FairnessThe Maryland Chamber of Commerce’s Business Agenda calls for careful review and revision of current government mandates especially those that "add to the cost of health insurance [for business] and limit customer choice." While the state’s all-payer hospital system has proven to be an asset for hospital economies and the health care system on the whole, it has unfairly shifted the hospital costs of the uninsured from "non-insuring and under-insuring employers" to businesses that provide quality health insurance to their employees. In Maryland, hospitals must inflate their charges to subsidize the uninsured. These extra charges are paid for directly by businesses that insure their workers, all insured people of the state, and by Maryland taxpayers. Each year, the state and federal government along with responsible Maryland businesses contribute $400 million to Maryland hospitals – subsidizing the costs of hospital care for the uninsured and giving non-insuring or under-insuring businesses a "free ride". Most large employers pay 9% or more of wages on health insurance, according to various industry studies, including companies like Giant Food and Safeway. However, there are a few large employers that pay just 3-8% of payroll on health benefits. Because the health benefit package they offer is so unaffordable, few employees elect to purchase it. As a result, when uninsured employees or their dependents get sick, they go to the emergency room for care and the costs of care are shifted to companies that do insure their workers.
Incentive to Purchase Benefits in the Private Health InsuranceFacing up to an 8% of payroll health system user fee, non-insuring or under-insuring companies would have a real economic incentive to begin offering affordable health benefits to their employees. A firm electing to pay the assessment, for example, would pay the equivalent of health benefit costs but not enjoy the benefits of reductions in turnover, training and recruitment costs as well as the federal tax deductions for their employees’ insurance. Revise a Current Mandate to Create a Level Playing FieldThis proposal redistributes the cost of an existing mandate—the mandate on insuring employers to subsidize the cost of care for the uninsured—more equitably within the business community. The alternative is to continue with an un-level playing field that drives up the cost of health insurance, limits consumer choice and creates a financial incentive for employers to drop coverage. Failure to reverse this situation and stem the erosion of employer sponsored coverage will lead eventually to collapse of the private market system
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