
WASHINGTON, DC - MARCH 21: Senate Majority Leader Charles Schumer (D-NY) (R) talks with House Minority Leader Hakeem Jeffries (D-NY) while attend an event to mark the 14 anniversary of the passage of the Affordable Care Act at the U.S. Capitol on March 21, 2024 in Washington, DC. While celebrating the anniversary of the landmark law, Democrats from the House and Senate warned that Republicans continue to try to weaken or eliminate the legislation that made health care affordable for millions of Americans. (Photo by Chip Somodevilla/Getty Images)
As Chair of the Senate Health and Human Services Committee, I think about healthcare access every single day—because for many Nevadans, it’s not a policy issue. It’s personal. It’s about whether your child gets to see a doctor. Whether your mom can afford her insulin. Whether your neighbor can survive cancer without going bankrupt.
March marked the 15th anniversary of the Affordable Care Act (ACA)—what most people know as Obamacare. When it passed in 2010, it changed everything. For the first time in our nation’s history, insurance companies were banned from discriminating against people for having pre-existing conditions. No more charging women more just because they’re women. No more lifetime caps that leave patients high and dry when they need care the most.
Was it a perfect rollout? No. But like so many game-changing reforms, it faced its fair share of resistance—especially from people like President Trump who made it his mission to repeal the Affordable Care Act during his first term. Despite all that, the ACA survived. It’s stronger, more popular, and more vital than ever.
Today, over 24 million Americans are covered through the ACA marketplaces. That’s a record. And thanks to enhanced tax credits passed under President Biden, that coverage is more affordable than ever. In states like Texas, where Republican leaders refused to expand Medicaid—ACA enrollment tripled. That’s the power of policy that puts people first.
Right here in Nevada, 99,312 people received healthcare through the ACA in 2024. But that number doesn’t even capture the full scope. More than 800,000 Nevadans—that’s nearly 1 in 4 of us—got coverage last year through Medicaid, which was expanded under the ACA to include low-wage workers, gig workers, and folks who otherwise wouldn’t have access to insurance.
These are not just statistics. These are our neighbors, our friends, our families. People that I hear from in the Legislature every single day. But all of this—all of it—is under threat again.
Less than 100 days into this new year, the Republican-led House has already passed a budget proposal that takes direct aim at both ACA coverage and Medicaid expansion. Their plan? Let the enhanced premium tax credits expire. That means next year, millions of people will lose coverage or face skyrocketing premiums. Research shows over 5 million Americans are at risk of losing coverage entirely.
And the impact won’t be felt equally. Young adults, Black and Latino families, and people living with chronic illnesses are all expected to be hit hardest. We’re talking about folks with asthma, cancer, cardiovascular disease, and diabetes—people who simply can’t afford to go without coverage.
For those who do manage to stay on ACA coverage without the enhanced credits, they’ll be paying an average of $1,200 more per year. For many families, that’s rent. That’s groceries. That’s a car payment.
Meanwhile, House Republicans are already floating proposals to slash Medicaid expansion—the very lifeline that now covers over 20 million Americans. Most of these individuals work in low-wage jobs—like hospitality, food service, and home care—where no affordable insurance is offered.
So where is all this “savings” going? Not to lower prescription drug prices or fix our broken long-term care system. Nope. The plan is to funnel it into tax breaks for the wealthiest Americans. Over $1 trillion in cuts to Medicaid and SNAP food assistance—just to keep tax cuts for billionaires and corporations on the books.
Let me be clear: that’s not fiscal responsibility. That’s robbery dressed up in a budget resolution.
Republicans claim they want to help working families. But their actual plan would strip healthcare and food assistance from those families—just to make the rich a little richer.
In Nevada, we won’t stand for that.
As long as I serve in the Legislature, I will fight tooth and nail to protect the Affordable Care Act, defend Medicaid, and make healthcare more affordable—not less. But we need every Nevadan in this fight, because the stakes have never been higher.
Let’s protect the progress we’ve made. And let’s keep pushing forward—toward a future where every Nevadan can get the care they need, when they need it, without fear of going broke

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