said, can be resolved through separate legislation that has been introduced on the same topic.

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