California Congressman David Valadao faces a significant challenge ahead.
In his Central Valley district, approximately 64% of voters—about 527,000 Californians—are enrolled in Medi-Cal, the state’s Medicaid program designed for low-income individuals and people with disabilities. This rate is the highest for any Republican seat in the nation.
However, last year, Valadao and fellow Republicans supported a major piece of legislation pushed by former President Donald Trump that proposed to cut over $1 trillion from Medicaid, among other essential programs. These cuts are expected to affect the poorest Americans, with California officials tightening Medicaid eligibility requirements and, as a result, potentially pushing 2 million residents out of the healthcare system.
As the midterm elections loom, Republicans are grappling with an uphill battle to defend their record under a president who remains widely unpopular. Valadao, in particular, must now explain why he has continually backed a bill with severe repercussions for his constituents, not just at its final vote, but throughout the legislative process.
His Democratic challengers have already indicated that Valadao’s support for this “big, beautiful bill,” which contradicted his earlier stance against Medicaid cuts, is a breach of trust that could jeopardize his reelection. “His vote could have stopped it,” said Jasmeet Bains, one of his opponents and a local doctor.
Another challenger, Randy Villegas, offered a more scathing critique, accusing Valadao of dishonesty in his dealings with voters: “We have someone in our administration who is willing to do or say whatever is politically expedient to save his own butt,” he said, punctuating his statement with a choice word for emphasis.
A spokesperson for Valadao declined an interview with Calmatters, citing his busy schedule, but emphasized that he has been fighting for tangible solutions to enhance the lives of Central Valley families and healthcare.
In the aftermath of the mega-bill vote, Valadao acknowledged that while he supported the legislation, there were still unresolved issues. He defended his decision by stating it was necessary to avoid tax hikes linked to the expiration of Trump’s 2017 tax cuts. Despite Republican claims that these cuts would benefit middle- and low-income households, many economists argue they primarily serve affluent Americans and corporations.
Can Democrats repeat their success from 2018?
Valadao’s electoral history reveals that he has lost only once in seven elections, that being during the pivotal “blue wave” in 2018, which flipped the House majority amid then-President Trump’s first midterms. That year, Democrats capitalized on failed Republican attempts to repeal the Affordable Care Act and controversial immigration policies, which resonated with voters.
There’s a sense that the 2026 elections might mirror the past, and the National Democratic Party has been employing similar strategies to regain control of the House.
Republican strategists agree that this election could be particularly tough for Valadao, despite his generally strong performance in areas leaning Democratic. “I think this year is going to feel a lot like 2018, possibly even worse,” remarked Mike Madrid, a Republican consultant and co-founder of the anti-Trump Lincoln Project.
Since taking office in 2020, Valadao has faced two formidable opponents in former Democratic Representative Rudy Salas. Recently, Salas hinted he hasn’t yet decided whether to run again.
Valadao is trying to position himself as a moderate and independent thinker, distancing himself from Trump, particularly as he is the last remaining Republican in Congress who voted to impeach Trump after the January 6 insurrection.
Will Valadao’s Medicaid vote cost him reelection?
Even as Trump campaigns for reelection in 2024, Valadao has reiterated his opposition to any legislation that threatens Medicaid funding. He and several Hispanic lawmakers expressed concerns that the proposed cuts would disproportionately impact rural and largely Hispanic areas struggling with healthcare access.
Still, he supported the Trump administration’s domestic policy agenda that faced backlash from healthcare advocates and constituents. “There was a real sense of betrayal among voters who thought he would represent them differently,” shared Amanda McAllister Wallner, executive director of Health Access, who led efforts to persuade Republicans to oppose Medicaid cuts.
Given the high percentage of Medicaid recipients in his district, Valadao’s vote was particularly pivotal. Defending his stance, he stated he supported the bill as it preserved Medicaid for specific vulnerable groups such as children, pregnant women, and the elderly. However, critics highlighted that the stricter eligibility requirements could lead to many losing their coverage due to the complexities involved in proving eligibility.
“I understand how crucial this program is to my constituents,” Valadao noted after casting his vote, adding that significant adverse policy changes were halted following discussions with Republican leadership.
Valadao attempts damage control
Since the vote, Valadao has shied away from interviews about the issue, seemingly trying to avoid difficult questions. In line with the healthcare matters that hurt him in 2018, he went against his party’s leadership by supporting a symbolic vote to extend tax subsidies from the Affordable Care Act, which had expired. For over 85,000 enrollees in ACA plans, health insurance premiums surged significantly, according to healthcare advocates.
When Medicaid funding is brought up, Valadao often references “rural health care transformation projects,” a $50 billion component of Trump’s legislation intended to help keep rural hospitals functioning. Critics argue that California will receive only a small fraction of what its hospitals need in Medicaid support.
“It felt performative,” expressed Virginia Hedrick, CEO of the California Rural Indian Health Commission, regarding his recent roundtable involving health leaders and Dr. Mehmet Oz, which was closed to the press. She felt much of the agenda was pre-scripted, lacking genuine dialogue about healthcare issues.
While Valadao’s adversaries aim to capitalize on Medicaid cuts, some strategists caution against placing too much focus on it. “If I were running against him, I wouldn’t rely entirely on that,” Madrid advised, pointing out that voter concerns about the economy and rising living costs tend to be more impactful.
Rob Stutzman, a Republican strategist, argued that Medicaid cuts may not resonate as strongly with voters compared to the Affordable Care Act. The individuals most affected—low-income households and those with disabilities—are typically not as politically active in midterm elections.
“He’s equipped to handle a Trump midterm election,” Stutzman commented, noting Valadao’s established presence in the district gives him a significant advantage.
