WASHINGTON - Cynthia Murray never set out to play the role of health-care activist. But now the $9.47-an-hour fitting-room attendant at a Wal-Mart in suburban Maryland is at the heart of a movement to force the giant retailer and other big employers to spend more on employee health insurance.

Ever since the Maryland legislature overrode Gov. Robert Ehrlich Jr.'s veto Jan. 12 of a bill requiring Wal-Mart Stores Inc. to spend 8 percent of its payroll on health insurance, Murray has been a public face of a union-led campaign to pressure employers to spend more for health care. Murray said she had nothing in particular against Wal-Mart, but she said the Bentonville, Ark., company should improve its employee health insurance plan.

"I can't afford their insurance," said Murray, 49. "I either go to a clinic or see a doctor. Other than that, I pray a whole lot and hope that I don't get sick."

The veto override in Maryland has jumped-started similar campaigns around the country. On Monday, the Oregon AFL-CIO filed notice with the secretary of state's office that it was seeking a ballot question this year on whether firms with more than 4,500 employees should be required to spend at least 9 percent of their payrolls on health insurance. Lawmakers in Pennsylvania, Colorado and New Jersey also plan to introduce bills in the coming weeks that would make similar requirements of employers.

"The problem of profitable companies' not carrying health insurance for their workers is one that we have been struggling with for quite a while," said Charles Wowkanech, president of the New Jersey AFL-CIO, who has been working with New Jersey legislators to craft a bill.

Yet it is not at all clear that the Maryland initiative or other proposals will do much to solve the problem. During legislative hearings in Maryland, Lisa Woods, director of benefits administration for Wal-Mart, testified that the company already was spending between 7 percent and 8 percent of payroll on health care. If that were true, then the Maryland law would only modestly increase Wal-Mart's health-care spending, if at all.

Moreover, because the law applies only to the state's four largest employers, three of which already provide substantial coverage and probably would not be affected, it does not address the problem of workers at small and midsize companies that provide no health insurance. Critics point to another potential failing: By requiring Wal-Mart and other employers to simply spend more, there is no incentive for the firms to find the best coverage for their workers.

"It would make more sense to require employees to have a certain level of health insurance, and let the employers decide how they want to do it," said Jack Calfee, an expert on health care at the American Enterprise Institute, a conservative think tank in Washington.

Calfee said requiring employers to provide insurance might work, but he said the Maryland law offered no incentives for them to reduce their healthinsurance costs.

Even supporters of the effort say it falls short of comprehensively addressing the related problems of rising health-care costs and decisions by employers to curtail benefits or eliminate them altogether. Still, one little-noticed benefit, they say, is that labor unions and others have succeeded in keeping the issue at the center of public debate, even as President Bush pushes various free-market alternatives such as health savings accounts to help with medical costs.

"It's a very interesting tactical strategy on the part of labor unions, and indeed, a company like Wal-Mart, which is so big and profitable, should on equity grounds provide their employees with decent health coverage," said Howard Wachtel, an economist at American University and an expert on health-care policy. "It is another way of getting a discussion going."

Wal-Mart disputes the claim that it provides inadequate health coverage. Company spokesman Dan Fogleman said employee payments for family coverage for Philadelphia-area Wal-Mart employees started at $65 a month. That comes with a $1,000 annual deductible, but every member of the family can get three doctor visits and three prescriptions filled before the deductible kicks in, he said.

It is the deductible and the monthly payments that stick in Cynthia Murray's craw. Murray, who lives just outside of Washington, said she could not afford them on her Wal-Mart pay.

"Anyone who works at Wal-Mart, they are not carrying $1,000 around," she said.

It took Maryland activists six years of statehouse lobbying and grassroots organizing to eventually push the issue over the top. Vincent DeMarco, a lawyer and veteran of causes such as campaigns to reduce gun violence and smoking, joined with labor unions and employers such as Giant food stores to persuade the Maryland legislature to pass the law.

DeMarco worked the legislature and addressed church, community and business groups, doing what he could to keep the issue in the news. Giant, a unit of Ahold USA, became a powerful ally. It spends substantially on health care for its large unionized workforce and competes against Wal-Mart. But DeMarco also linked up with small employers such as Mark Derbyshire, who owns a moving and storage firm in Aberdeen, Md.

Derbyshire said he had long been concerned about the cost of health insurance for his employees, and decided to join forces with DeMarco after hearing him speak at his church. Derbyshire, who testified in a legislative hearing for the proposal, said his company paid 75 percent of the cost of comprehensive health insurance for his workers; they pick up the balance of $200 a month for family coverage.

If the cost of health insurance continued to rise, it could become unaffordable for his workers, who earn $10.50 to $18 an hour, he said. Maryland - to defer the cost of hospital treatment of people who are uninsured, but who have too much income to qualify for government health-care programs - imposes a surcharge on health-insurance premiums. Derbyshire reasoned that his premiums might go down if Wal-Mart paid more into the system.

"I am a businessman, and I don't like government interference," Derbyshire said. "But the health-care system needs help, and maybe it needs government interference."