Amazon, Walmart remain atop list of companies with most employees on Nevada Medicaid

Amazon remains Nevada’s leading employer of Medicaid recipients, a designation it has maintained for several years.

Approximately 7,500 Amazon employees were eligible for Nevada Medicaid in state fiscal year 2023, according to a new report from the Nevada Department of Health and Human Services. Those employees had 8,212 dependents who were also enrolled in Nevada Medicaid.

The cost of their coverage: $59 million.

Walmart and Clark County School District rank second and third. Amazon, Walmart and CCSD have all held those spots since 2020.

Rounding out the top five companies with the most employees on Nevada Medicaid was Wynn Las Vegas, which jumped up two spots from sixth to fourth, and Smiths Food & Drug, which dropped one spot from fourth to fifth. The State of Nevada, Aria Resort & Casino, call center operator Telus International, Resorts World, and private security company Universal Protection Service placed six through 10th.

DHHS found that during the last fiscal year Nevada Medicaid covered nearly 178,000 employees at companies with 50 or more employees. An additional 198,000 people, the majority of them children, were covered as dependents of those employees.

The cost of providing health care to these approximately 376,500 Nevadans was $1.45 billion last fiscal year. The state’s share of that cost was $263 million, or 18% of the total. The federal government covered $1.19 billion, or 82% of the total.

Medicaid costs increased by 20.8% from 2022 to 2023 and have doubled since 2019, according to DHHS.

Nevada’s annual report, which has been required by lawmakers since 2017, does not include data on the total number of people each company employs, but some unofficial points for reference are available through public statements made by the companies. Amazon on its corporate website boasts it has created 18,000 full- and part-time jobs in Nevada as of January 2023.

Amazon has received more than $3.2 million in tax breaks from Nevada since 2015, according to Good Jobs First, which maintains a nationwide tracker of the retailer’s economic development deals.

Walmart on its corporate website claims it employs 15,795 associates in Nevada across its 50 retail locations and three warehouses. The company says its average hourly wage for full-time workers in Nevada is $19.31.

Walmart’s 4,726 Nevada Medicaid-eligible employees and their 5,218 dependents cost the state and federal health care programs $36.5 million.

CCSD employs more than 40,000 people.

The number of employees of large companies and their dependents who are eligible for Medicaid has risen in recent years — from 261,151 in fiscal year 2019 to 376,597 in fiscal year 2023.

Nearly half — 48% — of the Nevada Medicaid members covered in the report earned the equivalent of the median wage in Nevada, which as of May 2022 was $19.62 an hour.

Medicaid enrollment numbers are expected to decrease as a pandemic-era pause on eligibility redetermination requirements are fully lifted. But to what extent that will impact numbers isn’t clear. The state expects to complete that redetermination process by this August.

Employees who are offered health insurance through their employer may still enroll in Medicaid if they meet eligibility requirements, which include being low income.