Prior to the Medicaid expansion, Nevada for many years had been among states with the highest percentage of adults with no health insurance.

That was attributed in large part to the texture, or lack thereof, of the state’s economy. The Culinary union’s hard-won contracts notwithstanding, the vast majority of workers in Nevada’s extremely service sector-heavy economy were not covered by those contracts. Instead, those employees were in jobs where neither the pay nor the benefits were anywhere near those enjoyed by Culinary workers on the Strip.

A battery plant, a football stadium, and tax breaks for hundreds of businesses later, that texture, or lack thereof, still heavily characterizes Nevada’s economy and workforce.