All Roll Calls
Yes: 42 • No: 20
NevadaSB21783rd Regular Session (2025)SenateWALLET
AN ACT relating to health care; prohibiting a governmental entity from substantially burdening certain activity relating to assisted reproduction under certain circumstances; authorizing a person whose engagement in such activity has been so burdened to assert the violation as a claim or defense in a judicial proceeding; authorizing a court to award damages against a governmental entity that substantially burdens such activity in certain circumstances; providing certain immunity from civil and criminal liability and administrative sanctions for certain persons and entities involved in the provision of assisted reproduction; providing that a fertilized egg or human embryo that exists before implantation in a human uterus is not a person for legal purposes; requiring certain health insurers to authorize a pregnant person to enroll in a health plan during a specified period; requiring certain public and private health insurers to provide certain coverage for the treatment of infertility and fertility preservation; providing a penalty; and providing other matters properly relating thereto.
Sponsored By: Julie Pazina (Democratic), Marilyn Dondero Loop (Democratic), Melanie Scheible (Democratic), Nicole J. Cannizzaro (Democratic), Rochelle T. Nguyen (Democratic)
Vetoed
BDR 40-24
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 7 benefits, 0 costs, 0 mixed.
Group health maintenance plans cover fertility
Beginning July 1, 2027, covered group health maintenance organization plans must cover medically necessary infertility care through network providers. Coverage includes at least 3 and no more than 5 completed egg retrievals and embryo transfers. Plans must also cover at least 5 years of standard fertility preservation for qualifying medical, genetic, or treatment-related fertility risks. Cost-sharing, authorization rules, waiting periods, and other limits cannot be worse than for similar non-fertility benefits. This mandate excludes small-employer plans, Medicaid managed-care plans, specified association plans, and infertility caused solely by unsuccessfully reversed voluntary sterilization. Qualifying religious objections require advance written notice. Nevada's insurance commissioner can suspend or revoke an organization's authority for violating the listed coverage or charge rules, following required legal procedures.
Group plans add fertility treatment coverage
Beginning January 1, 2026, covered group insurance and managed-care plans must cover medically necessary infertility care through network providers. Group insurance requirements apply to policies delivered, issued, or renewed on or after that date. Coverage includes at least 3 and no more than 5 completed egg retrievals and 3 to 5 embryo transfers. Plans must also cover at least 5 years of standard fertility preservation for qualifying medical, genetic, or treatment-related fertility risks. Cost-sharing, waiting periods, authorization rules, and other limits cannot be worse than for similar non-fertility benefits. Plans cannot discourage benefit use, penalize providers, or deny or cancel coverage solely because someone uses or may use fertility benefits. Exceptions include small-employer plans, qualifying association or employee benefit plans, and self-insured employers with fewer than 51 employees. Religious objections require advance written notice, including before issuance and renewal for group insurers; infertility caused solely by unsuccessfully reversed voluntary sterilization is excluded.
Medicaid adds coverage for fertility care
Nevada Medicaid must cover medically necessary infertility care to the extent federal matching funds are available. Coverage includes at least 3 and no more than 5 completed egg retrievals, plus 3 to 5 embryo transfers. It also includes at least 5 years of standard fertility preservation for qualifying medical, genetic, or treatment-related fertility risks. Fertility benefits cannot face worse cost-sharing or access rules than similar benefits; infertility caused solely by unsuccessfully reversed voluntary sterilization is excluded. The law also changes which added requirements apply to Medicaid managed-care health maintenance organizations. The supplied provisions conflict on whether the added fertility-drug requirements apply to these organizations, so that specific coverage obligation is unclear.
Local government workers gain fertility coverage
Nevada local governments using self-insurance reserve funds must follow the law's group infertility treatment and fertility preservation coverage rules. Coverage applies within the stated limits for active officers, employees, and their dependents. Beginning January 1, 2026, the local-government expense rule in NRS 354.599(1) does not apply to added expenses related to this law. The law does not state the amount of those expenses.
Pregnancy opens new health plan enrollment
After a qualified provider confirms pregnancy, individual insurers and individual-market managed-care plans must offer at least 60 days to enroll. Group insurers, carriers, and group-market managed-care plans must offer at least 30 days; cafeteria plans are excluded where specified. Prepaid limited health service organizations covering pregnancy and childbirth must offer at least 60 days. Enrollment carries no added fee or penalty, and the individual and group insurance rights apply even with existing coverage. Coverage starts on the first day of the confirmation month or, at the enrollee's choice, the following month.
Pregnant workers get another enrollment window
Employers offering health benefits must allow enrollment for at least 30 days after a qualified provider confirms an employee's pregnancy. This applies even if the employee already has coverage, with no added enrollment fee or penalty. Coverage starts on the first day of the confirmation month or, at the employee's choice, the following month. Cafeteria plans defined by federal tax law are excluded. Employers violating this right face a misdemeanor penalty and possible Labor Commissioner fines of up to $5,000 per violation.
Stronger legal protections for fertility care
Beginning July 1, 2025, Nevada governments cannot single out assisted reproduction and substantially burden access, services, coverage, or control of reproductive material. Exceptions require clear and convincing proof of a compelling government interest and the least restrictive approach. Affected people, providers, and coverage organizations can sue or raise a defense; winning claimants receive legal fees and costs. Damages remain subject to Nevada's government-liability limit, and the Attorney General can seek orders stopping violations. Providing or receiving fertility services alone cannot trigger civil or criminal liability, professional discipline, or administrative penalties. Embryo storage and transport providers and relevant manufacturers also receive protection based solely on embryo death or damage, but negligence and work outside professional qualifications remain actionable. Before implantation in a uterus, a fertilized egg or embryo is not a person or child under Nevada or local law.
Sponsors & Cosponsors
Sponsors
Julie Pazina
Democratic • Senate
Marilyn Dondero Loop
Democratic • Senate
Melanie Scheible
Democratic • Senate
Nicole J. Cannizzaro
Democratic • Senate
Rochelle T. Nguyen
Democratic • Senate
Cosponsors
Angela D. Taylor
Democratic • Senate
Dina Neal
Democratic • Senate
Edgar Flores
Democratic • Senate
Fabian Doñate
Democratic • Senate
James Ohrenschall
Democratic • Senate
Michelee "Shelly" Cruz-Crawford
Democratic • Senate
Roberta Lange
Democratic • Senate
Skip Daly
Democratic • Senate
Roll Call Votes
House vote • 6/2/2025
Final Passage - Assembly (2nd Reprint)
Yes: 27 • No: 15
Senate vote • 5/26/2025
Final Passage - Senate (1st Reprint)
Yes: 15 • No: 5
Actions Timeline
Vetoed by the Governor.
6/12/2025legislatureEnrolled and delivered to Governor.
6/6/2025legislatureTo enrollment.
6/4/2025SenateIn Senate.
6/3/2025SenateRead third time. Passed. Title approved. (Yeas: 27, Nays: 15.) To Senate.
6/2/2025HouseTaken from General File. Placed on General File for next legislative day.
6/1/2025HousePlaced on General File.
6/1/2025HouseFrom committee: Do pass.
6/1/2025HouseRereferred to Committee on Ways and Means. To committee.
5/30/2025HouseTaken from General File.
5/30/2025HouseRead second time.
5/30/2025HousePlaced on Second Reading File.
5/30/2025HouseFrom committee: Do pass.
5/30/2025HouseRead first time. Referred to Committee on Commerce and Labor. To committee.
5/27/2025HouseIn Assembly.
5/27/2025HouseFrom printer. To re-engrossment. Re-engrossed. Second reprint. To Assembly.
5/27/2025SenateRead third time. Passed, as amended. Title approved. (Yeas: 15, Nays: 5, Excused: 1.) To printer.
5/26/2025SenateReprinting dispensed with.
5/26/2025SenateRead third time. Amended. (Amend. No. 757.)
5/26/2025SenatePlaced on General File.
5/26/2025SenateFrom committee: Amend, and do pass as amended.
5/26/2025SenateTo committee.
4/22/2025SenateFrom printer. To engrossment. Engrossed. First reprint.
4/22/2025SenateTaken from General File. Re-referred to Committee on Finance. Exemption effective. To printer.
4/18/2025SenateRead second time. Amended. (Amend. No. 219.)
4/18/2025Senate
Bill Text
As Enrolled
As Introduced
Reprint 1
Reprint 2
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