Health Law Daily Wrap Up, MEDICAID—GAO REPORTS: Millions of working adults, many employed by the nation’s largest companies, remain enrolled in Medicaid and SNAP, (Aug 28, 2026)

By Jordan Sonderegger

According to the GAO, an estimated 13.8 million adults who worked at some point during 2024 were enrolled in Medicaid, most of them working full time and overwhelmingly in the private sector, and 46 companies–17 of them among the 50 largest Fortune 500 companies by number of employees–ranked among the top 25 employers of Medicaid enrollees or SNAP recipients in at least two of the 11 states that provided data.

The Government Accountability Office (GAO) found that wage-earning adults enrolled in Medicaid or living in households receiving Supplemental Nutrition Assistance Program (SNAP) benefits shared a consistent set of labor characteristics: they worked predominantly for private-sector employers, worked mostly full-time schedules, and were heavily concentrated in five industries and five occupations. More than one-third worked for employers with 1,000 or more employees. GAO made no recommendations; the report transmits updated data to Senator Bernard Sanders, Ranking Member of the Senate Committee on Health, Education, Labor, and Pensions (GAO Report, No. GAO-26-108703, Aug. 24 2026).

Background. The report responds to a request for current data on adult wage earners enrolled in Medicaid or receiving SNAP benefits and on their employers, and updates findings GAO published in October 2020. To estimate labor characteristics, GAO analyzed the Census Bureau’s Current Population Survey (CPS) March 2025 Annual Social and Economic Supplement, extracting individuals who reported Medicaid enrollment or SNAP household participation in calendar year 2024. To identify employers, GAO collected September 2025 data from 15 agencies in 11 states and used a statistical name-aggregation process to estimate the 25 employers in each state with the most working adult Medicaid enrollees or SNAP recipients.

Work Schedules and Employment Sector. An estimated 13.8 million working adults were enrolled in Medicaid, and 10.6 million lived in households receiving SNAP. About 66% of wage-earning adult Medicaid enrollees and 71% of SNAP recipients worked full-time weekly schedules of 35 hours or more, compared with 87% and 86% of nonparticipants. Roughly 88% of wage earners in each program worked in the private sector, a higher share than the approximately 81% of nonparticipants, and participants were less likely than nonparticipants to work in the public sector or to be self-employed.

Industry and Occupational Concentration. An estimated 71% of wage-earning adults in each program worked in the five industry categories with the highest concentrations of low-wage workers. The starkest divergence was in arts, entertainment, and recreation; and accommodation and food services, which employed 16.6% of wage-earning Medicaid enrollees and 15.0% of SNAP recipients, but only about 7.5% of nonparticipants. Occupational concentration was even sharper: the top five occupations accounted for 52.6% of Medicaid enrollees and 54.0% of SNAP recipients, compared with roughly one-third of nonparticipants. Two occupations–food preparation and serving, and health care support–ranked among the top five for program participants but not for wage earners outside the programs. Food preparation and serving employed 11.2% of Medicaid enrollees versus 4.4% of non-enrollees; health care support employed 8.9% versus 3.1%.

Employer Size. An estimated 35.2% of wage-earning adult Medicaid enrollees and 41.5% of SNAP recipients worked for employers with 1,000 or more employees. Participants were also more concentrated than nonparticipants at the smallest end of the scale: 21.1% of Medicaid enrollees worked for employers with fewer than 10 employees, compared with 12.5% of non-enrollees.

State-Level Data. In the six states that provided Medicaid data, nondisabled, nonelderly (NDNE) working adult Medicaid enrollees ranged from 15% of all adult Medicaid enrollees in Georgia to 34% in Rhode Island. Working adult SNAP recipients ranged from 13% of adult SNAP recipients in Georgia to 35% in Tennessee across the nine states that provided SNAP data. These enrollees and recipients worked overwhelmingly in the private sector–between 76% and 93% for Medicaid across states, and between 85% and 97% for SNAP. Restaurants and other eating places, grocery and convenience retailers were the leading private-sector industries in most states, with department stores prominent in several.

Employers Across States. The employers of the largest numbers of Medicaid enrollees and SNAP recipients varied by state, but 46 companies–about one-third of the total companies across all 11 states–appeared among the top 25 employers in at least two states, and 17 of those 46 were among the 50 largest Fortune 500 companies by number of employees. Walmart ranked first among employers of NDNE working adult Medicaid enrollees in Georgia, Indiana, and Oklahoma, and Amazon appeared in the top three in five of the six Medicaid states. Public-sector and nonprofit employers also appeared: the Commonwealth of Massachusetts ranked first in that state’s Medicaid data. In SNAP data, GAO’s combined “app-based food delivery” category–covering DoorDash, Grubhub, Instacart, and Uber Eats–ranked first in Georgia, Indiana, Nebraska, and Tennessee.

Data Limitations. CPS data are self-reported, are known to underreport program benefits, and may be subject to high sampling error for certain subpopulations; GAO did not independently verify their accuracy. The state-derived employer estimates are generalizable only to the states that provided data, not nationwide. States reported the employer of record rather than the current employer, and because GAO could not always separate multiple employers for a single individual, the estimates may systematically undercount employees. GAO revised the report on August 24, 2026, to correct the figures for Rhode Island NDNE working adult Medicaid enrollees.

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