"required employers with 25 or more employees to offer federally certified HMO options alongside traditional indemnity insurance upon request (the "dual choice provision")." is the exact wording of the legislation. UPON REQUEST is quite different from REQUIRES. The HMO model had been very very successful in California (Kaiser Permanente) in the 1960s and 1970s with success measured by excellent prevention and management of chronic health problems. Wellness is the focus of true HMO models. Unfortunately, "managed care" has come to be the boogey-man of the 1990s and people erroneously think of only the gatekeeper aspects of HMOs.

Fair enough, "upon request" might as well be "requires" because why would an employee not take advantage of an employer sponsored health plan, unless they already had better care at a better price elsewhere?

The problem is that the government has mandated that these companies HAVE to offer a health care option to the employee; "upon request". Health care, like child care, paid/unpaid time off, etc are perks to specific companies. Should the government also mandate child care and 9 months paid leave for pregnant mothers UPON REQUEST? Where does it stop? Companies should be the ones that OFFER these benefits to employees in order to keep them happy, and in turn working hard on the job...this shouldn't be a mandate by Big Brother.