Healthcare Crisis Ignites Voter Fury in Nevada's Gubernatorial Showdown

Steven Cohen's vote hinges on one brutal reality: which candidate can shield him from losing Medicaid coverage?

Cohen, a Las Vegas resident with autism, faces a nightmare scenario as work requirements and stricter eligibility checks loom 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 stated.

Republican Gov. Joe Lombardo battles Democratic state Attorney General Aaron Ford in a razor-thin race for reelection. Lombardo boasts President Trump's endorsement, but the healthcare policies from the Trump administration are backfiring with voters like Cohen.

Medicaid funding cuts threaten to cripple state budgets. New work requirements and eligibility rules for Medicaid and the Supplemental Nutrition Assistance Program (SNAP) are set to push an estimated 7.5 million people into the uninsured category by 2034 and strip 2.4 million from SNAP monthly between 2025 and 2034.

Americans are already feeling the sting of skyrocketing health insurance premiums after Congress let enhanced Affordable Care Act subsidies expire. Many are opting for cheaper plans with less coverage or ditching insurance altogether.

Nevada's economy, heavily reliant on tourism, hospitality, and gaming, faces dire consequences. Nearly 300,000 Nevadans are self-employed or freelancers without employer-sponsored health insurance. The state's ACA health exchange saw a 5.5% drop in enrollment this year after a record 110,000 signed up for 2025.

Even before federal changes, Nevada's uninsurance rate stood at 11.4%, the fourth-highest in the nation. A state Medicaid official warned lawmakers that around 70,000 Nevadans could lose Medicaid coverage under the new rules. In May alone, approximately 28,000 people lost access to SNAP.

"This is going to come down to an affordability election, and that's going to hurt the Republicans," said David Damore, a political science professor at the University of Nevada-Las Vegas.

A national KFF poll revealed two-thirds of respondents worry about affording healthcare—more than those concerned about food, housing, or gas. Over half reported rising healthcare costs in the past year.

While most voters indicated healthcare costs would influence their November votes, the urgency is more pronounced among Democrats and independents.

Competitive gubernatorial races are also heating up in Arizona, Georgia, Iowa, Michigan, and Wisconsin—all toss-ups.

The Democratic Party holds an edge on healthcare issues over Republicans, but about 30% of voters express distrust in both parties, according to Liz Hamel from KFF.

"It's not an overwhelming advantage," she noted.

Lombardo's campaign highlights his support for a new children's hospital in Las Vegas and his consolidation of Medicaid programs into a single agency. He also expanded community behavioral health centers during his term.

Before his governorship, Lombardo served eight years as sheriff in Clark County and spent 26 years with the Las Vegas Metropolitan Police Department.

His healthcare positions diverge from typical Republican stances. In 2022, he opposed a national abortion ban and signed a Democratic-led bill preventing state agencies from aiding prosecutions against those traveling to Nevada for abortions.

In 2023, he enacted laws prohibiting insurance companies from gender discrimination and mandating protections for transgender and nonbinary individuals in state correctional facilities.

However, Lombardo recently aligned more closely with the Make America Great Again movement. In 2025, he vetoed a bill protecting clinicians providing gender-affirming care and endorsed a constitutional amendment banning transgender athletes from girls' and women's sports.

Lombardo's campaign declined an interview request for this report. In a March interview with Jon Ralston of The Nevada Independent, he expressed surprise at the complexity and cost of healthcare during his first term.

"Government seems to complicate some of those bigger processes more often than not," Lombardo remarked. "But in this case, they're instrumental in the success or failure of healthcare and how people suffer as a result of bad decisions."

Ford began his political career as a Nevada state senator and became the state's first Black attorney general in 2019.

He shared how he raised his eldest son alone while attending Texas A&M University, relying on public benefits like Section 8 housing and Medicaid.

Ford's experiences shape his perspective on Nevadans losing Medicaid coverage whenever he hears about the "Big Beautiful Bill." "It hits me differently," he said.

His campaign's "Affordable Nevada" plan aims to lower prescription drug costs, raise awareness of new public-option health plans, and eliminate medical debt.

KFF's poll indicates most voters lack confidence in how the Trump administration is handling living costs.

"It seems like the Trump administration's approach is not going to help Republicans in the midterms," Hamel stated. "But November is many months away. A lot of things could change."

Lombardo appears to be distancing himself from Trump amid rising gas prices and affordability issues.

When Trump visited Las Vegas in April, Lombardo skipped the event. He later claimed they spoke only by phone during Trump's visit.

Damore suggested Lombardo's absence from Trump's public appearance was intentional.

"Lombardo has done a nice job trying to thread the needle between himself and Trump," he said.

Ford has an easier path campaigning on healthcare issues. "He just has to say, 'I'll do better,' and point at Trump," Damore added. "That's a pretty easy campaign for him."

Nevada's partisan voters are nearly evenly split, but most are registered as nonpartisans due to automatic voter registration at the DMV. As of last year, voters can no longer choose a party at the DMV; they must fill out paperwork mailed by their county election office after registering.

Clark County leans Democratic while Washoe County is the only swing county. The rest of Nevada consistently votes Republican.

Voter fatigue runs high in Nevada after years of inflation since COVID-19. "People are just kind of surly," Damore said. "They keep ping-ponging back and forth between parties without much change."

Cohen identifies as a nonpartisan voter. He plans to support Ford because he believes Ford will fight for Medicaid enrollees' rights.

"Sometimes the only way to get something done, to protect it, is to sue," Cohen asserted. "I think he'll bring that background."