The Stakes
Nevada consistently ranks near the bottom in healthcare quality and access. Medicaid covers nearly 29% of the state budget, and 81.6% of rural and frontier Nevadans live in federally designated Health Professional Shortage Areas. The opioid crisis has produced over $1.2 billion in settlement funds—making healthcare policy one of the most consequential issues in this race.
Only three of five candidates have articulated substantive healthcare positions. Governor Lombardo emphasizes enforcement and administrative reform while Attorney General Ford highlights his massive opioid settlements and ACA defense. Two Republican challengers have no documented healthcare platforms whatsoever.
Where They Stand
Aaron Ford
Democrat · Attorney General
$1.2 Billion+ in Opioid Settlements
Nevada's largest healthcare-related financial recovery in history:
Funds flow to Fund for a Resilient Nevada ($462.2M) and One Nevada Agreement ($370M for cities/counties)[HC5]AG Office settlement records
Medicaid Defense
Most aggressive legal defender of Medicaid in the race.
- • Joined 22-state coalition challenging Trump admin Planned Parenthood cuts[HC6]July 2025 coalition lawsuit
- • Filed lawsuits against HHS rules threatening 100,000+ Nevadans
- • Personal narrative: relied on Medicaid as single father in college
Fentanyl Policy Evolution
Shifted from reform to enforcement—will draw scrutiny from all sides.
- • 2019: Supported AB 236 raising trafficking threshold to 100g
- • 2023: Backed SB 35 lowering fentanyl threshold to 4-28g[HC7]SB 35 fentanyl bill
- • SB 35 also removed fentanyl from Good Samaritan protections
Policy Tension
Ford acknowledged the difficult balance: "I've had dreams, and frankly nightmares, over ensuring that in pursuit of this bill that we don't re-create the war on drugs from the crack cocaine days."
Critical Gaps
No rural healthcare platform despite Nevada's significant challenges. No comprehensive mental health policy—no positions on 988 implementation or mental health parity. No specific Medicaid reform proposals for gubernatorial campaign despite defense actions.
Alexis Hill
Democrat · Washoe County Commission Chair
Washoe Behavioral Health Center
Flagship mental health achievement: transforming former West Hills Behavioral Health Hospital into a $23M, 70-bed facility (expected late 2027), with half dedicated to youth services.[HC8]2023 facility acquisition
"For so long we've said, 'That's the State's job,' but the State isn't able to do it so the County is trying to find partners."
Mental Health Leadership
Strongest documented local-government mental health record.
- • Hired Washoe County's first Behavioral Health Administrator
- • Secured $15M for jail-based mental health programs through June 2027
- • Doubled Mobile Crisis Response Team call capacity
- • Adopted Sequential Intercept Model to divert mentally ill from justice system
Opioid Response
Oversaw $41M in county opioid settlement allocations over 20 years.
- • Funded Northern Nevada HOPES opioid treatment program
- • Bristlecone Family Resources: 20-bed medical detox center
- • County-funded orgs provide free naloxone, fentanyl test strips, needle exchange
Critical Gaps
No explicit Medicaid positions—though Commission acknowledged "inadequate Medicaid reimbursement rate in Nevada." No rural healthcare proposals despite statewide candidacy. No explicit opioid policy statements—leans toward harm reduction through county actions but hasn't articulated gubernatorial platform.
Irina Hansen
Republican · Challenger
No Documented Healthcare Positions
Despite extensive searches of campaign materials, news coverage, and candidate surveys, Hansen has no documented positions on Medicaid, opioids, rural healthcare, or mental health.
Her only healthcare-adjacent statement from the 2024 mayoral race referenced supporting "policies that allocate resources for mental health and addiction treatment" for homeless populations—without specifics.
Matthew Winterhawk
Republican · Challenger
Healthcare Entirely Absent from Platform
Winterhawk's platform focuses on government efficiency ("state D.O.G.E."), education reform, and land sovereignty. Healthcare is completely absent. He completed Ballotpedia's candidate survey without mentioning healthcare.
As a self-funded, "zero-dollar" campaign, he has received minimal media coverage on policy issues.
At-a-Glance Comparison
| Issue | Lombardo | Ford | Hill | Hansen | Winterhawk |
|---|---|---|---|---|---|
| Medicaid | Defended expansion | Legal defender | Limited record | No position | No position |
| Opioid Policy | Enforcement focus | $1.2B settlements | Harm reduction | No position | No position |
| Fentanyl | Harsher penalties | Evolved to stricter | No explicit stance | No position | No position |
| Rural Healthcare | $200M proposal | No platform | No platform | No position | No position |
| Mental Health | 988 infrastructure | Youth litigation | $23M facility | No position | No position |
| Harm Reduction | No statements | Mixed signals | County-funded | No position | No position |
Source: Healthcare Policy Analysis