June 22, 2026 / 5:00 AM EDT
/ KFF Health News
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One issue will decide Steven Cohen's vote for Nevada governor this fall: Which candidate can best protect him from getting kicked off Medicaid?Cohen is a 38-year-old Las Vegas resident with autism and has dual enrollment in Medicaid and Medicare. He said he's very concerned that he could lose his Medicaid coverage once work requirements and more frequent eligibility checks take effect in January, under congressional Republicans' One Big Beautiful Bill Act."When you're going to some providers, notably mental health, once a month, or in the case of one provider, a couple of times a week, those copays quickly add up," Cohen said. Republican Gov. Joe Lombardo is running for reelection in a tight race against Democratic state Attorney General Aaron Ford in one of 39 U.S. gubernatorial elections to be decided in November. Lombardo has President Trump's endorsement, but healthcare policy changes made by the Trump administration are working against him with voters like Cohen in the swing state.Those changes include Medicaid funding cuts that are expected to strain state budgets, along with new work requirement and eligibility rules for Medicaid and the Supplemental Nutrition Assistance Program, which provides food assistance for low-income families. The changes are expected to increase the number of people without health insurance nationwide by an estimated 7.5 million in 2034 and decrease the number of people who receive SNAP by 2.4 million people in an average month from 2025 to 2034.People across the U.S. have also been feeling the pinch of rising health insurance premiums since Congress allowed enhanced Affordable Care Act subsidies to expire at the end of last year. Many who purchase health plans on the ACA marketplace have chosen less expensive plans with less coverage or are going without insurance altogether.These changes will have a significant impact in Nevada, where tourism, hospitality, and gaming are cornerstones of the state's economy. Nearly 300,000 people in Nevada are self-employed, independent contractors, or freelancers without employer-sponsored health insurance benefits. Many purchase insurance through the state's ACA health exchange, which saw a 5.5% decrease in enrollment this year after a record 110,000 people signed up for 2025.
