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145,000 Nevadans could lose Medicaid under Big Beautiful Bill new report shows

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A new report estimates how many Nevadans could lose Medicaid coverage in 2028 due to the Big Beautiful Bill.

People who are self-employed, family caregivers, or have difficulties working but aren’t disabled are most at risk. They will need to meet new work requirements and six-month redeterminations, or prove they remain exempt. The changes go into effect in January.

Katherine Hempstead, a senior policy officer with the Robert Wood Johnson Foundation, said the rollout will vary depending on how much each state can automate data to determine eligibility.

“Match people on SNAP to people in Medicaid, because then you can see whether people are exempt from a SNAP work requirement. There’s also pulling in payroll, being able to figure out who’s a parent, what medical treatment people have gotten,” Hempstead said.

The study outlines the impacts based on high and low mitigation efforts. In the best-case scenario, 71,000 Nevadans would be at risk of losing Medicaid. If the state doesn’t act, up to 145,000 people could be affected.

Lucia Starbuck is an award-winning political journalist and the host of KUNR’s monthly show Purple Politics Nevada. She is passionate about reporting during election season, attending community events, and talking to people about the issues that matter most to them.
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  • Purple Politics Nevada is back for its fourth season, featuring the voices driving the 2026 election. Tune in on the third Friday of each month at 7:30 a.m. and 6:30 p.m., as well as the following Sunday at 4 p.m.