Health care and pharmaceutical groups gave Nevada legislators more than $1.7 million during the 2024 election cycle, an increase of about 30 percent from the prior cycle.

The pharmaceutical industry was responsible for about $300,000 of the total contributions, while health care groups — defined as anything from hospitals and insurers to patient advocacy groups — donated about $1.4 million.

About two-thirds of health care groups' dollars went to Democrats (who hold 40 of the Legislature’s 63 seats) while the pharmaceutical industry was more even in giving to lawmakers in both parties, with about 60 percent of the donations going to Democrats.

The spending totals reflect the prominence of Nevada’s health care players, ahead of a legislative session where dozens of proposals have been brought forward to address the rising cost of health care and make other changes that could significantly alter the state’s health care landscape.

Gov. Joe Lombardo highlighted health care costs in his January State of the State address, noting that access to health care is “too limited for too many.” He pledged to make one of his five proposed policy bills address Nevada’s health care system, while also calling to split up the state’s Department of Health and Human Services into two agencies.

Though Lombardo’s bill has not yet been introduced, lawmakers have already heard measures to expand residency training and postdoctoral fellowships (a popular idea on both sides of the aisle), update requirements for insurance approvals for specific treatments or prescriptions, set a timeline for overpayments to providers to be returned and tackle the high cost of prescription drugs by proposing changes to pharmacy benefits managers, or those administering an insurer’s prescription drug benefit plan.

Lawmakers aren’t weighing the various proposals in a bubble — they’re negotiating with members of the health care industry, patient advocates and policy experts.

This analysis is part of The Nevada Independent’s “Follow the Money” series, which explores the industries that gave the most money to state legislators during the 2024 election cycle and their goals for the 2025 session. The series results from a manual categorization of about 11,000 contributions from donors who gave more than $200 throughout the cycle.

Click here to see previous editions.

Pharmaceutical

The $144,000 donated by the Pharmaceutical Research and Manufacturers of America (PhRMA) — a trade group that represents pharmaceutical groups — made up nearly half of the pharmaceutical sector’s total donations to lawmakers, with the donations almost evenly split among Democrats and Republicans. This was a nearly $30,000 increase from the 2022 election cycle.

The Nevada Independent previously reported that pharma groups typically do not base long-term contribution strategies on specific pieces of legislation, but rather use it as a way to get their foot in the door with influential lawmakers.

Most donations came in 2024, but about one-third was donated in 2023 — all to Republicans.

The 2023 session was a prominent one for the industry. Lombardo vetoed a Democrat-backed, industry-opposed proposal (AB250) that would see Nevada piggyback off the federal Inflation Reduction Act — which allowed Medicare to negotiate the price of prescription drugs — by applying those price caps statewide, not just to those on Medicare. 

The bill has been reintroduced this session with no changes as AB259, and PhRMA is once again opposing the bill on the grounds that it places an arbitrary price cap on medicines without state-level review.

“The needs are still here,” Assm. Venicia Considine (D-Las Vegas), who sponsored the bill and 2023 version, said at a hearing last month. “It’s two years later, and we’re still in the same situation … I am hopeful that the governor will do the right thing this time.”

It is also opposing AB44, the proposal from Attorney General Aaron Ford that aims to outlaw price fixing of essential goods, including medication. PhRMA has argued that it is akin to price controls.

In a statement, PhRMA spokesman Reid Porter said “we may not agree on every issue, but we believe dialogue is important to promoting a policy environment that supports innovation, a highly-skilled workforce and lifesaving medicines that are affordable for patients.”

In second was the Pharmaceutical Care Management Association (PCMA) — a trade association that represents pharmacy benefit managers (PBMs) — which gave $36,500 to legislators, a slight uptick from 2022. Notably, more than 80 percent of the group’s donations went to Democrats, among the highest shares of any pharmaceutical group.

PBMs are responsible for determining the list of prescription drugs health plans offer to enrollees and negotiating discounts with manufacturers, among other roles. 

Read More: Indy Explains: Are pharmacy benefit managers to blame for high drug prices?

This year, legislators are considering a handful of PBM-related bills, including SB389, which would require the state’s health agency to contract with a single PBM by 2030 to oversee all coverage and prescription drug benefits. 

SB316, a wide-ranging bill, would also establish certain PBM transparency and disclosure rules, including prohibiting them from obstructing a person’s ability to access a prescription drug at certain pharmacies in a timely manner and other new requirements.

PCMA opposed the bill, saying that the transparency requirements should also apply to all other entities in the pharmaceutical supply chain. It also said that PBM bills passed in other states have not lowered patient costs or increased access to drugs, noting that pharmaceutical manufacturers determine drug costs, not PBMs.

By contrast to PCMA’s Democratic lean, about two-thirds of the money that major drug manufacturer Pfizer donated went to Republicans, despite their significant minority in the Legislature.

Of the five top recipients of the industry’s dollars, four were either in leadership roles or sit on their chamber’s health committees, led by Sen. Rochelle Nguyen (D-Las Vegas), the vice chair of the Senate Committee on Health and Human Services, who raised $28,500.

The top Republican recipient was freshman Assm. Rebecca Edgeworth (R-Las Vegas), who is a doctor and received $11,500.

Health care

The distribution of health care sector’s campaign dollars were more evenly distributed.

Half of the industry's $1.4 million in donations came from just 10 groups, primarily state advocacy groups and insurance providers. Groups that The Indy designated as part of the health care sector often have different priorities, with entities that advocate on behalf of patients often at odds with larger health care providers.

The top non-pharmaceutical health care donor was HCA Healthcare, a Tennessee-based health care conglomerate that runs many Nevada urgent care practices and the Sunrise, Sunrise Children's, MountainView and Southern Hills hospitals in Las Vegas.

The company donated more than $150,000 — split evenly between Democrats and Republicans — which was slightly more than its donations made in 2022.

HCA Healthcare declined to comment, but has been involved in several bills this session.

It is opposing SB378, a bill that would hinder the use of freestanding emergency departments, a type of emergency room that is separate from a hospital but provides the same level of care.

It also opposed SB182, which would require minimum nurse-to-patient staffing ratios in Nevada hospitals, on the grounds that it could lead to increased patient wait times by limiting bed availability and higher costs of care.

The second-largest donor was the Nevada Hospital Association, the state’s top advocacy group for hospitals. It gave $135,000 to legislators during the 2024 cycle, with about 60 percent going to Democrats.

In a statement, the association said it “works to safeguard consumers from legislative action that could potentially increase the cost of healthcare.”

“Our priority is to work with legislators to ensure they fully understand how proposed policies align with hospital operations and the potential impacts — both positive and negative — on our already fragile healthcare delivery system,” the statement said.

Sean Golonka contributed data analysis and Tabitha Mueller contributed reporting.