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BAKERSFIELD, Calif. — When Rep. David Valadao, R-Calif., was knocked out of office in 2018, Democrats around the country were riding a wave of backlash against President Donald Trump and the GOP’s attempts to cut health care.
Now, after Valadao provided a critical vote for a sweeping tax cuts and spending package that slashed Medicaid and food stamps, Democrats see an opportunity for a repeat in California’s Central Valley, where many low-income residents depend on social safety net programs.
Valadao has already drawn at least two Democratic challengers in his battleground district, which will be key to Republicans’ efforts to hang on to their narrow majority in next year’s midterm elections. These include Jasmeet Bains, a doctor and member of the California state Assembly who officially jumped into the race last week. She told NBC News she was motivated by Valadao’s support for the bill and plans to make health care a defining issue in the campaign against him.
“This isn’t something that I ever envisioned for myself. I’m a doctor,” Bains said of her decision to run for Congress. “When I saw Valadao vote for the ‘big, beautiful bill,’ I was shocked. As was everyone. How could you do that in a district that has some of the highest needs? Some of the highest Medicaid patients in the country?”
Randy Villegas, a school board trustee who is affiliated with the Working Families Party, is also mounting a bid in the 22nd District.
Even prior to his vote on the megabill, Valadao was seen as one of the more vulnerable Republicans up for re-election in 2026. After he lost in 2018, Valadao made a comeback bid and returned to Congress the following cycle. But his vote for Trump’s bill could now put his swing seat even more at risk. Valadao’s district has the highest share of Medicaid recipients and households receiving food stamps of any represented by a Republican in Congress, according to an NBC News analysis.
In a preview of the attack ads to come, House Majority Forward, a nonprofit group aligned with Democratic leadership, and the League of Conservation Voters are launching new ads next week hitting Valadao over his support for the bill, according to a source familiar with the matter.
The agriculturally rich region, which relies heavily on migrant farmworkers, is also bracing for mass deportations that some fear could disrupt the local economy and national food supply chains. Valadao has urged Trump to prioritize deporting criminals over undocumented laborers, but the administration has sent mixed signals about its approach.
It all has the community here on edge.
“I’m definitely scared. I’m worried about it,” 53-year-old Rick Garcia, a local resident who relies on Medicaid after he was permanently paralyzed in his early 20s, told NBC News in an interview about the health care cuts.
Valadao had repeatedly vowed to oppose the “big, beautiful bill,” warning just several days before final passage that he couldn’t support the Senate product. But he ended up supporting that version without any changes to the legislation.
When asked how he felt about Valadao’s vote, Garcia told NBC News: “Betrayed.”
“If you’re a politician and you’re gonna say you’re gonna do something, you’re relying on that politician to do something about that problem,” Garcia said. “Be a man of your word.”
Republicans argue that only those they say don’t deserve to be on Medicaid, like undocumented immigrants and able-bodied adults who don’t work, will be kicked off the program. But Garcia said the state’s Medicaid program, Medi-Cal, has already tried to remove him twice before, so he worries people could erroneously get swept up in all the new changes or will struggle to navigate the more frequent eligibility check-ins.
The nonpartisan Congressional Budget Office projected Trump’s new law will increase the number of people without health insurance by 10 million by 2034.
Valadao’s office said the congressman was not available for an interview for this story. In a statement after the House vote on the bill earlier this month, Valadao defended his decision.
“I voted for this bill because it does preserve the Medicaid program for its intended recipients — children, pregnant women, the disabled, and elderly,” he said.
Christian Martinez, a spokesman for the National Republican Campaign Committee, said the bill that Valadao voted for will “ease the burden on hardworking Californians” and took a swipe at Villegas and Bains.
“Their far-left agenda will continue to wreck California’s economy, raise taxes, and put illegal immigrants ahead of California families,” Martinez said.
Valadao has stood up to his own party before. Most notably, he was one of 10 House Republicans who voted to impeach Trump in 2021 following the Jan. 6 attack on the U.S. Capitol. But Trump has since further tightened his grip on the party, even threatening to back primary challenges to Republicans who stood in the way of his “big, beautiful bill.”
The sprawling domestic policy bill extends Trump’s 2017 tax cuts, removes some taxes on tips and overtime, and beefs up funding for immigration enforcement and the military. While the legislation is generally unpopular in public polling, Republicans are betting once they start selling it, their members will be rewarded for supporting it.
Some local business owners in Valadao’s district hailed the bill and praised Valadao for backing it.
Rob Taylor, who has owned Stafford’s Chocolates in Portersville for the last 14 years, said he thinks some of the bill’s tax provisions will be a boon for small businesses like his.
“I appreciate Valadao sticking up for himself and his constituents here,” Taylor, who has voted for Valadao in the past, told NBC News. “He’s not just a rubber stamp. He does look at both sides [of an issue].”
In order to partially pay for the bill, Republicans opted to scale back Medicaid and food stamps. That includes instituting new work requirements for able-bodied adults, making undocumented immigrants ineligible for the program and putting new restrictions on the state provider tax, which is a significant source of revenue for rural hospitals.
Moderate Republicans fended off even steeper cuts to Medicaid that had been in the mix during the negotiations, such as reducing the federal cost-sharing formula. But Valadao acknowledged he still harbors concerns over some of the Medicaid changes, particularly those impacting rural hospitals.
Access to health care in rural areas can already be difficult. Often, facilities are dependent on help from the government to stay afloat. Kern Hospital in Bakersfield, a social safety net hospital, gets 72% of its patient revenue from Medi-Cal.
Then there are rural health clinics, like the Bakersfield American Indian Health Project, where Garcia receives some of his care. These clinics rely on various revenue streams from the federal government and provide critical preventive care services to many low-income patients on Medicaid.
“There’s no frills here. No one’s taking advantage of anything. They’re trying to survive,” Dr. Carson Chambers, a clinical psychologist at the Bakersfield American Indian Health Project, told NBC News.
Asked about the impacts of the Medicaid cuts, Chambers said: “It may be well-intentioned, it may be fiscally sound, but in the long run, I think it’s going to cost more.”
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