Federal Reductions to Hit Nevada Health Coverage Hard

In Nevada, 612,400 people are enrolled in Medicare, a figure that represents about 20% of the state's total population. Medicare, created in 1965 as a federal health insurance program, primarily covers adults aged 65 and older, along with younger individuals who qualify due to disabilities. It is not free. Beneficiaries pay premiums, deductibles, and copays. For low-income Nevadans unable to afford these costs, the state uses Medicaid funds, coordinated through the Centers for Medicare & Medicaid Services (CMS). Approximately 86,000 Nevadans qualify for both Medicare and Medicaid, representing a high-need group eligible for coordinated care and cost assistance.

Funding for Medicare and Medicaid comes from federal and state taxes. The federal government spends $4.1 billion annually on Medicare in Nevada, paying providers and plans (including Medicare Advantage) directly. For Medicaid, the federal government sends $4.3 billion to Nevada’s Department of Health and Human Services (DHHS), where the Division of Health Care Financing and Policy (DHCFP) contracts with insurers, doctors, and hospitals to make payments. The state adds $1.1 billion from its general fund. Combined, these programs account for about 28% of Nevada’s general fund budget impact.

More than half of Nevada’s Medicare enrollees have Medicare Advantage plans, which typically include dental, vision, and hearing benefits not covered by standard Medicare. The federal government funds approximately 85–90% of costs, while beneficiaries contribute through premiums and out-of-pocket expenses.

In addition, Nevada offers the Qualified Medicare Beneficiary program to cover Medicare costs for those at or below 100% of the federal poverty level, and the Specified Low-Income Medicare Beneficiary program to pay Part B premiums for slightly higher earners. The state also receives federal grants for the State Health Insurance Assistance Program for free Medicare counseling and Senior Medicare Patrol for fraud detection and reporting.

However, Nevada’s Medicare and Medicaid programs face impacts from 2025 federal budget cuts, which decrease Medicaid by $1 trillion nationally over 10 years and trigger $500 billion in Medicare reductions. These cuts will burden Nevada’s current DHHS budget. Medicaid unwinding has already disenrolled over 258,000 Nevadans, mostly due to procedural errors, with new work requirements expected to drive further disenrollment.

Compounding these impacts, Nevada ranks near the bottom in physicians per capita, leading to long wait times and emergency room overuse—worsened by low Medicaid reimbursement rates. Rural hospitals and Clark County clinics struggle with shortages of behavioral health and pediatric specialists. Meanwhile, Nevada Health Link premiums are set to rise 26% as federal subsidies expire. Payment delays, enrollment shutdowns, and fraud further erode resources, jeopardizing care access and stability for seniors, low-income families, and rural communities.

Sen. Jacky Rosen (D-NV) told the Nevada State Legislature: “It’s more than just funding. It’s a lifeline for families. It’s a lifeline for moms and for children...These are our families, our friends, our neighbors.”

AARP Nevada, representing the state’s senior citizens, warned that federal cuts will raise Medicare Advantage premiums for Nevada seniors higher than in any other state and urged Congress to protect access in both rural and urban communities.

Rep. Mark Amodei (R-NV2), while advocating targeted reforms to prevent premium increases in his northern Nevada district, said: “While we need fiscal responsibility, slashing Medicare Advantage payments hits rural Nevada hard—let’s reform overpayments without hurting access for our veterans and farmers.”

Darren Grubb, spokesperson for Medicare Advantage Majority, emphasized:“More than 300,000 Nevadans, about 51% of all Medicare-eligible seniors in the state, rely on Medicare Advantage for their health care needs. Many of the caregivers supporting these Nevadans are also juggling responsibilities for their own families and children. Medicare Advantage offers real peace of mind by saving families time and money and making it easier to balance work and care responsibilities. With health care costs on the rise and Congress considering additional cuts to federal programs, Medicare Advantage is once again at risk. Medicare Advantage Majority is proud to stand with hundreds of thousands of Nevada seniors as we work to protect and strengthen Medicare Advantage for Nevada’s seniors and the families who depend on it.”

Nevada’s Medicare, Medicaid, and Medicare Advantage programs face ongoing challenges from federal payment reductions, provider shortages, and administrative issues. These factors contribute to higher costs, reduced benefits, and limited access, especially in rural areas and for low-income and senior populations.