Fair Share Health Care Disclosure Act

Summary: The Fair Share Health Care Disclosure Act directs the Department of Health to publish a list of the fifty employers with the highest number of employees who receive state medical benefits or assistance, in order to promote a clearer understanding of the problem.

This model is based on Section 38 of Massachusetts Senate Working Group on Health Care Cost Containment and Reform’s “An Act furthering health empowerment and affordability by leveraging transformative health care” (October 2017) as well as California AB 1792 (2014).


This Act shall be called the “Fair Share Health Care Disclosure Act.”


(A) FINDINGS—The legislature finds that:

  1. Public benefit programs are essential to provide state residents with access to fresh, healthy food, quality health coverage, basic needs, cash assistance, child care, and income supports, among other benefits.
  2. The state needs to preserve and expand public benefit programs to ensure that no resident has to go hungry or forego medical care because he or she cannot afford basic life necessities.
  3. When low wages and a lack of benefits leave workers unable to make ends meet, they turn to public assistance programs for health care, food, and other basic necessities.
  4. Employers that pay low wages and offer insufficient benefits shift the costs of doing business onto taxpayers.
  5. Specifically, more than 60 percent of enrollees in Medicaid and CHIP nationwide are members of working families, meaning that the taxpayers bear a significant portion of the hidden costs of low-wage work.
  6. Large, profitable employers should pay wages and benefits that do not impoverish workers or shift costs onto taxpayers. Such employers put responsible employers at a competitive disadvantage, creating an unfair playing field for business in the state.
  7. To promote a deeper understanding of the causes and sources of underemployment, poverty wages, and the economic impacts on our society, business, and the state budget, it is appropriate for policymakers to possess a broader set of empirical data with which to make informed decisions.

(B) PURPOSE—This law is enacted to obtain data that will enable the state to protect workers and strengthen the economy.


After section XXX, the following new section XXX shall be inserted:

(A) REPORT REQUIRED—The [Department of Health] shall annually, not later than February 1, prepare and file a public health program beneficiary employer report to identify the 50 employers that have the highest number of employees who receive medical assistance, medical benefits or assistance through the [list the state Medicaid program and other state health benefit programs for low-income residents]. The report shall be filed with the clerks of the State Senate and House, [and the committees on health and ways & means]. The report shall also be made available on the Department’s website.

(B) CONTENTS OF REPORT—The report shall include:

  1. The name and address of the employer;
  2. The size of the employer;
  3. The number of public health program beneficiaries who are an employee of that employer;
  4. The number of public health program beneficiaries who are a spouse or dependent of an employee of that employer;
  5. Whether the employer offers health benefits to its employees;
  6. The cost to the state of providing public health program benefits for their employees and enrolled dependents, if available; and
  7. Whether the employer offered health benefits to its employees who are public health program beneficiaries and, if so, the number of such employees.

(C) RESTRICTIONS—The report shall not include the names of any individual public health access program beneficiaries and shall be subject to privacy standards pursuant to Public Law 104-191 and the Health Insurance Portability and Accountability Act of 1996. The Department may establish interagency agreements to collect information to fulfill the requirements of this section including, but not limited to, an interagency agreement to access and utilize information collected through the health insurance responsibility disclosure form established under [citation].


This law shall become effective on July 1, 20XX.