Lists of shame

July 18, 2005

EVEN OPPONENTS of Maryland's so-called Wal-Mart bill -- the mandate that very large employers spend a minimum percentage of income on employee health benefits -- agree that too many people lack insurance and they're a costly problem for taxpayers. Part of this dilemma is that companies with adequate health benefits subsidize, through higher insurance rates and taxes, employers that do not offer them.

Wal-Mart has gotten much notice, but it's hardly the only company with many uninsured workers. Who are the others and how great a cost does this place on taxpayers? That's not altogether clear, but lawmakers in a growing number of states have devised a way to find out.

It's a relatively simple strategy and works like this: Applicants for public health care are required to disclose the name of their employer. State health departments then compile those names and publish an annual list of employers with large numbers of Medicaid recipients (usually 25 or more). This shows what companies either don't provide health insurance to workers or whose employees don't enroll (likely because it's too costly or the benefits too modest, or some combination of the two).

Last month, the Illinois legislature approved a disclosure law. Massachusetts already has a similar requirement and at least two dozen other states have been debating it.

In Maryland, a disclosure law was introduced during the last legislative session but failed in committee. That's chiefly because it was overwhelmed by the more ambitious Wal-Mart bill, which was approved by the General Assembly but vetoed by Gov. Robert L. Ehrlich Jr.

In Illinois, some business groups have attacked the proposal as a "list of shame" meant to embarrass them. So much the better. If they find shame in having taxpayers subsidize their employment costs then perhaps there's hope yet.

Clearly, simple disclosure won't solve the health insurance problem, but the information could prove useful. And who knows? It may even allow for a market-based correction: Shoppers may decide that patronizing businesses that discount products but depend on the generosity of taxpayers may not offer a good bargain after all.

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