The Nevada Senate passed Senate Bill No. 4 after adopting Amendment No. 9 and declaring the measure an emergency during the special session; the final roll call was 15–5 and the bill was ordered to the Assembly.

Amendment No. 9, explained on the floor by Senator Marilyn Dondero Loop, removes a named section, adjusts the Clark County distribution in section 6 to $8,100,000, changes the funding source in section 13 from bond proceeds to a general fund appropriation, modifies membership of the Commission on Innovation and Excellence in Education, and adds a $68,500,000 general fund appropriation for construction of a new building at the UNLV Lee Business School. "Senate bill 4 first reprint makes various general fund appropriations to state agencies," Dondero Loop said, noting that all sections except section 12 become effective upon passage and approval and that section 12 becomes effective on 07/01/2026.

Senator Dondero Loop moved to adopt the amendment; the Senate voted by voice to adopt it. Following adoption, Senator Cannizzaro moved to suspend the necessary rules, dispense with reprinting, insert the adopted amendment, place the bill on the general file for immediate consideration, and declare the bill an emergency measure under the Nevada Constitution to move expeditiously during the special session. The presiding officer said the emergency declaration required a two-thirds vote; the motion carried by voice vote.

The most contested substantive point on the floor was Section 10, which Senator Titus said would pay insurance brokers for work they are already required to perform. "I cannot absolutely in good conscience support it," Senator Titus said, arguing that the payment to brokers was an improper use of taxpayer funds. She described the provision as effectively compensating a private broker for responsibilities already mandated by current broker compliance processes.

Senator Cannizzaro defended the provision as part of a pragmatic response to what she described as an imminent coverage gap and the limitations of the existing enrollment system. Cannizzaro said the measure aimed to ensure access to affordable plans, referencing forthcoming Battle Born plans and the public option mechanisms, and warned the chamber that the state might lose nearly 100,000 people from Medicaid rolls without interim measures. "That is an emergency for this state, and this is a way for us to solve it in that interim period," Cannizzaro said.

After debate the secretary opened and closed the roll; the yeas were 15 and the noes were 5. The presiding officer declared that a constitutional majority had been reached, the bill had passed, and it was ordered to the Assembly. The Senate adjourned after concluding business and set its next meeting for 9:00 a.m. on Saturday, 11/15/2025.

What happens next: The bill now proceeds to the Assembly for consideration. The Senate record shows the adopted amendment and emergency declaration; implementation details, including specific allocations and administrative rule changes, will be resolved in later drafting and in the Assembly process.