Public policy in Nevada

The Public Policy Project on Ballotpedia aims to illuminate major policy issues being discussed and implemented throughout the United States. Public policy can be complicated and controversial; deciding what works best and how to allocate resources to achieve a policy goal can involve multiple trade-offs. Much of the public policy that affects citizens economically, legally and socially, is made at the state level. Below you will find links and introductions to all the Nevada public policy articles on Ballotpedia. To see the policy overview of another state click on the map below.

For a list of all public policy articles on Ballotpedia see here.

Budget Policy

Budget and finances

In Nevada, as in other states, lawmakers and public officials are elected in part to manage the state's finances. This includes generating revenues (money coming into the state from various sources) and approving expenditures (the money spent on governmental functions and servicing state debt). State budgets are complex and fluid, as they depend on anticipated revenues and planned expenditures, which may alter over the course of a fiscal year. If revenues do not keep pace with expenditures, states generally have to raise taxes, cut services, borrow money, or a combination of the three. State budget decisions are also influenced by policy decisions at the national level, such as the Affordable Care Act or energy and environmental regulations, and issues at the local level, such as crime and the quality of education.

Taxes

Nevada generates the bulk of its tax revenue by levying a general sales tax and select sales taxes (otherwise known as excise taxes). The state derives its constitutional authority to tax from Article 10 of the state constitution.^[2][3]

Tax policy can vary from state to state. States levy taxes to help fund the variety of services provided by state governments. Tax collections comprise approximately 40 percent of the states' total revenues. The rest comes from non-tax sources, such as intergovernmental aid (e.g., federal funds), lottery revenues and fees. The primary types of taxes levied by state governments include personal income tax, general sales tax, excise (or special sales) taxes and corporate income tax.^[4]

Civil Liberties Policy

Affirmative action

Affirmative action in Nevada refers to the steps taken by employers and universities in Nevada to increase the proportions of historically disadvantaged minority groups at those institutions. Historically, affirmative action nationwide has taken many different forms, such as strict quotas, extra outreach efforts, and racial and gender preferences. However, racial quotas in university admissions were banned in a 1978 United States Supreme Court case, Regents of the University of California v. Bakke.^[5]

On June 29, 2023, the Supreme Court reversed lower court decisions in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina, effectively ending the use of affirmative action in college admissions.

As of March 2015, 109 out of 577 public four-year universities across the country reported that they considered race in admissions. This practice has been banned in eight states. Meanwhile, 28 states require affirmative action plans in either public employment or apprenticeships. Affirmative action programs that grant racial preferences have come under scrutiny in the courts for potentially violating the Equal Protection Clause of the Fourteenth Amendment and Title VII of the Civil Rights Act.^[6][7]

The following information details the use of affirmative action in universities and employment in Nevada, as well as notable court cases originating in the state.

The effects of affirmative action policies are contested. Proponents argue that affirmative action diversifies selective institutions and provides more opportunities to minorities. Opponents argue that implementing policies that favor some groups requires discrimination against others and that these policiesmay harm individuals they are meant to help.

Campaign finance

Nevada campaign finance requirements govern the following:

• how much money candidates may receive from individuals and organizations,
• how much and how often they must report those contributions, and
• how much individuals, organizations and political parties may contribute to campaigns.

In addition to direct campaign contributions, campaign finance laws also apply to third-party organizations and nonprofit organizations that seek to influence elections through independent expenditures or issue advocacy.

As of May 2015, individuals, corporations, and unions could contribute no more than $5,000 to candidates for office. They could make unlimited contributions to PACs, party committees, and ballot measure campaigns.

Nonprofit regulation

Nonprofit regulation in Nevada involves a complex set of rules that govern nonprofit organizations and charitable giving throughout the state. Major issues surrounding nonprofit regulation nationwide include the following:

• contribution limits,
• donor disclosure, and
• the redefinition of issue advocacy.

Nevada is one of 39 states that require charitable organizations, and those intending to solicit on their behalf, to register with the state in order to solicit contributions, whether they are Nevada organizations or based out of state. In Nevada a number of groups and organizations are exempt from registration. These groups, however, must apply for exempt status; it is not automatic.^[8]

Nevada is one of only seven states requiring registration that do not accept the Unified Registration System (URS). Unlike the 32 other states requiring registration that do allow the URS, those registering in Nevada must file through the state's electronic system.^[8]

Greater regulation of charitable contributions involves trade-offs that can affect participation in the civic sector and democracy itself. Proponents of more restrictions on nonprofits and more disclosure claim that undisclosed special interests reduce public trust in the system. Those against mandatory disclosure cite the right to privacy and freedom of speech; they point to research showing that more transparency has an unintended negative effect on giving.[9][10]

Education Policy

Charter schools  •  Higher education  •  Public education  •  School choice

K-12 Public education

The Nevada public school system (prekindergarten through grade 12) operates within districts governed by locally elected school boards and superintendents. In 2022, Nevada had 447,603 students enrolled in a total of 668 schools in 20 school districts. There were 23,577 teachers in the public schools, or roughly one teacher for every 19 students, compared to the national average of 1:16. In 2020, Nevada spent on average $9,814 per pupil.^[11] The state's graduation rate was 84 percent in the 2018-2019 school year.^[12]

Higher education

Nevada's higher education system is composed of 26 colleges and universities. Of these, seven are public institutions, four are nonprofit private schools, and 15 are for-profit private institutions.^[13]

School choice

School choice is a term that refers to programs offering alternatives to assigned local public school options. Public school choice options include open enrollment policies, magnet schools, and charter schools. Other options include school vouchers, scholarship tax credits, and education savings accounts (ESAs).^[14][15]

Proponents argue that school choice programs improve educational outcomes by expanding opportunity and access for historically disadvantaged students. In addition, advocates claim that school choice programs empower parents and improve traditional public schools through competition. Critics contend that these programs divert funds from traditional public schools, thereby generating unequal outcomes for students. In addition, some critics argue that school voucher programs wrongly direct tax dollars to religious organizations, which operate many private schools.

Charter schools

Charter schools in Nevada are public schools operated independently of public school systems, either by nonprofit or for-profit organizations. Although they are largely publicly funded, charter schools are exempt from many of the requirements imposed by state and local boards of education regarding hiring and curriculum. As public schools, charter schools cannot charge tuition or impose special entrance requirements; students are usually admitted through a lottery process if demand exceeds the number of spaces available in a school. Charter schools generally receive a percentage of the per-pupil funds from the state and local school districts for operational costs based on enrollment. In most states, charter schools do not receive funds for facilities or start-up costs; therefore, they must rely to some extent on private donations. The federal government also provides revenues through special grants. As of March 2017, 44 states and the District of Columbia had approved legislation authorizing the creation of public charter schools. Six states had not.

Election Policy

Ballot access requirements

In order to get on the ballot in Nevada, a candidate for state or federal office must meet a variety of state-specific filing requirements and deadlines. These regulations, known as ballot access laws, determine whether a candidate or party will appear on an election ballot. These laws are set at the state level. A candidate must prepare to meet ballot access requirements well in advance of primaries, caucuses, and the general election.

There are three basic methods by which an individual may become a candidate for office in a state.

1. An individual can seek the nomination of a state-recognized political party.
2. An individual can run as an independent. Independent candidates often must petition in order to have their names printed on the general election ballot.
3. An individual can run as a write-in candidate.

This article outlines the steps that prospective candidates for state-level and congressional office must take in order to run for office in Nevada. For information about filing requirements for presidential candidates, see "Ballot access requirements for presidential candidates in Nevada." Information about filing requirements for local-level offices is not available in this article (contact state election agencies for information about local candidate filing processes).

Redistricting

Redistricting is the process by which new congressional and state legislative district boundaries are drawn. Each of Nevada's four United States Representatives and 63 state legislators are elected from political divisions called districts. United States Senators are not elected by districts, but by the states at large. District lines are redrawn every 10 years following completion of the United States census. The federal government stipulates that districts must have nearly equal populations and must not discriminate on the basis of race or ethnicity.^{[16][17][18][19]}

Nevada was apportioned 4 seats in the U.S. House of Representatives after the 2020 census, the same number it received after the 2010 census.

Voting

Energy Policy

Energy information

Energy policy involves governmental actions affecting the production, distribution, and consumption of energy in a state. Energy policies are enacted and enforced at the local, state, and federal levels and may change over time. These policies include legislation, regulation, taxes, incentives for energy production or use, standards for energy efficiency, and more. Stakeholders include citizens, politicians, environmental groups, industry groups, and think tanks. A variety of factors can affect the feasibility of federal and state-level energy policies, such as available natural resources, geography, and consumer needs.

Fracking

Environmental Policy

Environmental information

Environmental policy aims to conserve natural resources by balancing environmental protection with economic growth, property rights, public health, and energy production. Federal, state, and local government entities develop and implement environmental policies through laws and regulations. This page features information about environmental policy in Nevada.

Environmental governance in Nevada

• The Nevada legislature has both a House and Senate standing committee on Natural Resources, Agriculture, and Mining. The committee manages bills relating to natural resources, agricultural and environmental policy.^[20]
• The Department of Conservation & Natural Resources implements state and federal environmental laws. The office includes divisions that oversee environmental protection, forestry, state parks and lands, and water resources.^[21]
• The Division of Environmental Protection is found within the Department of Conservation and Natural Resources. The division is involved with environment and health issues, including air quality, surface and drinking water quality, waste management, mining, oversight of federal facilities within the state, and contaminated sites.^[22]
• The Division of Water Resources is found within the Department of Conservation and Natural Resources. The division manages water resources, water rights, water availability and the construction/operation of dams.^[23]
• The Bureau of Water Pollution Control within the Division of Environmental Protection was created "to protect the waters of the State from the discharge of pollutants." The bureau regulates discharges into Nevada's waters through its permit programs and enforces water pollution control standards.^[24]

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Environmental budget

See also: Environmental spending in the 50 states

The table below features annual budget information for the Nevada Department of Conservation and Natural Resources from 2011 to 2022:

Environmental and natural resources budget in Nevada, 2011-2022
Fiscal year	Total spending
2022	$145,016,703
2021	$148,651,472
2020	$143,082,519
2019	$141,638,933
2018	$131,529,433
2017	$135,347,929
2016	$128,966,017
2015	$126,482,492
2014	$111,813,726
2013	$108,179,079
2012	$110,190,488
2011	$109,356,174
Source: Nevada State Legislature - Fiscal Analysis Division

Air

Clean Air Act

See also: Implementation of the Clean Air Act

The Clean Air Act is a federal law aimed at maintaining air quality and reducing air pollution. The law requires states and private industries to meet national air pollution standards. Each state must implement an EPA-approved plan to reduce air pollutants from industrial facilities such as chemical plants and utilities. Over 47,000 facilities nationwide were regulated under the Clean Air Act as of February 2023.^{[25][26][27][28]}

The table below features information about the number of regulated facilities under the Clean Air Act in Nevada from 2014 to 2023:

Regulated facilities under the Clean Air Act in Nevada, 2014-2023
Year	Number of EPA-regulated facilities	Number of state-regulated facilities	Number of local-regulated facilities	Total regulated facilities
2023	6	93	52	151
2022	8	93	52	153
2021	6	93	50	149
2020	8	94	50	152
2019	10	94	50	154
2018	6	93	49	148
2017	6	90	48	144
2016	6	89	47	142
2015	6	90	44	140
2014	7	87	44	138
Source: U.S. Environmental Protection Agency, "EPA/State Air Dashboard"

Mercury and air toxics standards

See also: Mercury and air toxics standards

Citing its authority under the Clean Air Act, the U.S. Environmental Protection Agency (EPA) in 2011 issued a rule (commonly known as the MATS rule) limiting the amount of mercury and other toxic air pollutants emitted by power plants. Mercury and air toxics standards (MATS) target mercury and other hazardous pollutants from over 580 coal and oil-fired power plants nationwide. The MATS rule was issued by the Obama administration as part of its larger policy limiting emissions from coal-fired power plants.^[29]

The EPA later reconsidered the MATS rule and, in 2020, determined "that it is not 'appropriate and necessary' to regulate electric utility steam generating units under section 112 of the Clean Air Act (CAA)."^[30]

A 2021 proposed rulemaking from the EPA seeks to revoke the 2020 action and reinstate the MATS rule.^[31]

During the period that the MATS rule was in effect, Nevada had six power plants subject to the mercury standards.^[32]

Ozone standards

See also: Ground-level ozone standards

Federal ozone standards establish the acceptable amount of ground level ozone, commonly known as smog, which is formed when nitrogen oxide combines with other organic chemicals in the atmosphere. Automobiles, power plants, factories and manufacturing centers emit the nitrogen oxide necessary for ozone formation. In high concentrations, ozone is harmful to human health.^[33][34]

EPA in 2015 lowered the acceptable amount of ground-level ozone (smog) in the air. The standards will go into effect in 2025. States would have between the years 2020 and 2037 to create and establish a plan to meet the standards, depending how much ozone forms in certain areas of a state.^[35][36]

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Clean Power Plan

See also: Clean Power Plan and climate change

The EPA in 2015 finalized a regulatory action known as the Clean Power Plan aimed at mitigating what the agency views as potentially human-caused climate change. The plan aims to reduce carbon dioxide (CO₂) emissions from coal- and oil-fired power plants (fossil fuel-fired) and natural gas-fired power plants by 32 percent from 2005 levels by 2030. Each state would have to meet goals based on the number of fossil fuel- and natural gas-fired plants in the state.^[37][38][39]

After several states challenged the plan in court, arguing in part that the plan exceeded the EPA's statutory authority, the U.S. Court of Appeals for the District of Columbia Circuit delayed the rule's implementation in June 2016. The Trump administration later moved to replace the Clean Power Plan with the Affordable Clean Energy rule. The D.C. Circuit vacated the Trump-era rule in January 2021, "giving the incoming Biden administration a clean slate for" drafting a new rule, according to Bloomberg.^[40][41]

Carbon dioxide emissions

The following table provides information about annual carbon dioxide emissions in Nevada from 2010 to 2020:^[42]

Carbon dioxide emissions in Nevada, 2010-2020 (in million metric tons of energy-related carbon dioxide)
Year	Total carbon dioxide emissions
2020	36.2
2019	41.7
2018	41.4
2017	40.2
2016	40.0
2015	38.5
2014	40.6
2013	39.7
2012	37.9
2011	37.9
2010	41.4
Source: U.S. Energy Information Administration

Land

Federal land policy

See also: Federal land policy

Federal land policy involves the conservation and management of natural resources on land owned by the federal government. Most federal land policies focus on conservation, recreation, oil and natural gas extraction, wildlife and forest management, and grazing.

The federal government as of 2018 owned around 640 million total acres of land (about 28 percent) of the 2.27 billion acres of land in the United States. Four federal agencies (the Bureau of Land Management (BLM), the Fish and Wildlife Service (FWS), the National Park Service (NPS), the Forest Service (FS) oversee public lands for conservation, recreation, wildlife protection, grazing, energy production, and other purposes. The Department of Defense also oversees federal lands used for military, training, and related purposes. The majority of federal land is located in Alaska and 11 coterminous Western states^[43]

Federal land ownership

See also: Federal land ownership by state

The table below features information about changes in federal land ownership in Nevada from 1990 to 2018:^[43]

Change in federal land ownership in Nevada, 1990-2018
Year	Total federal land (in acres)	Percentage of state land owned by the federal government
2018	56,262,610	80.1%
2010	56,961,778	81.1%
2000	60,180,297	85.6%
1990	60,012,488	85.4%
Source: Congressional Research Service

Federal land management by agency

The following table features information about federal land management in Nevada by federal agency in 2018:^[43]

Federal agency land management in Nevada, 2018
Agency	Total federal land in state managed by agency (in acres)	Percentage of total federal land in state
Bureau of Land Management (BLM)	47,298,840	84.1%
Forest Service (FS)	5,760,954	10.2%
Fish and Wildlife Service (FWS)	2,345,102	4.2%
National Park Service (NPS)	797,613	1.4%
Department of Defense (DoD)	60,101	0.1%
Source: Congressional Research Service

National parks

The U.S. National Park Service (NPS) as of February 2023 oversaw what the agency describes as 424 units (often referred to as parks) and more than 150 related areas within the National Park System. The agency assists in managing national historic areas, wild and scenic rivers, historic landmarks, and national trails. The National Park System contained more than 85 million acres as of February 2023, including national parks, historical parks and sites, national monuments, battlefields and military parks, recreation areas, seashores, and parkways. More than 297 million visitors attended sites in the National Park System in 2021. NPS employed around 20,000 permanent, temporary, and seasonal employees as of February 2023.^[44][45][46]

NPS operated four national parks in Nevada as of February 2023.^[47]

The following table features visitation statistics for national parks in Nevada from 2017 to 2021.^[48]

National Park Service visitation in Nevada, 2017-2021
Year	Total recreation visits
2021	5,880,514
2020	6,143,460
2019	5,756,090
2018	5,837,312
2017	6,079,783
Source: U.S. National Park Service

Payments in lieu of taxes

See also: Payments in lieu of taxes

The U.S. Department of the Interior pays local governments each year to offset what they lose in property taxes due to non-taxable federal land within their borders, commonly known as payments in lieu of taxes (PILT). PILT payments go toward fire and police departments, public schools, road construction, and other local services. PILT amounts are based on population and the amount of federal land in a county. From 1977 (when PILT payments began) to 2022, the Interior Department paid out around $10.8 billion to states, territories, and Washington, D.C. PILT payments can be used for any governmental purpose.^[49][50]

The following table features information about payments in lieu of taxes received by local governments in Nevada from 2017 to 2021.^[51]

Total payments in lieu of taxes, Nevada, 2017-2021
Year	Total payments in lieu of taxes
2022	$26,987,166
2021	$27,250,038
2020	$27,868,890
2019	$28,450,646
2018	$29,146,696
Source: U.S. National Park Service

Oil and natural gas activity

See also: Oil and natural gas extraction on federal land and BLM oil and gas leases by state

The federal government leases its land to private individuals and companies for energy development, including drilling for crude oil and natural gas, solar energy, and geothermal energy. Oil and natural gas drilling on federal lands in the United States is primarily overseen by the U.S. Bureau of Land Management. Private oil and natural gas companies apply for leases from the BLM to produce energy on federal land. About 26 million acres of federal land—12.8 million of which produced oil and gas in economic quantities—were leased to about 24,000 oil and gas developers operating 96,000 wells at the end of fiscal year 2018.^[52]

The following table features information about oil and natural gas activity on federal land in Nevada from 2017 to 2021:^[53][54]

Oil and natural gas activity on federal land in Nevada, 2017-2021
Year	Oil production (in thousands of barrels)	Natural gas production (in million cubic feet)	Total leases in state	Total leased acres in state
2021	222,579	4,344	413	741,895
2020	220,966	9,231	482	872,234
2019	264,989	3,829	518	934,970
2018	252,253	1,666	498	881,252
2017	281,608	1,773	426	715,441
Source: U.S. National Park Service

Water

Clean Water Act

See also: Implementation of the Clean Water Act

The Clean Water Act is a federal law regulating pollutants discharged into all waters of the United States, including lakes, rivers, streams, and wetlands. The federal government approves water quality and technology standards for major sources of water pollution, such as chemical plants, steel manufacturers, municipal facilities, and others. Each state must establish water quality standards for all bodies of water within its boundaries.^[55]

Under the Clean Water Act, it is unlawful to discharge any pollutant from any source into navigable waters without a federal permit. The permit specifies what limitations or conditions apply to a facility before the facility may discharge any pollutants. Federal permits may contain facility-specific requirements and limitations depending on the water source.^[56]

The following table provides information about the number of Nevada facilities subject to regulation under the Clean Water Act from 2014 to 2023:^[57]

Clean Water Act permits, Nevada, 2014-2023
Year	Number of facilities
2023	5,099
2022	5,099
2021	5,089
2020	5,062
2019	4,833
2018	3,827
2017	3,290
2016	2,669
2015	2,033
2014	887
Source: U.S. Environmental Protection Agency, "National Water Activity Dashboard"

Waste

Superfund sites and hazardous waste facilities

See also: Comprehensive Environmental Response, Compensation and Liability Act

Superfund is a federal program that addresses contaminated waste sites and their return to practical use. Superfund sites include oil refineries, smelting facilities, mines and other industrial areas. The federal government can compel the private entities responsible for a waste site to clean the site or face penalties. If the federal government cleans a waste site, it can compel the responsible company to reimburse the government for cleanup costs. Because Superfund sites are added and removed from a prioritized list on a regular basis, the total number of Superfund sites since the program's inception in 1980 is unknown.^[58][59][60]

The federal Resource Conservation and Recovery Act covers hazardous wastes, including their generation, treatment, storage and disposal. States may regulate hazardous wastes rather than the federal government. The EPA is responsible for all hazardous waste requirements if no state program exists. Hazardous waste regulations cover waste generators, transporters, treatment centers, storage and disposal facilities.^[61]

Nevada had one Superfund site and 2,382 regulated hazardous waste facilities as of February 2023.^[62][63]

Endangered species

Endangered Species Act

See also: Endangered species in Nevada

The Endangered Species Act is a federal law that mandates the listing and conservation of endangered and threatened species. The legislation aims to prevent the extinction of vulnerable species throughout the United States and to recover a species' population to the point where listing the species as endangered or threatened is no longer necessary. The U.S. Fish and Wildlife Service is responsible for the law's implementation.^[34][64]

Nevada had 48 federally listed endangered or threatened plant or animal species as of February 2023. To view the full list, click here.^[65]

Environmental ballot measures in Nevada

The following list features historical information about ballot measures relating to environmental issues in Nevada.

Natural resources

• Nevada General Obligation Bonds for State Parks, Question 9 (1970)

Environment

• Nevada Parks and Wildlife Bonds, Question 5 (1990)
• Nevada Hazardous Operation Relocation for Property Tax Reduction, Question 6 (1994)

Water

Ballotpedia staff have tracked no ballot measures relating to water in Nevada

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Recent environmental legislation in Nevada

The following list features information about environmental bills that have been introduced in or passed by the Nevada State Legislature in the last five years. To learn more about these bills, click the bill title. This information is provided by BillTrack50 and LegiScan.

Note: Due to the nature of the sorting process used to generate this list, some results may not be relevant to the topic. If no bills are displayed below, no legislation pertaining to this topic has been introduced in the legislature recently.

See also

• Endangered species in Nevada
• Energy policy in Nevada
• Federal land policy
• Federal land ownership by state
• U.S. Bureau of Land Management
• U.S. Department of the Interior
• U.S. Environmental Protection Agency
• U.S. Fish and Wildlife Service
• U.S. National Park Service

External links

• Search Google News for this topic
• Nevada Department of Conservation and Natural Resources
• U.S. Environmental Protection Agency

Footnotes

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Endangered species

Endangered species policy in Nevada involves the identification and protection of endangered and threatened animal and plant species. Policies are implemented and enforced by both the state and federal governments.

Finance Policy

Financial regulation information

The United States financial system is a network that facilitates exchanges between lenders and borrowers. The system, which includes banks and investment firms, is the base for all economic activity in the nation. According to the Federal Reserve, financial regulation has two main intended purposes: to ensure the safety and soundness of the financial system and to provide and enforce rules that aim to protect consumers. The regulatory framework varies across industries, with different regulations applying to different financial services.^[1]

Individual federal and state entities have different and sometimes overlapping responsibilities within the regulatory system. For example, individual states and three federal agencies—the Federal Reserve, the Office of Comptroller of the Currency (OCC), and the Federal Deposit Insurance Corporation (FDIC)—regulate commercial banks. Other sectors of the financial market are regulated by specific entities.^[2][3]

Some, such as the Brookings Institution, argue that expanded governmental regulation of banks and financial products (e.g., mortgages) can prevent large-scale financial crises, protect consumers from abusive practices, and stabilize financial markets. Others, such as the Cato Institute, argue that over-regulation of banks of banks and financial products burdens business, stalls economic growth, and does little, if anything, to stabilize financial markets. Beyond this basic debate about the role of the government in regulating the private financial sector, there are varying opinions about the proper extent of governmental regulation.^[4][5]

Healthcare Policy

Healthcare information

Healthcare policy in Nevada involves the creation and implementation of laws, rules, and regulations for managing the state's healthcare system. The healthcare system consists of services provided by medical professionals to diagnose, treat, and prevent mental and physical illness and injury. The system also encompasses a wide range of related sectors, such as insurance, pharmaceuticals and health information technology.

According to the National Conference of State Legislatures, the 50 state legislatures collectively "make thousands of health policy decisions each year," not including the decisions made by local governments, which often oversee hospitals, and private bodies, such as insurers. These decisions can include budget appropriations, requirements for doctors obtaining their licenses, which services are covered by insurance, how personal health information is managed, and which immunizations children must receive, among many others.^[6]

Healthcare policy affects not only the cost citizens must pay for care, but also their access to care and the quality of care received, which can influence their overall health. A top concern for policymakers is the rising cost of healthcare, which has placed an increasing strain on the disposable income of consumers as well as on state budgets.

Other issues in healthcare policy include

• state Medicaid expansion,
• health information technology and privacy,
• uninsured and underinsured portions of the population,
• a shortage of primary care physicians, and
• mental healthcare access and coverage.

Medicaid spending

Nevada's Medicaid program provides medical insurance to groups of low-income people and individuals with disabilities. Medicaid is a nationwide program jointly funded by the federal government and the states. Medicaid eligibility, benefits, and administration are managed by the states within federal guidelines. A program related to Medicaid is the Children's Health Insurance Program (CHIP), which covers low-income children above the poverty line and is sometimes operated in conjunction with a state's Medicaid program. Medicaid is a separate program from Medicare, which provides health coverage for the elderly.

Effect of the Affordable Care Act

The impact of the Affordable Care Act of 2010 (ACA), also known as Obamacare, has been debated among politicians, policymakers, and other stakeholders. The ACA was signed into law in 2010 by President Barack Obama (D). The law facilitated the purchase of health insurance through a system of health insurance exchanges, tax credits, and subsidies. Initially, states were required to expand eligibility for Medicaid under the law; a 2012 ruling by the United States Supreme Court made the Medicaid expansion voluntary for states. The law also required insurers to cover healthcare services within a standard set of benefits and prohibited coverage denials based on preexisting conditions. Under the law, all individuals were required to obtain health insurance.

Immigration Policy

Immigration information

Immigration policy determines who may become a new citizen of the United States or enter the country as a temporary worker, student, refugee, or permanent resident. The federal government is responsible for setting and enforcing most immigration policy.

Meanwhile, states assume a largely supportive role, enacting their own supplementary laws and setting policies that may, for example, determine which public services immigrants can access, establish employee screening requirements, or guide the interaction between related state agencies and their federal counterparts.

Some jurisdictions, including some states, cities, and counties, have adopted policies of not cooperating with federal immigration enforcement; these jurisdictions have become known as sanctuary jurisdictions.

Pension Policy

Public pensions

Nevada public pensions are the state mechanism by which state and many local government employees in Nevada receive retirement benefits.

There were four public pension systems in Nevada as of 2020. Of these, three were state-level programs while the remaining one was administered at the local level. Membership in Nevada's various pension systems totaled 204,684, as of fiscal year 2020. Of these, 113,140 were active members.^[7]

Public policy in other states

Footnotes

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