Fighting for the health and wellbeing of all Nevadans has always been a top priority for me. I championed the passage of the Affordable Care Act, commonly referred to as the health reform law, which is helping thousands of Nevadans and millions of Americans gain access to the affordable health care that they need and deserve. I am also committed to protecting and preserving Medicare for seniors, investing in critical biomedical research to advance promising new medical discoveries, and supporting our health care workforce through investing in education and recruitment.

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Health Care Reform Means
A Better Future for Nevada

The Affordable Care Act will ensure that all Nevadans and Americans have access to quality, affordable health coverage. This reform is not only lowering costs, but improving choices, competition and offering more assistance to ensure that all Americans can afford health insurance. The law strengthens Medicare for Nevada’s seniors, extending the solvency of the program by more than a decade. This law can be improved, but with over 605,000 Nevadans without health insurance, Nevada cannot afford to repeal it.

In 2014, the Affordable Care Act began ensuring a competitive insurance marketplace where individual Nevadans and our small businesses can purchase affordable health insurance coverage. Nevada has also expanded its Medicaid program to cover an additional 78,000 people with the Federal government covering all medical costs for the first three years. The law provides assistance to help small businesses retain insurance, preserves early retiree coverage, lowers costs for Medicare beneficiaries, and covers young people who cannot afford insurance.

The health reform law is a fiscally responsible approach to improving our health care system, lowering costs for businesses and consumers, and covering uninsured Americans. The Congressional Budget Office has determined that the law is fully paid for, will slow the growth of health care costs, and will actually reduce the deficit by more than a trillion dollars over the next two decades.

For detailed information on health care reform, please click here.

Highlights of Benefits of Health Care Reform for Nevada

Bans Denials Due to Pre-Existing Conditions

  • Because of the law, insurance companies are no longer allowed to deny coverage or charge more to cover people with pre-existing conditions. As many as 1,157,045 non-elderly Nevadans have some type of pre-existing health condition, including 162,452 children.
  • To bridge the gap to 2014, uninsured Nevadans with pre-existing conditions benefitted from $61.1 million to provide coverage through the Pre-Existing Condition Insurance Plan (PCIP), funded by the Federal government.

Bans Dropping Patients When They Get Sick

  • Insurance companies are banned from dropping people from coverage when they get sick just because of a mistake in their paperwork. This protects individuals who purchase insurance in the individual market from dishonest insurance practices.

Provides New Coverage Options for Young Adults

  • Parents can now keep their children up to age 26 without job-based coverage on their insurance plans. As of the end of 2011, 33,000 young adults in Nevada gained insurance coverage as a result of the law.

Ends Caps on Coverage

  • Insurance companies are no longer able to place lifetime limits on the coverage they provide. Already, 937,000 people in Nevada are free from worrying about their coverage running out and facing catastrophic out-of-pocket costs.
  • Insurance companies are no longer allowed to place annual limits on coverage.

Provides assistance to Small Businesses and early Retirees

  • 30,345 small businesses in Nevada may be eligible for the new small business tax credit that makes it easier for businesses to provide coverage to their workers by making premiums more affordable.
  • Thanks to the Affordable Care Act’s Early Retiree Reinsurance Program, 24 employers in Nevada have been approved to receive support for continuing to provide health coverage to their early retirees.

Offers Free Preventive Care

  • All 379,860 of Medicare enrollees in Nevada now have access to preventive services such as colorectal cancer screenings, mammograms, and an annual wellness visit without copayments, coinsurance, or deductibles.
  • 71 million Americans with private health insurance now have access to preventive service coverage such as mammograms and cancer screenings with no cost-sharing, including 615,000 in Nevada.
  • Since 2010, Nevada has received $7.5 million in grants from the Prevention and Public Health Fund, which was established by the Affordable Care Act to support effective policies in Nevada, and across the country so that all Americans can lead longer, more productive lives.
  • Starting on August 1, 2012, new and renewed health insurance plans started providing women with access to a full range of preventive services without co-pays or deductibles. This includes important preventive services such as: annual well-women visits, prescription birth control, HIV screening and counseling, sexually transmitted infection counseling, screening for gestational diabetes, breastfeeding consultation and supplies, and screening and counseling for domestic violence. Almost 400,000 women in Nevada now have guaranteed access to these additional preventive services without cost-sharing.

Strengthens Medicare

  • In the first 11 months of 2013 alone, 169,577 Nevadans on Medicare received one or more free preventive services – such as mammograms and colonoscopies – and 22,142 took advantage of free annual wellness visits with their doctor.
  • More than 25,077 Nevadans who hit the Medicare prescription drug coverage gap known as the “donut hole” received $250 tax-free rebates in 2010.
  • Nationwide, more than 7.3 million people with Medicare have saved $8.9 billion on prescription drugs.
  • In 2013, almost 21,000 Nevadans with Medicare who reached the donut hole have saved more than $15 million, an average of $761 per beneficiary.
  • The savings for seniors will increase in the coming years, and by 2020, the law will close the donut hole completely.

Increases the Value of Your Premium Dollar

  • Under the health care law, insurance companies must provide consumers greater value by spending at least 80 percent of premium dollars on health care and quality improvements instead of non-health care costs, such as overhead, executive salaries, or marketing. Otherwise, they must provide consumers a rebate or reduce premiums. This means that 88,491 Nevada residents with private insurance coverage benefited from $3,977,544 in rebates from insurance companies in 2013, for an average refund of $75 per family covered by a policy.

Supports Nevada’s Work on Health Insurance Marketplaces and Policing Unreasonable Premium Increases

  • Nevada has received almost $74.8 million in grants for research, planning, information technology development, and implementation of the health insurance marketplace (also known as Exchanges), where Nevadans will be able to shop for the health insurance option that best meets their needs. In Nevada, the state-run marketplace is called Nevada Health Link.
  • In every state, and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Nevada has received nearly $5 million under the new law to help fight unreasonable premium increases. We are already seeing the impact of these policies: nationwide, the average premium increase in 2012 was 30 percent lower than in 2010. And today, far fewer insurance plans are raising premiums over 10 percent than in 2012.

Increases Support for Community Health Centers

  • The Affordable Care Act increases resources available to community health centers in all 50 states, including the 30 existing Community Health Center Sites in rural communities and cities across Nevada.
  • Health centers in Nevada have received more than $8.3 million from the Affordable Care Act. These funds are being used to create new health center sites in medically-underserved areas, enable existing health centers to increase the number of patients served, expand preventive and primary health care services, and support major construction and renovation projects.

Increases the Health Care Workforce Shortage

  • Nearly 13 percent of Nevada residents live in an area with a shortage of doctors or nurses or lacking in health care facilities. The law includes new resources to boost the number of doctors, nurses, and health care providers in communities where they are needed most. These resources include grants, scholarships, loan repayment programs, as well as increased support for educational institutions that provide training for a range of health care careers.
  • The Affordable Care Act also ensured that Nevada received more graduate medical education training slots because physicians who train in our state are more likely to stay in Nevada to practice when they complete their educations.

Provides More Resources for Nevada

The law provides states resources to support their work to expand the health care workforce, crack down on fraud, and support public health. So far, Nevada has received millions of dollars from the Affordable Care Act to support these efforts, including funding:

  • To support the National Health Service Corps, by assisting Nevada in recruiting health care professionals to serve in areas with a shortage of doctors, nurses, and other health care workers in exchange for assistance with their educational loans.
  • To help Nevada reduce health care fraud by identifying efficient and effective procedures for long-term care facilities to conduct background checks on prospective employees, thereby protecting their residents.
  • To support outreach to eligible Medicare beneficiaries about the benefits they have earned.
  • For Family-to-Family Health Information Centers, organizations run by and for families with children with special health care needs.
  • To support the Personal Responsibility Education Program, to educate youth on both abstinence and contraception for the prevention of pregnancy and sexually transmitted infections, including HIV/AIDS.
  • For disease demonstration projects, to test innovative health care approaches for Medicaid beneficiaries.
  • For Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the support needed for a child’s health, development, and ability to learn – such as health care, early education, parenting skills, child abuse prevention, and nutrition.

Provides Tax Credits to Make Health Care More Affordable

  • New tax credits are now available to help middle class families afford health insurance coverage through Nevada Health Link, Nevada’s health insurance marketplace.
  • The tax credits are advancable, meaning that you do not have to wait until tax time to benefit.

Expands Coverage Through Medicaid

  • Nevada is now receiving additional resources to expand Medicaid to cover individuals with incomes of up to $15,282, or $31,322 for a family of four. The federal government will cover 100 percent of the costs of expansion at the outset.
  • As more Americans gain coverage, states and local governments are estimated to save approximately $70-80 billion in uncompensated care which exceeds the new costs to states of expanding Medicaid. In Nevada, an additional 78,000 people will be eligible for coverage.
  • In 2013 and 2014, primary care physician rates in Medicaid will be increased to rates equal to Medicare rates with full federal funding.

Reduces the Deficit and Strengthens the Economy

  • The Congressional Budget Office projects that the Affordable Care Act will reduce the deficit by more than $1 trillion in the next two decades.
  • As a result of expanding Medicaid, Nevada will add an estimated 3,400 to 8,600 jobs.
  • The economy has created nearly 6.2 million private sector jobs nationwide since the law was signed in 2010. Experts predict that the law will create anywhere from 250,000 to 400,000 jobs each year.


Seniors and people with disabilities know the value of the Medicare program, which is why I am proud the health care reform legislation we passed in Congress will strengthen and extend Medicare’s solvency. For more information on how health care reform with benefit Nevada’s seniors and the Medicare program, please click here.

I am committed to protecting and preserving Medicare for current and future beneficiaries, which is why I will continue to lead the fight against ending the program as we know it by turning it into a voucher program and increasing seniors’ costs.

If you need assistance enrolling in Medicare, please visit If you have an issue that requires my help, please visit my Casework page.

Women’s Health Care

Thanks to the Affordable Care Act, millions of uninsured women are now eligible for comprehensive health coverage. Women cannot be charged more for the same policy as men, and women cannot be denied coverage because they have a pre-existing condition. In addition, new health plans are now required to cover recommended preventive care like mammograms and prescription contraception without any co-pays or deductibles.

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Investing in Medical Research and Supporting Patients

Throughout my time in Congress, I have supported funding for lifesaving medical research and legislation to advance prevention, treatment and the development of cures for a wide range of illnesses.

National Institutes of Health

I have long supported increased funding for the National Institutes of Health (NIH), our nation’s premier medical research institution. As part of the American Recovery and Reinvestment Act, I supported allocating over $9 billion in additional funding for the NIH. These investments were intended to advance research by our nation’s most promising researchers affecting a broad range of illnesses and conditions like cancer, Alzheimer’s disease, heart disease, diabetes, Parkinson’s disease, and spinal cord injuries.

Stem Cell Research

In 2006 and 2007, I supported legislation that passed both the Senate and House that would have lifted the ban on promising stem cell research and supported federal funding and regulation of this research. In 2009, President Obama implemented this policy through an Executive Order.


In addition to directing federal funds to cancer research at the NIH, I have supported a number of bills dedicated to cancer research, prevention, and treatment which are now law, including: the Recalcitrant Cancer Research Act, which will intensify research efforts to cancers like pancreatic, lung, liver, and ovaries that are difficult to detect and treat, the Family Smoking Prevention and Tobacco Control Act, which is helping to prevent the high rate of death from lung cancer in Nevada; the Breast Cancer and Environmental Research Act, which is helping to establish a national strategy to study the potential links between the environment and breast cancer; the Caroline Pryce Walker Conquer Childhood Cancer Act, which expands research programs aimed at preventing childhood cancer; and the National Breast and Cervical Cancer Early Detection Act, which funds the Women’s Health Connection in Nevada and provides timely access to breast and cervical cancer screening for low-income, uninsured, and underserved women.


I also supported the creation and reauthorization of the Special Diabetes Program which provides $150 million annually for research towards a cure for type 1 diabetes and $150 million annually for diabetes treatment and prevention strategies targeted to Native American populations.


I have repeatedly advocated for funding to fight HIV and AIDS and to treat those living with the disease. I supported the creation of the Ryan White CARE Act in 1990 and its reauthorizations in 1996, 2000, 2006, and 2009. Most recently, I led the Senate in passing the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act, which will help fight HIV/AIDS and other diseases in Africa and around the globe.

Mental Health

Throughout my time in Congress, I have fought to pass legislation that is improving the quality and availability of mental health services. I was instrumental in the creation of the first ever National Suicide Prevention Strategy, which created a framework to address the crisis of suicide in the United States. I also helped pass the Garrett Lee Smith Memorial Act, a law which provides additional funding for research, training, and technical assistance to target youth suicide, and I was the author of the Stop Senior Suicide Act. I also supported legislation that will lower Medicare coinsurance for outpatient mental health, and in 1996 and 2008, I helped to secure passage of mental health parity laws that are helping to ensure that mental illnesses are treated on par with other physical illnesses. And thanks to the Affordable Care Act, an estimated 62.5 million Americans will have access to mental health and substance abuse benefits and federal parity protections.

For more information about my work on suicide prevention, please read:


Throughout my time in Congress, I have championed many other bills that are now law, like the ALS Registry Act, a law that will help scientists find treatments or a cure for ALS (Lou Gehrig’s disease); and the Genetic Information Nondiscrimination Act of 2008, a law that will help fulfill the promise of genetic research by ensuring that genetic information cannot be used to discriminate against individuals by their insurance companies and employers. I will continue to support legislation that invests in life-saving medical research and that supports patients.