For the second consecutive year, Amazon ranks as the company with the most employees and dependents on Medicaid in Nevada, according to a new state report. 

Amazon’s number of employees and dependents on Medicaid increased from 7,892 in 2019 to 14,331 in 2020, according to a report published by the Department of Health and Human Services earlier this month. Amazon employs more than 22,000 workers in Nevada, with about 6,596 employees and 7,735 dependents on Medicaid. Since the beginning of 2020, Amazon has hired approximately 15,000 people, a spokesperson said.

Although Amazon says it offers new employees and eligible family members “a range of great benefits” including health care, its number of employees on Medicaid has nearly doubled from fiscal year 2019.

The increase might have several reasons, a spokesperson said, including employees at Amazon who intend to be short-term and don’t enroll in Amazon’s health plan. Employees who have been with the company for more than a year are more likely to enroll, and temporary or seasonal employees later become eligible for the company’s health plan. 

It costs the state and federal governments more than $758 million to provide health care to those employees, including more than $471 million for employees and more than $287 million for dependents. Amazon employees and their dependents alone cost Nevada Medicaid $43 million, a 103 percent increase from the previous year. 

Walmart was the leading employer of Nevada Medicaid recipients from 2017 through 2019. In Nevada, Walmart employs about 15,470 people and has an average wage of $16.36 an hour for full-time and part-time associates as of July 2021. Walmart’s number of employees and dependents on Medicaid increased by 26 people from last fiscal year’s report. 

Clark County School District was ranked third in Nevada for most Medicaid recipients, moving down from second on the list in the 2020 fiscal year. According to the report, nearly 4,000 CCSD employees and dependents are on Medicaid, fewer than the 4,311 reported in fiscal year 2020. 

The report includes companies with at least 50 employees and Medicaid recipients who earned at least $3,840 per quarter fiscal year 2021, which represents 40 hours of work a week at a minimum wage of $8 an hour, as reported by the Nevada Department of Employment, Training, and Rehabilitation (DETR). 

According to Nevada Health Link, households with annual incomes of up to 138 percent of the federal poverty level — $16,753 per year for an individual or $34,638 per year for a family of four — may qualify for Medicaid. Eligibility for the program has broadened during the pandemic, including continuation of a federal Medicaid “maintenance of effort” protection that has preserved coverage.

Out of the 106,836 employees on Medicaid included in the report, 42 percent earned at least $8,904 (the median wage of $18.55 an hour in Nevada as of May 2020) in a quarter. Last February, a record more than 810,000 Nevadans were enrolled in Medicaid or Nevada Check Up.

A bill passed by state lawmakers in 2017 mandates the annual report from the Department of Health and Human Services’ Office of Analytics to list all employers in the state that have 50 or more employees and their number of full-time employees enrolled in Medicaid.

Updated at 12:30 p.m. on 1/7/22 to reflect Amazon explanation for enrollment trends.