Divided Fourth Circuit Holds Maryland’s Fair Share Act Preempted

Several states and localities have responded to the federal call to reduce escalating Medicaid costs for low-income individuals who lack health care benefits by passing so-called “fair share” statutes. Under these statutes, employers either pay for (or at least arrange for) health care benefits, or they pay an assessment to the state. A prior Management Alert in May 2006 describes the Massachusetts Health Care Reform Act of 2006 and other state “fair share” efforts.