Massachusetts leads the nation in employer-provided health care coverage. But with today’s report showing 5717 Wal-Mart employees using state health benefits last year, costing Massachusetts taxpayers $12,819,641, we again ask, “The question is not whether employers are doing their fair share for the employees they are covering, it’s whether they are doing their fair share for their employees the state is covering.”

Here are the big numbers to remember: over 530,000 workers and dependents, costing Massachusetts almost $800 million. All working at over 1500 companies that have at least 50 workers using state health benefits.

This afternoon the Division of Health Care Finance and Policy released their fifth annual installment of Employers Who Had Fifty or More Employees using MassHealth, Commonwealth Care, or the Uncompensated Care Pool/Health Safety Net. The report, required by HCFA-originated legislation, details how many workers in large firms were enrolled in state-subsidized plans in FY08 and how much the state spent to provide this coverage.

The report found that in FY 2008:

• 532,155 employees and dependents of firms with at least 50 workers in state programs received publicly subsidized care, at a cost of $793.7 million to the state:

• 337,307 enrolled in MassHealth at a cost of $573.1 million
• 185,755 in the UCP/HSN at a cost of $75.2 million
• 109,863 Commonwealth Care members at a cost of $145.4 million

From FY07 to FY08:

• The number of employees and dependents on public health plans increased by 12.2%.
• Total spending by the state on employees and their dependents increased by 24.6% over the FY07 figure $636.8 million.
• The number of employers on the list grew by 18.8%, to 1,553

Most of the growth in spending on public programs is attributed to expected increases in CommCare expenditures. Since CommCare was ramping up implementation in 2007, the costs for FY07 don’t represent a full year of enrollment for most members. Cost of CommCare coverage for employees increased by 32% from FY07 to FY08. MassHealth costs for employees and their dependents increased by 14.7% but costs associated with workers in UCP and HSN decreased by 33.1%, because of the shift of uninsured people to Commonwealth Care.

Compared to national statistics, MA employers are offering coverage to their workers at impressive rates. Another DHCFP survey found that 72% of MA employers offered insurance in 2007 and 99% of employers with 50 or more workers offered coverage. This compares to a national average of just 60% for all firms. While employer coverage has been going down nationally, it has been increasing slightly in Massachusetts.

However some firms rely on the state to cover their workers. This report shows that over 70% of CommCare members are working adults whose employers do not offer them coverage. The state is footing a $145.4 million bill for this coverage. These employers are reaping the benefits of state subsidies for their employees. Just as businesses pay the state to use resources such as water we think they should pay at least a portion of the cost for the use of publicly-funded health insurance for their workers.

Health Care For All and many other groups are supporting legislation to raise needed revenue from these employers not pulling their weight on the health reform boat. It’s only fair. An Act Relative to Shared Responsibility in Health Reform will honor health reform’s framework of shared responsibility by requiring contributions from employers who do not provide minimal health benefits. This bill offers four methods for increasing employer responsibility, to even the playing field for non-offering employers and to reimburse the state for part of its cost in covering workers. To learn more about the bill, contact Lindsey Tucker at ltucker@hcfama.org.
Catherine Hammons