Nevada expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 265,520 of them (13.9% of an expansion pool of 283,845) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.
This model's bottom-up estimate is that 83,853 people in Nevada lose coverage by 2034: 75,887 of them still eligible but lost to paperwork and reporting failures, and 7,966 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.
Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Nevada scores 72 of 100 on this model's ex parte capability index, a low band; its eligibility system is ACCESS Nevada.
Key figures
| Measure | Nevada |
|---|---|
| Expansion state | Yes |
| Subject to the requirement via waiver | No |
| Expansion pool (adults 19 to 64) | 283,845 |
| Adults subject, strict definition | 265,520 |
| Adults subject, permissive definition | 260,210 |
| Share of expansion pool subject | 13.9% |
| Projected coverage loss by 2034 | 83,853 |
| Hardship exception status | Adopting |
| Early implementer | No |
| Ex parte capability score (0 to 100) | 72 (low) |
Who is subject in Nevada
Of the 265,520 subject adults, 40% already work 80 or more hours a month and 54% are not working. 40% have a child under 14 at home. Among those not working, 41% report a disability and 20% are caregivers.
| Characteristic | Share of subject adults |
|---|---|
| Age 19-24 | 12% |
| Age 25-34 | 26% |
| Age 35-44 | 21% |
| Age 45-54 | 18% |
| Age 55-64 | 24% |
| Not working | 54% |
| 1 to 19 hours a month | 1% |
| 20 to 79 hours a month | 6% |
| 80 or more hours a month (meets the bar) | 40% |
| Not working: Disabled | 41% |
| Not working: Caregiver | 20% |
| Not working: Postpartum | 0% |
| Not working: Student | 4% |
| Not working: Other | 34% |
Why eligible people lose coverage
Of the 83,853 projected to lose coverage in Nevada, 75,887 meet the requirement or qualify for an exemption but fail to document it. 26,888 of those are working people who cannot prove their hours through data the state can see, and 49,000 qualify for an exemption the state does not detect automatically.
| Group | Projected to lose coverage |
|---|---|
| Multiple part-time jobs (aggregation failure) | 6,870 |
| Self-employed (other) | 6,483 |
| Variable shifts / on-call work | 5,767 |
| Full-time students not auto-verified | 1,933 |
| Gig / courier (DoorDash, Uber, Lyft, Instacart) | 1,931 |
| Volunteering / job training | 1,616 |
| Seasonal: agriculture, hospitality, food service | 1,484 |
| Cash-paid construction & trades | 803 |
| Parent caregivers of children ≤13 without auto-match | 13,396 |
| Medically frail without auto-match | 12,550 |
| Caregivers of a disabled adult | 11,055 |
| Kinship caregivers (non-parent) of children ≤13 | 3,191 |
| American Indian / Alaska Native (tribal exemption) | 3,029 |
| SUD treatment not flagged in claims data | 2,646 |
| Recent incarceration (data-match gap) | 1,579 |
| Other categorical exemptions (foster, AYA cancer, SNAP/TANF) | 1,371 |
| Pregnancy / postpartum data lag | 183 |
Can the state renew people automatically?
The ex parte capability index blends the state's observed automatic-renewal rate (84% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Nevada's composite score is 72 (low band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.
| Component | Score |
|---|---|
| Composite | 72 |
| Observed ex parte | 84 |
| Core capability | 62 |
| Data sources | 65 |
| Historical churn | 50 |
How subjects overlap across exemption categories
| Combination | Adults | Share |
|---|---|---|
| None of the four | 95,510 | 36.0% |
| Working ≥ qualifying hours / income | 53,099 | 20.0% |
| Working ≥ qualifying hours / income + Parent caregiver of child ≤13 | 41,723 | 15.7% |
| Medically frail | 30,605 | 11.5% |
| Parent caregiver of child ≤13 | 19,624 | 7.4% |
| Full-time student | 9,780 | 3.7% |
| Working ≥ qualifying hours / income + Full-time student | 4,659 | 1.8% |
| Working ≥ qualifying hours / income + Medically frail | 2,883 | 1.1% |
Counties in Nevada
Subject adults concentrate: Clark County (188,533), Washoe County (43,568), and Lyon County (5,791) account for 90% of the state's subject population.
| County | Adults subject | Subject rate | Projected loss | Poverty rate | Working-age population |
|---|---|---|---|---|---|
| Clark County | 188,533 | 13.3% | 59,540 | 13.0% | 1,416,675 |
| Washoe County | 43,568 | 14.5% | 13,759 | 11.0% | 300,323 |
| Lyon County | 5,791 | 16.5% | 1,829 | 10.0% | 35,090 |
| Nye County | 5,618 | 20.0% | 1,774 | 15.0% | 28,126 |
| Douglas County | 5,353 | 20.9% | 1,691 | 7.0% | 25,588 |
| Carson City | 5,031 | 14.9% | 1,589 | 11.0% | 33,788 |
| Elko County | 4,743 | 14.8% | 1,498 | 10.0% | 32,134 |
| Churchill County | 2,132 | 14.8% | 673 | 10.0% | 14,384 |
| Humboldt County | 1,559 | 16.1% | 492 | 14.0% | 9,717 |
| White Pine County | 739 | 14.5% | 234 | 9.0% | 5,112 |
| Lander County | 547 | 16.7% | 173 | 11.0% | 3,276 |
| Storey County | 442 | 20.8% | 140 | 9.0% | 2,120 |
| Pershing County | 437 | 10.4% | 138 | 10.0% | 4,220 |
| Lincoln County | 400 | 17.2% | 126 | 7.0% | 2,324 |
| Mineral County | 324 | 13.6% | 102 | 18.0% | 2,383 |
| Eureka County | 229 | 26.1% | 72 | 18.0% | 880 |
| Esmeralda County | 73 | 11.3% | 23 | 16.0% | 641 |
State brief and methodology
Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.