The Wal-Mart Tax: A Review of Studies Examining Employers' Health Care Cost-Shifting

Abstract

[Excerpt] As job-based health coverage declines and employers shift ever-growing health costs onto employees, workers increasingly must turn to taxpayer-funded programs like Medicaid to get health care for themselves and their families. Meanwhile, Medicaid is wrestling with explosive cost growth, increasing 56 percent since 2000. Medicaid is the second largest expense for most states, accounting for around 16 percent of state budgets, on average. States’ spending on the program is expected to grow almost 12 percent this year, four times faster than the increase in states’ general fund spending. Recent studies in 13 states have examined the extent to which employers’ workers utilize public health programs to secure health coverage for themselves and their families. As the following summary of those analyses reflects, in each one of these states, Wal-Mart ranks at or near the very top of the list of employers that are shifting to the public the cost of providing health care for their workers. In so doing, Wal-Mart is directly contributing to the nation’s Medicaid crisis.