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The Massachusetts law "addresses health care issues comprehensively and in a manner that arguably has only incidental effects upon Erisa plans," the judge wrote. He noted that "it is strongly in the public interest to permit states to perform their traditional role of serving as laboratories for experiment in controlling the costs and increasing the quality of health care for all citizens."
Unlike the Maryland bill, which was passed over the veto of the Republican governor, Robert L. Ehrlich Jr., the Massachusetts law was also viewed as a ground-breaking political compromise, requiring individuals to buy coverage if they have the means and companies to pay a fee if they did not offer insurance.
But any state law, including the one in Massachusetts, could be challenged on similar grounds since the ruling finds that the federal law pre-empts any state efforts. While the courts may well draw distinctions between different laws, the question, Mr. Piro said, is "how much room to do you have to experiment?"
Some policy experts say states are already looking more to the Massachusetts model than the one in Maryland in thinking about how to expand health insurance for their residents. "What happened in Massachusetts is going to be far more instructive to other states than what happened in Maryland," said Ronald Pollack, executive director of Families USA, a health advocacy group that supported the Maryland bill.
In Maryland, Governor Ehrlich issued a statement after the ruling praising it but legislators said they would try to draft a new law if the state loses its appeal. "We will not abandon this," said Thomas V. Mike Miller Jr., the Democratic president of the Maryland Senate.
"To continue to allow this huge corporation to take profits out of the state without providing adequate health care coverage would be wrong," he said.
And proponents said the law had already influenced Wal-Mart's health insurance policies. Since it was passed, the retailer has announced that it will permit part-time employees to enroll their children in the health plan and that it will reduce by a year the waiting period before a new part-time employee is eligible for benefits.
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