Amazon Leads Nevada Medicaid Enrollment Among Employers, Report Shows

Amazon has become the leading employer of Nevada Medicaid recipients, with 18,093 employees and dependents enrolled in the program as of 2024, according to a report released by the Nevada Department of Health and Human Services (DHHS). This marks a 143% increase since 2020, when the retail giant had 7,892 Medicaid-enrolled workers and dependents. The surge in enrollment far outpaces Walmart, the second-largest employer of Medicaid recipients in the state, which had approximately 4,500 enrollees last year.

The DHHS report, which analyzes Medicaid enrollment among employees of businesses with 50 or more workers, highlights the growing reliance on public health programs by employees of major corporations. Medicaid eligibility is largely income-based, and critics argue that the high enrollment numbers reflect low wages and inadequate benefits offered by these employers. Amazon and Walmart have faced scrutiny for their reliance on taxpayer-funded programs to subsidize employee healthcare costs.

Amazon’s expansion in Nevada, including the opening of several new facilities, has contributed to the rise in Medicaid enrollment. The company has also benefited from significant tax abatements, including $1.8 billion approved by the Nevada Governor’s Office of Economic Development in 2016. Critics contend that these tax incentives, combined with the public cost of Medicaid coverage for Amazon employees, amount to a public subsidy for the retail giant.

In fiscal year 2024, Medicaid covered approximately 183,000 employees of large companies in Nevada, along with 197,000 dependents. The total cost of care for these individuals exceeded $1.1 billion, with the state contributing $240 million. Amazon employees and their dependents alone accounted for $51 million in Medicaid costs, $11 million of which was paid by Nevada.

The report also notes that the number of Medicaid-eligible employees and dependents may be artificially inflated due to COVID-era continuous enrollment policies, which were phased out during the fiscal year covered by the report. The full impact of this “unwinding” process will not be reflected until 2026.

Other top employers of Medicaid recipients in Nevada include the Clark County School District, Wynn Las Vegas, and the State of Nevada. Bowtie Hospitality, the operator of the recently opened Fontainebleau Las Vegas, made its debut on the list as the eighth-largest employer of Medicaid recipients, with 1,476 employees covered.

Southern Nevada, particularly Clark County, is overrepresented in the report, accounting for 80% of Medicaid-enrolled employees and dependents despite making up 73% of the state’s population. The report underscores the ongoing challenges of low wages and limited access to employer-sponsored healthcare in the region.