So Mr. Hubbard and others settled on a new approach--pushing through smaller, bite-sized pieces. The first piece was the Wal-Mart bill. It passed last year and was enacted last month, when the Legislature overrode Gov. Robert Ehrlich's veto. Two weeks ago Mr. Hubbard was at it again, this time introducing a new bill to mandate that companies with at least 1,000 employees spend 4.5% of their payroll on health care or pay the state the difference. Once this piece is in place, Mr. Hubbard told me, the next step will be to create a similar mandate--perhaps 2% or 3%--for companies with fewer than 1,000 employees. Each year, Mr. Hubbard hopes to expand the mandate to include ever smaller companies with the ultimate goal of "health coverage for all Marylanders."
Mr. Hubbard noted how effective splitting the difference can be in moving legislation toward a larger goal. "If you give up 80% of what you want to get 20%," he said, "after five years you will have nothing left to give up." Mr. Hubbard also noted a quirk in the system that made raising taxes and expanding the Medicaid rolls attractive. With the federal government paying half or more of every dollar spent on Medicaid, states were essentially leaving federal dollars on the table by not expanding the program.
