The act would have required for-profit employers with more than 10,000 workers in the state of Maryland to spend at least 8% of their payroll on employee health benefits or make a contribution to the state's insurance program for the poor.
[4][2] On July 18, 2006, federal judge J. Frederick Motz struck down the law as preempted by ERISA.
On January 17, 2007, the United States Court of Appeals for the Fourth Circuit upheld the decision.
[5] While the Maryland bill drew the most national media attention, similar measures were considered in other states but also failed.
In February 2006, a version of the bill that would have required companies with 5,000 or more employees to spend 9% of their payroll on health care benefits was defeated in Washington.