As governor, Joe Lombardo vetoed SB419 on June 16, 2023, a bill that would have spent $1.7 million on prenatal and childbirth coverage for uninsured pregnant women left out of Medicaid.
On July 3, 2025, the day the House gave final passage to the One Big Beautiful Bill Act, Lombardo posted his support for the bill. The law cuts federal Medicaid funding for Nevada by $8.45 billion over ten years, 19 percent of what the state would otherwise receive, by KFF's estimate, and Nevada's own analysis expects about 100,000 people could lose Medicaid in the first two years of the work requirement that starts January 1, 2027. In May 2026 he said of that work requirement, "I support that."
A month after the post, Lombardo said the law did not cut anything in the short term; about 5,000 lawfully present immigrants in Nevada were set to lose Medicaid starting October 1, 2026, the Nevada Current reported in July 2026. In July 2026 his campaign would not make him available for a KFF Health News interview on health care.
Joe Lombardo's Veto and Statements on Medicaid and Health Coverage
- Lombardo Vetoed Prenatal and Delivery Coverage for Uninsured Pregnant Nevadans in June 2023. On June 16, 2023, Joe Lombardo vetoed SB419, which would have paid for prenatal, labor and delivery coverage through the Children's Health Insurance Program for uninsured pregnant people who do not qualify for Medicaid, regardless of immigration status, with $1.7 million over two years. Because of the veto, uninsured pregnant Nevadans in that group did not gain the prenatal coverage the bill would have added.
- Lombardo Praised the One Big Beautiful Bill Act, Which Cuts Nevada's Federal Medicaid Funding by $8.45 Billion. Joe Lombardo posted on July 3, 2025, the day of the bill's final House vote: "Nevadans should be excited about the potential impacts of tax cuts, investments in small businesses and American manufacturing, and efforts to help secure our border." That statement of support covers the whole law, including its Medicaid provisions. KFF's allocation of the Congressional Budget Office estimate puts Nevada's loss of federal Medicaid money at $8.45 billion from 2025 to 2034, a cut of 19 percent, and because Nevada expanded Medicaid, every eligibility change in the law applies here.
- Lombardo Said He Supports the Law's Medicaid Work Requirement, Which Puts 280,000 Nevadans Under It in January 2027. In a KTVN 2 News interview on May 21, 2026, Joe Lombardo named the Medicaid work requirement in the law and said: "And I support that. I support that." The law requires adults covered by Nevada's Medicaid expansion to show 80 hours a month of work, school or service, starting January 1, 2027, and to renew their coverage every six months; Nevada officials say about 280,000 Nevadans are affected. The state's own analysis estimated that about 100,000 Nevadans, one in eight people on Medicaid, may be dropped during the requirement's first two years, and people who lose it lose their doctor visits, prescriptions and hospital coverage with it.
- The Law Lombardo Praised Set an October 1, 2026 Medicaid Cutoff for About 5,000 Lawfully Present Immigrants in Nevada. The law Joe Lombardo praised limits federal Medicaid to citizens, green-card holders and a few other groups, ending eligibility for many refugees, asylees and other lawfully present immigrants. The Nevada Current reported in July 2026 that "about 5,000 legally present immigrants in Nevada will be cut from Medicaid regardless of whether they meet work requirements starting October 1, 2026."
- The Law Lombardo Praised Was Cited by Boulder City Hospital as It Cut About 70 Jobs and Ended Overnight Stays in 2026. The law Joe Lombardo praised also limits the provider taxes and state-directed payments that Nevada uses to raise Medicaid payments to hospitals. Boulder City Hospital announced in March 2026 that it would lay off about 70 employees and stop keeping patients more than a day starting May 1, 2026, and its chief executive, Thomas Maher, cited funding changes in the law as a significant factor.
- Lombardo Called Lower Hospital Provider-Fee Funding Among the Changes Most Harmful to Nevada, Then Praised the Law That Limits It. In a February 2025 letter to congressional leaders, Joe Lombardo listed lower federal matching funds for hospital provider fees among the changes "most detrimental for Nevada," the Nevada Independent reported. Five months later he wrote that "Nevadans should be excited" about the bill, which became law with limits on those provider taxes. The Nevada Health Authority projects $600 million to $800 million a year less in provider-tax-related payments to Nevada hospitals by the end of 2028, falling mostly on the state's urban acute-care hospitals, which treat insured and uninsured patients alike.
- Lombardo Said the Law Directed No Short-Term Cuts; It Set a Medicaid Cutoff for About 5,000 Nevada Immigrants 14 Months Later. Joe Lombardo said of the law and Nevada Medicaid on August 4, 2025: "The bill doesn't direct any cuts in the short term." The law set October 1, 2026 as the start of the Medicaid cutoff for about 5,000 lawfully present immigrants in Nevada, and Nevada Medicaid said in September 2026 that about 250,000 people would receive work-requirement letters ahead of the January 2027 start.
- Lombardo's Campaign Declined a KFF Health News Interview on Health Care in July 2026. Joe Lombardo's campaign declined to make him available to KFF Health News for its July 8, 2026 report on health care and affordability in the Nevada governor's race. The report covered the Medicaid changes in the law he praised, under which KFF projects 100,000 more uninsured Nevadans in 2034.
What the Medicaid Cuts Joe Lombardo Praised Mean for Nevada Patients and Hospitals
- Up to 145,000 Nevadans could lose Medicaid by 2028 without strong state help. An Urban Institute analysis reported by KUNR put 71,000 Nevadans at risk of being dropped from Medicaid under the work requirement even if the state works hard to limit losses, and up to 145,000 if it does not.
- 100,000 more Nevadans will be uninsured in 2034, mostly through Medicaid. KFF estimates the law raises Nevada's uninsured population by about 100,000 in 2034, with about 83,000 of them losing coverage through Medicaid; people without coverage skip care until it becomes an emergency, and hospitals absorb more unpaid bills.
- Rural Nevada loses about $553 million in federal Medicaid over ten years. KFF estimated the law's federal Medicaid cuts in rural Nevada at about $553 million over ten years, money that pays for care at small hospitals and clinics that are often the only ones for many miles.
- Four Nevada hospitals are on Public Citizen's at-risk list. Public Citizen lists Grover C. Dils Medical Center in Caliente, Pershing General in Lovelock, Humboldt General in Winnemucca and St. Rose Dominican-de Lima in Henderson as at high risk of closing or cutting services, because Medicaid and low-income patients are a large share of their payers and their margins were negative.
Frequently Asked Questions About Joe Lombardo on Health Care
What is Joe Lombardo's record on health care under Trump?
Joe Lombardo, Nevada's governor, praised the One Big Beautiful Bill Act on July 3, 2025, a law that cuts Nevada's federal Medicaid funding by an estimated $8.45 billion over ten years and adds a work requirement that the state expects could cost about 100,000 Nevadans their coverage. Earlier, in June 2023, he vetoed SB419, which would have covered prenatal care and childbirth for uninsured pregnant Nevadans who do not qualify for Medicaid. He said in August 2025 that the law directed no short-term cuts, yet it set an October 1, 2026 Medicaid cutoff for about 5,000 immigrants in Nevada.
When does the Medicaid work requirement in the law Joe Lombardo praised start in Nevada?
Under the law Joe Lombardo praised, Nevada's Medicaid work requirement starts January 1, 2027, for adults ages 19 to 64 who gained coverage through the expansion. The administration's own rule projects that the requirement will cut Medicaid enrollment nationwide by 2.3 million people in fiscal year 2027.
Did Joe Lombardo veto health coverage for pregnant women?
Yes. Joe Lombardo vetoed SB419 in June 2023; the bill would have extended the Children's Health Insurance Program to pregnant women shut out of Medicaid, including those barred by their immigration status. The veto message is on file with the Nevada Legislature.
Will Nevada hospitals lose money under the law Joe Lombardo praised?
Yes. Under the law Joe Lombardo praised, KFF found that about $900 million a year of Nevada's state-directed hospital payments sits above the new federal limits, and the law starts reducing existing payments on January 1, 2028. Boulder City Hospital is already shrinking to a rural emergency hospital, and its chief executive cited the law as a significant factor.
Last updated: 2026-10-26