William M. Thomas: “And in addition to that, because one of the things we have tried to do is to take a look at what States and companies…”

“And in addition to that, because one of the things we have tried to do is to take a look at what States and companies are doing in the private sector to get some ideas about whether or not it works, if you take a look at the employer mandate out in the real world. For example, in Hawaii, which has an employer mandate, I think it is useful to take a look at the experience in the real world of people who attempt to utilize these concepts that we are trying to foist on all of the United States without a comfort level in terms of the unintended consequences. Mr. Speaker, in the spring issue of Health Affairs, spring 1994, in an article by Andrew W. Dick, who is a health economist in the public policy analysis program at the University of Rochester, NY, he analyzes the employer mandate structure that Hawaii has, and he comes to these conclusions: The consistent pattern that emerges from careful consideration of available data is that the Hawaiian mandate did relatively little in extending insurance to the uninsured. While Hawaii does have high rates of coverage compared with other States, this is due largely to the characteristics of Hawaii's population. That is, a federally mandated program will impact differently in different States.”