Workers for large employers got $637m in state-supported health care

Employees at more than 1,400 workplaces in Massachusetts – including Wal-Mart, Stop & Shop, and the Commonwealth itself -- received $637 million in healthcare for themselves and their families through publicly funded programs last year, according to a state report released today.

The cost to insure people who worked for companies with 50 or more employees came to $372 million for coverage through three state programs: MassHealth, the state’s Medicaid plan; Commonwealth Care, the subsidized insurance plan created by the 2006 healthcare law; and the Uncompensated Care Pool, which pays hospitals for treating the uninsured. When dependents and non-working spouses are added, the total rises to $637 million, an increase of 14 percent over fiscal 2006 when the estimate was $559 million.

“It shows that the level of public dollars being used to provide coverage to lower-income folks working for large employers is much greater than anybody imagined,” John McDonough, executive director of Health Care For All, said in an interview on his last day as head of the advocacy organization. “It also shows that the number of folks, adults and dependents, is much larger than anybody imagined.”

The report, from the Executive Office of Health and Human Services, said that in Massachusetts, 72 percent of employers offer health insurance to their workers, higher than the national rate of 60 percent. And that rate has held steady here in recent years, while dropping nationally.

Today’s report reflects data from July 2006 through June 2007 and includes the early months of the new law requiring near-universal healthcare coverage. It also shows the effect of expanding MassHealth coverage to children of families whose incomes fall below 300 percent of the federal poverty level. That move increased cases by 16 percent, the report said.

Still, two-thirds of people working without insurance are employed at businesses that do not offer them coverage. Among those uninsured people, almost half are not eligible because they are temporary, part-time, or face a waiting period before they do qualify for employer-sponsored insurance.

McDonough, who is joining Senator Edward M. Kennedy's staff in Washington, said large employers should pay a share of the costs.

“It is legitimate to suggest employers on this list ought to contribute something,” he said. “Just like Wal-Mart has to pay for water and electricity, it should also pay something for this significant public benefit of a healthy workforce, rather than it being paid solely by taxpayers and the state.”

Wal-Mart led the state Department of Revenue's top 25 list of employers whose employees used publicly subsidized care: 5,021 of its Massachusetts employees and dependents used care that cost $13.9 million. Stop & Shop came next, with 3,868 of its workers and their families using $8.7 million in healthcare. The Commonwealth of Massachusetts had 3,320 employees and dependents using $8.6 million in care.

The report also included slightly different rankings based on employment information individuals reported to MassHealth and Commonwealth Care. That list showed Dunkin Donuts, McDonalds, and Stop & Shop as the employers whose employees got the most state-supported healthcare. At Dunkin Donuts, 1,850 employees and dependents used $6.9 million in care; 1,324 McDonalds workers and dependents used $5 million in care, and at Stop & Shop, 1,189 used $4.8 million in care. Wal-Mart was fourth in that ranking.

“This report demonstrates both the success we have had with health care reform and some of the challenges,” Dr. JudyAnn Bigby, secretary of Health and Human Services, said in a statement. “We should celebrate our success in increasing enrollment of low-income children, many of whom are dependents of workers, into MassHealth. We know that many workers do not have access to employer-sponsored insurance and depend on state programs for health coverage.”