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Nevada’s “Public Option” Health Insurance Is Unconstitutional

National Taxpayers Union v. Lombardo

National Taxpayers Union, along with Nevada State Senator Robin L. Titus, MD, filed a lawsuit challenging the constitutionality of SB 420, a 2021 bill that provides for the establishment of a “Public Option” health insurance system controlled by the state government.

The lawsuit, which was filed in Nevada’s First Judicial District Court and seeks declaratory and injunctive relief, demonstrates that SB 420 violates three distinct provisions in the Nevada Constitution. The lawsuit explains, in part:

First, [SB 420] is at odds with Article IV, Section 18(2), which provides that a two-thirds majority in each legislative house is required to pass any bill that “creates, generates, or increases any public revenue in any form, including but not limited to taxes, fees, assessments and rates, or changes in the computation bases for taxes, fees, assessments, and rates.” The challenged bill plainly generates public revenue, but it was not passed by the required two-thirds vote in either the Assembly or the Senate.

Second, SB 420 is in direct conflict with Article IV, Section 19, which states that “[n]o money shall be drawn from the treasury but in consequence of appropriations made by law.” SB 420 purports to give the State Treasurer and DHHS Director nearly unlimited discretion to use unspecified amounts of funds from the state treasury for unspecified purposes that the legislature did not approve in passing SB 420.

Third, SB 420 violates the separation-of-powers principle in Article III, Section 1, which states that “no persons charged with the exercise of powers properly belonging to one of these departments shall exercise any functions appertaining to either of the others[.]”  SB 420 impermissibly delegates lawmaking authority to executive branch agency directors, without providing any suitable standard to govern the manner and circumstances under which that authority is exercised.

“My decades of experience as a family physician in rural Nevada and my desire to stand up for Nevada patients are what led me to public service in the first place. I opposed SB 420 as a member of the Nevada Assembly because creating a state government-controlled ‘Public Option’ will worsen our state’s already severe shortage of doctors and nurses, harm Nevadans’ access to quality health care, and drive costs even higher,” said State Senator Robin L. Titus, MD. “In addition to the negative consequences this law will have for Nevadans’ health care, it was enacted in clear violation of our state’s constitution. I am proud to bring forward this legal action to protect Nevadans and I urge the court to recognize the unconstitutional nature of SB 420 and to stop its implementation accordingly.”

“Not only is the substance of SB 420 harmful to Nevada taxpayers, it violates the Nevada Constitution in several ways,” said Joe Bishop‐Henchman, Executive Vice President of NTUF. “We urge the court to weigh the facts, which demonstrate clearly that SB 420 is unconstitutional, and to stop the state from taking any further action to implement, enforce or execute this law.”