The HOPE Act was lobbied for by health care and immigration advocates, including Make the Road Action Nevada, seen here during a press event in May. (Photo courtesy Make the Road)
Legislation lowering prescription drug costs, giving long-term substitute teachers insurance stipends, and protecting doctors who provide gender-affirming care all met Gov. Joe Lombardo’s veto stamp this legislative session. In all, 12 health care bills were among the 75 pieces of legislation the governor rejected.
Chief among the health care bill vetoes was Senate Bill 419, referred to as the HOPE Act by its proponents. Highlighted as a priority for the Latino Legislative Caucus and sponsored by its chair, state Sen. Fabian Doñate (D-Las Vegas), the bill as introduced would have expanded Nevada Medicaid coverage to undocumented immigrants who are otherwise eligible for the program. It was amended to provide coverage of prenatal and delivery services to undocumented people who are pregnant, using a provision allowed by the Children’s Health Insurance Program (CHIP).
Lombardo in his veto message said the state’s Division of Health Care Financing and Policy, which oversees the Nevada Medicaid and CHIP, had “insufficient resources to implement this new service this biennium.” He noted that there were “at least six other bills” passed by the legislature that expanded Medicaid coverage.
Doñate after the veto, which came on the day before the bill would have automatically become law, issued a statement vowing to move forward and work with the governor’s administration to find a bipartisan solution.”
“We will be relentless with our efforts until we are treated as equal to others – where the right to live is afforded to everyone, regardless of who they are or where they come from,” his statement concluded.
Here are the health care bills that Lombardo vetoed:
- AB 11: codified the state’s long-standing practice of prohibiting corporate hospitals and hospital systems from directly hiring physicians.
- AB 201: required the Department of Health and Human Services to provide oversight and recommendations for children’s behavioral health.
- AB 251: required pharmacies to provide prescription drugs in the 10 most commonly spoken languages in the state.
- AB 250: lowered drug prices negotiated through the Federal Inflation Reduction Act and extended those price caps to all Nevadans, even those not on Medicare.
- AB 265: created a statewide mental health consortium and a subcommittee on children’s mental health.
- AB 282: provided a $450 monthly health care coverage stipend for long-term substitute teachers who work for 30 or more consecutive days.
- AB 383: ensured all Nevadans had a right to contraception.
- AB 439: ensured that insurance companies with arbitration provisions would not be binding to the person insured who makes a claim.
- SB 302: prevented licensing boards from prosecuting health care professionals providing gender-affirming care.
- SB 429: required certain new or expanding businesses to provide family and medical leave to employees to qualify for a partial abatement of certain taxes, did contain veto messages.
- SB 419: dubbed the HOPE Act, required insurers and health care entities to provide patient documents and information electronically and provided prenatal and delivery coverage to pregnant people regardless of immigration status.
- SB 239: legalized the use of medication designed to end the life of a terminally ill patient.
Because their vetoes were issued after the conclusion of the regular session, four of the vetoed health care bills will return to the 2025 Legislative Session, where they could be overridden with a two-thirds majority vote. This includes the HOPE Act.
The other vetoed bills were already returned to the legislature and no further action was taken. Veto overrides are uncommon in the Nevada State Legislature. Democrats have a supermajority in the Assembly but are one senator shy in the Senate, meaning a Republican would have to agree to override the governor.
Proponents of the vetoed bills say they could have addressed the health care concerns from the years-long COVID-19 pandemic that exasperated mental health and physical health, America’s ongoing healthcare affordability crisis, and the opioid epidemic as more Nevadans expressed concern over the cost of prescription drugs and struggling to find doctors for care.
“Governor Lombardo’s veto of this legislation is a slap in the face to our patients and people across the state who are struggling to afford the prescriptions they need just to live,” said Dr. Harpreet Tsui, an internist in Henderson and Nevada Lead for the Committee to Protect Health Care, in a press release responding to the veto of the prescription drug cap bill (AB 250). “Too many Nevadans are suffering needlessly, making impossible choices between paying for medicine and getting groceries, and Governor Lombardo had an opportunity to work with the Legislature to fix the broken status quo. Doctors are deeply disappointed that Lombardo apparently chose partisan politics and pharmaceutical profits over the health of Nevada residents.”
In his veto message, Lombardo said that the substitute teacher health stipend bill (AB 282) does not provide the stipend for charter school long-term substitute teachers and is burdensome to the school districts.
“With a veto of this bill that had bipartisan support, Governor Lombardo has doubled down on the notion that his priority is private school vouchers. Our substitute teachers in public schools should not be subject to political games and risk financial ruin from medical debt,” Athar Haseebullah, the director of ACLU of Nevada, said in a press release.
Lombardo touched on government efficiency, a stated priority of his, in his veto message of the bull to create a statewide mental health consortium (AB 265), stating it would add an “unnecessary level of bureaucracy.”
The veto letter for the bill requiring paid family medical leave for tax-abated companies echoed that sentiment.
However, the provisions of that bill were enacted into law after Democrats attached it as an amendment to the legislation approving subsidies for the A’s baseball field, which passed during a legislative special session Lombardo called after the conclusion of the regular session.
Lombardo is the first U.S. governor to veto a medical-aid-in-dying bill. California, Colorado, Hawaii, Maine, Montana, New Mexico, New Jersey, Oregon, Vermont, Washington and Washington, D.C. have all authorized medical aid in death.
“His decision to veto this bill effectively puts him in the exam room with terminally ill patients, interfering with their decisions about end-of-life care and preventing them from dying on their terms when their suffering is intolerable,” said Sara Manns, Nevada campaign director for Compassion & Choices Action Network, in a press release. “He vetoed this bill without ever talking to the people it will immediately impact or meeting with policy experts who have worked on this issue for decades.”
Lombardo now holds the record for most vetoes by a Nevada governor in a single session. His 75 vetoes far surpass the previous high of 49, set by Republican Gov. Jim Gibbons in 2009.
“Nevadans elected me to protect and serve our state – which includes protecting Nevadans from harmful and dangerous legislation,” Lombardo said in a press release announcing he had signed or vetoed all outstanding bills. “So, while I’m proud of the legislation we were able to pass this session, I’m also confident in my decision to veto bills that did not serve the best interest of all Nevadans.”
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