Gov. Lombardo unveils sweeping health care legislation

Editor's note: Este artículo está traducido al español.

Gov. Joe Lombardo’s sweeping health care bill, introduced Thursday, would create a state office of mental health, accelerate the licensing process for health care providers and invest millions with the goal of increasing access into underserved areas.

Senate Bill 495, the Nevada Healthcare Access Act — which Lombardo deemed one of his priority bills during his January State of the State address — comes in the final full month of the ongoing legislative session. It’s one of dozens of proposals addressing the state’s teetering health care system this year in Carson City.

Nevada faces shortages in primary, dental and mental health care in all 17 counties, according to the Health Resources and Services Administration.

“By bolstering and growing our health care workforce, expanding mental health resources and streamlining health care services across the state, we’re going to build a more robust, accessible and sustainable health care system for all Nevadans,” Lombardo said in a news conference Thursday morning.

The governor talked about the comprehensive, 100-page piece of legislation inside UNLV’s Kirk Kerkorian School of Medicine with students sitting behind his podium and wearing their white medical coats.

A core part of the legislation, he says, is incentivizing them and their peers to stay in the state during their residencies; it’s why the bill would increase funding for graduate medical education residency programs. Among the recently graduated students at the school, half will be leaving the state for their residencies.

“If you don’t have the residency programs here in the state of Nevada, where are these graduates going to end up?” Lombardo asked.

For Nehal Naik, a physician practicing in Southern Nevada, the current medical system causes serious harm. As he puts it, patients experience delays daily and doctors dedicate much of their time caught up in the path of bureaucratic red tape.

“Nevada faces a severe physician shortage,” Naik said. “We can’t afford a limited number of doctors spreading precious hours on the phone fighting with insurance companies instead of being where they’re needed most: with their patients.”

The legislation also creates a “Nevada Healthcare Workforce and Access Fund,” which would include an annual $25 million investment for furthering public and private partnerships with the primary focus of bringing more health care professionals into underserved and high-need areas of Nevada.

Funding has been a topic of conversation for state leaders this year. The session began with the governor’s office submitting a $335 million deficit through fiscal year 2027, which was soon rectified to meet the balanced budget required. Since then, the Nevada Economic Forum projected a general fund $191 million lower than last year’s forecast — coming as legislators have been worrying about what the possible federal cuts to state funding for programs like Medicaid could mean forstate revenue and spending.

Nevada Medicaid Administrator Stacie Weeks, who would lead a newly established Nevada Health Authority if Lombardo’s bill is enacted, has been monitoring health care proposals at the federal level. She said the possible damage isn’t as bad as she had previously anticipated.

“It is not as big in terms of cuts that we expected for the state,” Weeks said. “So, that’s the good news.”

The federal effort to reduce Medicaid spending is part of the budget reconciliation process Republicans are trying to get through Congress as part of President Donald Trump agenda. The state was first alerted when a framework of the package called for the House committee overseeing Medicaid to slash $880 billion through 2034. This week, that same committee put forth proposals for the package that would, in part, create work requirements for Medicaid eligibility.

Congressional Republicans have not yet determined the exact amount of cuts to Medicaid.

Establishing an office to tackle mental health was another priority Lombardo shared in his January speech and included in the bill. It would be tasked with overseeing services like community-based options to support individuals with severe mental illnesses.

The governor’s other priority bills would address housing affordability, education, public safety and economic policies, though the process has been slow-moving.

While Lombardo, a Republican, said that sometimes it might feel like he’s facing a personal or a partisan divide dealing with the Democratic-majority in the Legislature, he knows that isn’t the reality.

“What we experienced in this session is unique because we’ve had a lot of federal funding from previous years and a lot of ability to act on funds,” Lombardo said. “This session, we don’t have that much.”

The bill would earmark a total of $25.75 million with the vast majority of $25 million going to the access fund. It would also set aside $250,000 for a legislative study on the development of an academic medical center in Nevada in the first year of the biennium and $500,000 per year for streamlining physician onboarding in the state.