With 48,000 workers, Wal-Mart easily breezes into the top slot of Pennsylvania's list of top 10 employers. But the world's largest retailer also easily qualifies for another top spot it's less likely to claim bragging rights about. Of those workers, 7,577 – or about one in six, according to an analysis by the Philadelphia Inquirer –receive assistance, the highest number of employees from any private employer in the state. Those kinds of numbers – repeated in headlines in states all across the country – have proven to be a public relations nightmare for Wal-Mart. As low-wage Wal-Mart employees turn to public assistance for medical care, a host of labor unions and community activists have seized on healthcare coverage as the Achilles' heel of the world's most profitable corporation. And unless it's able to fight off its dogged pursuers, the fight promises to cost the company dearly on the bottom line. Wal-Mart's critics cheered heartily when state lawmakers in Maryland recently overrode a governor's veto to seal a law that requires the retailer to set aside 8 percent of its payroll for health insurance. The so-called "fair-share" bill was also passed in Suffolk County, New York and now more than two dozen states – including Georgia and Colorado – have either taken up similar bills or promise to introduce one soon. Wal-Mart – which has 1.3 million employees – has responded by reducing the mandatory waiting period that existed before new employees could sign up for a health plan. It's extended a low-cost, high deductible plan that costs workers $11 a month plus 30 cents a day for children to half of its rank and file. And the children of part-timers will be eligible for coverage as well. Those changes were outlined in a speech Wal-Mart CEO Lee Scott delivered to the National Governors Association's winter meeting at the end of February. And Scott was quick to add that the company – stung by a rising tide of anti-Wal-Mart sentiment – has more announcements to come. "We're determined to make our health benefits even more affordable and accessible than they already are," he told the governors. "And we're confident that these steps, as well as the comprehensive package we'll announce in the coming months, will make even more progress." Opponents aren't buying it. "If Lee Scott is serious about working on real healthcare solutions, he should sit down with us and address why over 775,000 of his workers and their families have no company healthcare which costs taxpayers over $1.37 billion every year," said Paul Blank, campaign director for WakeUpWalmart.com. And while Wal-Mart fights a public relations campaign, business groups are digging in for a long and hard fight. "Retailers all already do set aside money for health benefits," says R. Bruce Josten, executive vice president of government affairs for the United States Chamber of Commerce, which has already filed amicus briefs in the legal battle brewing over the Wal-Mart bills passed in Maryland and Suffolk County, New York. "The challenge that most retailers have is that the cost of healthcare is so high that the younger kids in the workforce tend to feel invincible and therefore tend to opt out of the offering." The debate that has arisen around Wal-Mart misses some key points, he adds. Workers at small businesses and their children account for a large number of the country's uninsured. And Wal-Mart's critics are ignoring the fundamental economics at work in healthcare, where 80 percent of expenditures are devoted to the 30 percent of the population with chronic ailments to contend with. The healthcare industry has consistently lagged behind others in investing the kind of money in information technology needed to improve chronic disease management, which is needed to rein in the high inflation that pushes the cost of care beyond the reach of companies. Josten is particularly caustic about the motives of the labor unions. "Unions have been trying for years to unionize Wal-Mart," he says, "and it clearly seems part of a ramp-up campaign to target one company to unionize." Others believe that Wal-Mart is being unfairly singled out solely because of its size and high profile. The days when big employers provided a rich set of benefits has been fading fast. Now only about 60 percent of big companies provide health insurance to workers, according to the Kaiser Family Foundation. It remains to be seen, though, whether Wal-Mart's efforts to bend its insurance practices enough to mollify critics or its allies' work to shift the debate toward other targets have come in time to stop the legislative offensive now underway.