Major political donors in the health care and pharmaceutical industries pumped more than $1.3 million into legislative campaigns in the 2022 election cycle, ahead of a 2023 legislative session likely to be rife with fierce debate over health care issues. 

Of that money, roughly $249,000 came from pharmaceutical companies alone, while nearly $1.1 million came from other health care donors, such as hospitals, industry political action committees (PACs) and insurers. 

Those totals remain roughly on par with spending during the pandemic-affected 2020 election cycle, when health care political spending — excluding pharmaceuticals — reached just over $1 million. By comparison, the industry’s more recent spending is a significant increase over 2018 ($740,000), a cycle defined in large part by the national health care debate, and a modest increase from spending in the 2016 presidential cycle ($916,000). 

Lawmakers are working on a bevy of health care problems in Nevada, from the years-long implementation of the new public health insurance option to a raft of new bills aimed at addressing worsening shortages of specialists, physicians and nurses statewide. 

This story is part of The Nevada Independent’s “Follow the Money” series tracking money in politics. This installment, and others published throughout the legislative session, will analyze the fundraising activity of state lawmakers, with deep dives into how different industries and top contributors doled out money. Find other installments here.

The data offers a look at how the state’s most powerful companies and political organizations contribute to policymakers who set laws affecting businesses and residents alike. It also provides context for the 120-day legislative session, as lawmakers face lobbying and pressure from the same groups and individuals who donated to their campaigns.

Like last week’s edition on PACs, politicians and political donors, which combined different spending categories that were broadly similar, this week’s analysis combines two categories that have been traditionally treated separately as part of our “Follow the Money” series — health care and pharmaceuticals. 

Breaking down the top contributors

The health care industry was unusual among Nevada’s legislative donor class in that it was one of few industries where an individual donor gave more than corporations and PACs. In this case, it was physician and Democratic mega-donor Karla Jurvetson, who gave $176,800 to 27 legislators, all Democrats. 

That includes nine lawmakers who received the $10,000 maximum: Assemblywoman Shea Backus (D-Las Vegas), Assemblywoman Selena Torres (D-Las Vegas), Sen. Melanie Scheible (D-Las Vegas), Sen. Marilyn Dondero Loop (D-Las Vegas), Assemblywoman Elaine Marzola (D-Henderson), Sen. Edgar Flores (D-Las Vegas), Assemblywoman Daniele Monroe-Moreno (D-North Las Vegas), Assemblywoman Brittney Miller (D-Las Vegas) and Assemblywoman Angie Taylor (D-Reno). 

Jurvetson, who is divorced from a major Silicon Valley investor Steve Jurvetson, also spent more than $11.4 million nationally across hundreds of Democrat-affiliated PACs and individual candidates nationwide in 2022, according to the campaign finance tracking nonprofit OpenSecrets. Of that money, roughly $2.4 million went to individual campaigns, while the remainder went to PACs. Some of Jurvetson’s PAC contributions were singularly large, such as the $2.5 million she gave to Senate Majority PAC, the chief Democratic Party PAC aimed at U.S. Senate races.

But she has focused her political efforts on Western states, including California, where she was previously a school board member, and Nevada, where she has volunteered for the presidential campaigns of Barack Obama and Hillary Clinton and Sen. Catherine Cortez Masto’s (D-Nevada) 2016 campaign.

Close behind Jurvetson was hospital giant HCA Healthcare, a Tennessee-based corporation with facilities in 19 states, including three hospitals in Las Vegas. With $157,500 spread across 51 lawmakers, HCA’s contributions were frontloaded toward the Republican minority. 

Just five lawmakers received the $10,000 maximum from HCA, including both Democratic leaders, Assembly Speaker Steve Yeager (D-Las Vegas) and Senate Majority Leader Nicole Cannizzaro (D-Las Vegas). But three Republicans also received the max: Sen. Robin Titus (R-Wellington), Sen. Jeff Stone (R-Henderson) and Sen. Ira Hansen (R-Sparks). Titus and Stone are the only two Republican members of the five-member Senate Health and Human Services Committee. 

Other top recipients include Sen. Rochelle Nguyen (D-Las Vegas), who received $9,000, and Assemblywoman Heidi Kasama (R-Las Vegas), who received $7,000. The remaining 44 lawmakers received $5,000 or less from HCA. 

A spokesperson for the Nevada Hospital Association (which includes the three HCA-owned hospitals in Nevada) said the group's focus this legislation session would be to support policies to address health care workforce shortages in the state, including among nurses and physicians. They also mentioned concerns with possible legislation changing Nevada's medical malpractice laws and the state's low Medicaid reimbursement rates.

"We will support bills that encourage healthcare workers to live and work in Nevada and oppose bills that discourage healthcare providers from moving to Nevada," they said in a statement.

Behind HCA was PhRMA, which gave $112,000 to 43 legislators, again favoring Republicans over Democrats. 

The group’s lone maximum contribution went to Kasama. Rounding out the top eight were three lawmakers receiving $8,000 (Yeager, Titus and Sen. Scott Hammond (R-Las Vegas), two receiving $5,000 (Cannizzaro and Nguyen), Stone, who received $4,500, and Assemblywoman Melissa Hardy (R-Henderson), who received $4,000. 

The remaining 35 lawmakers received $3,000 or less from PhRMA.

PhRMA Senior Director of Public Affairs Reid Porter wrote in an email that pharmacy benefit managers and insurers have increasingly shifted more health care costs to patients through high deductibles and coinsurance and do not pass on discounts they receive from pharmaceutical companies to consumers. Porter said the industry is focused on addressing this discrepancy.

"Our industry is working to fix the health care system and lower out-of-pocket costs for medicines by supporting policies that ensure rebates and discounts are shared with patients at the pharmacy counter, making insurance work like insurance again and fixing misaligned incentives that allow middlemen to benefit at the expense of patients," Porter said.

Breaking down the top recipients

By far the single largest recipient of health care and pharmaceutical money was Yeager ($100,100), long one of the Democratic Party’s top legislative fundraisers and viewed throughout the 2022 campaign as the successor to ex-Assembly Speaker Jason Frierson. 

In a distant second to Yeager was Monroe-Moreno, chair of the powerful Ways and Means Committee and recipient of $56,309 in combined health care and pharmaceutical money. The rest of the top-five recipients followed close behind, including Nguyen ($53,250), Assemblyman Toby Yurek (R-Las Vegas) ($50,756) and Titus ($50,500). 

Other lawmakers also followed relatively close behind in combined contributions. That includes Assemblywoman Sandra Jauregui (D-Las Vegas) with $49,533, Cannizzaro with $48,550, Kasama with $45,500, Assemblywoman Sarah Peters (D-Reno) with $44,250 and Dondero Loop with $42,500.

Follow the Money explained

The Nevada Independent tracked and categorized more than 8,000 donations of $200 or more from Jan. 1, 2021, through the end of the election cycle on Dec. 31, 2022. 

Donors are limited to giving a maximum of $10,000 to a single candidate, but major corporations easily surpass that limit by contributing through various affiliated entities or businesses — a process sometimes referred to as bundling.

Some wealthy donors, ranging from lawyers to doctors to casino magnates, may also boost contributions to a single candidate by donating the maximum amount under their name and under their spouse’s name. 

Each donation was categorized by the industry or field of the organization or individual who contributed, and the entire set of donations was analyzed for patterns and trends. Our analysis has also sought to track bundled contributions where possible, linking contributions from LLCs or subsidiary companies to their largest parent company or individual donor. Total contributions from MGM Resorts International include not only money donated directly from MGM, but also from the properties it manages, for instance.  

Data collected does not include donations made to losing candidates, nor does it break down  small donations under the $200 threshold or fundraising activity for the many PACs or political groups that spend in support of candidates. 

It also excludes Assemblywoman Sabra Newby (D-Las Vegas), who was appointed after the election and did not raise funds. 

Still, the $200 threshold captures the vast majority of all the money contributed to elected lawmakers over the last two years. All legislative contributions under $200 in the 2022 cycle — more than 7,400 individual transactions — totaled just $221,000.

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Roy Visuett contributed data analysis to this report. This story is a part of The Nevada Independent’s weekly Follow the Money series, which examines the amount of money contributed by major industries to individual state lawmakers. For a list of all our Follow the Money stories, click here.