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As they prepare to enforce new federal rules requiring millions of low-income people to prove they are working to keep their Medicaid coverage, some states want to spotlight businesses that rely on the government program to provide their employees with health insurance.
California lawmakers seek to bring back a law that requires the state to publicly list those companies that employ 100 or more people and have workers enrolled in Medi-Cal, the state’s Medicaid program. Nevada has had a similar law in place since 2017.
“It’s a basic principle that taxpayers deserve transparency about which large employers are shifting their healthcare costs onto the public,” said California state Sen. Lola Smallwood-Cuevas, a Democrat and the bill’s sponsor.
Some states are going further than simply naming and shaming companies. Democratic New Jersey Gov. Mikie Sherrill signed a bill in June to fine businesses with at least 50 workers on Medicaid from $325 to $725 a year for each employee and dependent enrolled.
Similar proposals stalled in Washington state and Colorado this year.
A January deadline looms for states to enforce the new Medicaid work requirements under the One Big Beautiful Bill Act, which President Donald Trump signed last summer. For enrollees to keep their coverage after January, they’ll need to prove they are working, volunteering, or going to school at least 80 hours per month. This applies to nondisabled enrollees ages 19 to 64 in most states.
The change carries a significant administrative and financial burden for states that must implement it along with other adjustments to the joint state-federal program.
One health policy researcher said the push to identify businesses with employees on Medicaid highlights the lack of affordable healthcare options available to low-wage workers.
“There’s a whole set of people who are working — they may not satisfy the work requirement provisions, they may not get the exemption that they’re qualified for, and they don’t have access to that employer-sponsored insurance either,” said Edwin Park, a research professor at the Center for Children and Families at Georgetown University.
Nearly 5 million of the more than 14 million California residents on Medi-Cal will be subject to work requirements.
Compounded by changes to the federal Supplemental Nutrition Assistance Program, or SNAP, people may need to choose between paying for medicine or paying for rent when they lose food and health benefits, Smallwood-Cuevas said.
“We’re going to see more people in their cars, more people on the street, and a lot more people in the emergency room,” she said. “That is dangerous for all of California.”
With the federal Medicaid work requirements looming in January, Democrats are considering state legislation to call out big companies that employ workers enrolled in the safety net health program. Business giants such as Amazon and Walmart said the figures are misleading.
