Nearly 800,000 Nevadans are covered by Medicaid, a federal health insurance program used by one in five Americans who would otherwise struggle to afford medical care.
The program helps provide vital medical services, like the medication that Manuel Santamaria, a Las Vegas-based father of three, says that he uses for his 16-month-old daughter, Luna. After Luna’s birth—also covered by Medicaid—doctors discovered that she had an autoimmune disease known as psoriatic arthritis.
One of her treatments uses a topical steroid called Clobetasol, which Santamaria says prevents Luna’s skin from breaking out in “itchy patches of pink, scaly skin.”
“It comes in small tubes, so you’ve got to kind of ration it to make it last,” he says. “If we were to pay out of pocket, it’d easily be about $450 per month just to get that cream.”
Coverage for that medication and countless other essential services for disabled, pregnant and low-income people could be threatened after the House of Representatives on February 25 passed a budget resolution that calls for $880 billion in cuts from programs administered by the House Energy and Commerce Committee, which oversees Medicare and Medicaid.
The cuts are intended to help offset a $4.5 trillion pool that President Trump and Republicans are seeking for tax cuts. While the White House maintains that its goal of “eliminating waste, fraud, and abuse in government” won’t come through slashing Medicare or Medicaid, the numbers indicate that the cuts would almost certainly have to come from the latter.
Before any cuts can become official, the Republican majorities in both the House and Senate will have to reconcile differences between their respective budget resolutions and agree on a single, unified version. But congressional Democrats have wasted no time sounding the alarm.
On March 17, Sen. Catherine Cortez Masto, D-Nev., toured the Nevada Health Centers (NVHC) Martin Luther King Family Health Center in Las Vegas to speak with administrators and nurse practitioners about how the potential cuts could impact their system and the 40% of their patients who are enrolled in Medicaid.
J.C. Flowers, NVHC’s vice president of operations, expressed concern that cuts could force his team to scale back some operations across the system’s 20 facilities, five mobile units and specialty services like maternal screenings, homeless outreach and a residency program designed to bolster the state’s understaffed medical workforce.
“If the funding is cut, can we support all of our locations? I hate to speculate on that, but there’s a significant ripple effect that could be very impactful to the populations we serve,” Flowers said. “That makes us all very nervous.”
Cortez Masto reiterated that the cuts could be “devastating.” According to the Kaiser Family Foundation (KFF), 42% of enrolled Nevadans stand to lose their health care if they were implemented.
“NVHC would have to look at restructuring their locations and their accessibility to patients,” Cortez Masto said. “Our health care system would be strained beyond capacity, primary care for Nevadans could become unaffordable and they’ll get sicker more often. Their only options then will be to go to urgent care or the emergency room, filling up beds and further stressing our care facilities.”
State lawmakers have also responded to the potential cuts. After the state Department of Health and Human Services estimated that Nevada could lose nearly $1.9 billion in federal Medicaid funds over the next two years, Republican Gov. Joe Lombardo on February 26 sent a letter to members of the Legislature assuring them he was “actively engaged in conversations” with the White House and federal officials about Nevada’s concerns about the potential Medicaid rollbacks.
“An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would also destabilize public and private health care providers, leading to workforce reductions, service limitations and financial strain on already overburdened health care facilities,” Lombardo said in the letter.
Although elderly and disabled patients make up just 14% of Nevada’s Medicaid enrollees, their cumulative expenditures account for 32% of the program’s total spending in the state, according to an August 2024 KFF fact brief. Catherine Nielsen, director of the Nevada Governor’s Council on Developmental Disabilities, says cuts would likely have to include at least some elderly and disabled people if Republicans want to reach their budget goals.
“We understand eliminating waste and reducing redundancy, but we’re talking about people who did not have a choice in what they are experiencing. Individuals with disabilities, pregnant women and lower-income families are going to be the ones that are most impacted by this,” Nielsen says.
Nielsen commended Lombardo for taking a stance against his own party’s leadership on the issue, which she says is particularly “non-partisan” and impacts everyone. She adds that her daughter, a diabetic, also relies on Medicaid to acquire insulin.
“This isn’t blue, this isn’t red … we’re talking about individuals on every side of the living spectrum. And this really does mean life or death for some families who would have to rely on emergency rooms to receive care where they are,” she says. “Right now, there’s a lot of fear, concerns, questions and misunderstanding—and our state legislators’ hands are tied because they don’t know what to expect at the federal level. If it happens, we’re going to see families choosing to put health care second.”
Though U.S. Rep. Mark Amodei, a sixth-term Republican representing Nevada’s primarily rural northern half, acknowledged in a recent statement that the cuts aren’t “the ideal situation,” he also voted in favor of the budget resolution that included them. His Democratic counterparts from Nevada, Rep. Dina Titus, Rep. Susie Lee and Rep. Steven Horsford, joined their colleagues in voting against it.
Hundreds of people have assembled at Amodei’s Reno office multiple times since February to protest his vote and perceived lack of communication with constituents. More than 134,000 of his constituents are enrolled in Medicaid, according to KFF.