To reduce climbing Medicaid costs for low-income individuals who lack health care benefits several states have passed “fair share” statutes. Under these statutes, employers either pay for, arrange for health care benefits, or they pay an assessment to the state.
On January 17, 2007, the Fourth Circuit found in Retail Industry Leaders Association v. Fielder et al., Nos. 06-1840 and 06-1901 (4th Cir., January 17, 2007), that the federal Employee Retirement Income Security Act (ERISA) preempts Maryland’s Fair Share Health Care Fund Act.
The Maryland’s “Fair Share” Act requires employers with 10,000 or more Maryland employees to pay the state the difference between what the employer spends on health care insurance, including any costs to provide health care benefits, for its Maryland employees and 8% (for profits organization) or 6% (for non-profits organizations) of its total Maryland payroll. 
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