This story was originally published by KFF Health News.
by Jazmin Orozco Rodriguez, KFF Health News
As the Trump administration’s January deadline looms for states to enforce new Medicaid work requirements, some state lawmakers are turning the tables by pushing to publicly name the largest companies that have employees enrolled in the government program covering low-income and disabled people.
California lawmakers seek to revive an expired law that would require the state to identify companies that employ 100 or more people and have employees enrolled in Medi-Cal, the state’s Medicaid program. Nevada has had a similar law in place since 2017, though a proposal for one in Oregon stalled when its legislative session ended in March.
The California bill author, Democratic state Sen. Lola Smallwood-Cuevas, said she is deeply troubled by what is going to happen when work requirements kick in. According to the state, nearly 5 million of the roughly 15 million Californians on Medi-Cal could be subject to the new requirements.
Democratic New Jersey Gov. Mikie Sherrill signed a bill in June to fine businesses that have at least 50 Medicaid-enrolled employees. Companies with 50 to 249 workers on Medicaid will pay $325 a year per person, and those with at least 500 will pay $725. Bills that would have penalized companies with workers enrolled in Medicaid failed in Washington state and Colorado this year.
In Sacramento, California, Democrats want to figure out a way to make large businesses pay for their employees’ health coverage. State lawmakers struck a deal with Democratic Gov. Gavin Newsom, who is contemplating a presidential bid as he wraps up his final year in office, to explore tax options. Any tax hike would be up to the next governor.
States face losing billions of dollars under HR 1, the GOP tax-and-spending law known as the One Big Beautiful Bill Act, notably through a provision that requires nondisabled Medicaid enrollees ages 19 to 64 in most states to prove they are working, volunteering, or going to school at least 80 hours a month to keep their coverage.
Large employers that regularly top these states’ lists, such as Walmart and Amazon, have pushed back, saying the counts include part-time and seasonal workers. An Amazon spokesperson pointed to the $7.25-an-hour federal minimum wage and noted that Medicaid eligibility is based on household income and size rather than an individual’s wage — meaning two employees who earn the same pay may have different eligibility depending on whether they have children or live with parents. “Pointing fingers at Amazon over Medicaid is a red herring,” said Amazon spokesperson Alisa Carroll. “What really needs to happen is a significant and large increase in the federal minimum wage.”
Nevada Medicaid spent nearly $950 million on healthcare for more than 133,000 full-time employees and more than 140,000 of their dependents. While the total amount spent dipped in fiscal year 2025, the average cost per member per year increased by nearly 17%.
Yvanna Cancela, a former Nevada lawmaker who sponsored the legislation requiring the annual reports, said they force an important conversation about whether large, profitable employers should be relying on public health coverage for their workers, or paying enough for employees to afford coverage on their own.
Read the original story at KFF Health News. This story also ran on CBS News.
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