Because that's where the money is.

Quote of note:

...backers of the Maryland bill, which seemed to take special aim at Wal-Mart, the nation's largest employer, say the support for it there indicates a growing recognition of the growing financial burden of caring for the uninsured. They say taxpayers are unfairly supporting too many companies' uninsured workers, who turn to government programs like Medicaid or simply show up in the emergency rooms of hospitals subsidized by the state to provide care to people unable to pay.

Jonathan Parker, campaign director of Americans for Health Care, a union-led group in Washington that helped push for the Maryland bill, said legislative pressure was rising in state capitals nationwide. "We're going to see it in more and more states," he said, "and we're going to see it sooner rather than later."

States and Employers Duel Over Health Care
By REED ABELSON

The relentless rise in health care costs is causing states and businesses to fight over whose job it is to insure workers. And nearly two dozen states, struggling with the growing burden of providing public assistance to people with jobs but no insurance, are looking to shift more of the financial burden onto the workers' employers.

Last month, for example, Maryland, which spends roughly $350 million a year on health care for the uninsured, passed a bill requiring the state's very largest employers to spend at least 8 percent of their payrolls on health benefits for their workers. Lawmakers elsewhere, including Connecticut, are considering legislation that may also require some companies to provide coverage, either directly or by paying into a state fund.

Some measures, as with a New Jersey proposal, would let companies bid on state contracts only if they provided health insurance for their workers.

At the very least, some states would embarrass companies whose workers are on Medicaid or other forms of state assistance by publishing the employers' names - as Massachusetts has already done with a list of companies including Dunkin' Donuts, Stop & Shop and Wal-Mart Stores. Dunkin' Donuts says individual franchised stores, not the company, are responsible for coverage, while Wal-Mart challenged the findings. Stop & Shop declined to comment.

The Maryland bill may not presage passage of such measures in other states, but employers and others say there is no doubt that the issue is heating up around the country. Medicaid, the states' main public assistance health care program, now eats up about 16 percent of their budgets. Nationally, the number of uninsured is 45 million and rising. And with federal funds expected to be scaled back by $10 billion over the next five years, the states' burden seems likely to grow.

Some employers, though, question whether that national problem should necessarily be theirs to solve.

"The focus of the debate is whether there should be an employer mandate," said Ellen Valentino, Maryland director for the National Federation of Independent Business, whose state group of small companies opposed the legislation.