California Republican Rep. David Valadao and other potentially vulnerable Republicans face a vote this week on a plan that could mean big cuts in Medicaid, a vote with the potential to be a big deal in 2026 congressional races.

The House is expected to take up a sweeping budget plan as soon as Tuesday that could mean large reductions in Medicaid. The program, called Medi-Cal in California, helps about 15 million people in the state.

Valadao’s district benefits like few others from the health care program, which aids lower income people.

The California Health Care Foundation, an independent nonprofit group that studies health issues, estimates that two-thirds of all residents in the district get help from Medi-Cal. Valadao represents a majority Latino district that includes most of Kings County and slices of Tulare and Kern counties.

The foundation warned that big changes would “have far-reaching consequences for California’s health care system and the millions of Californians enrolled in the program.”

The political consequences for Valadao and other swing-area members of Congress could be huge.

“It’s hard to know what cuts will happen and, if they did, what the political ramifications would be, although Democrats campaigning on actual health care cuts in a midterm with Donald Trump in the White House sure strikes me as a politically potent message,” said Kyle Kondik, managing editor of Sabato’s Crystal Ball, a nonpartisan political analysis firm.

He said it’s important that “in the short term, Valadao and some other swing-district Republicans recognize both the practical and political ramifications of Medicaid cuts and are making their opposition known.”

Worried Republicans

Last week, Valadao joined seven other House Republicans by signing a lengthy letter to House Speaker Mike Johnson, R-La.

They pointed out that nearly 30% of people on Medicaid across the country are Hispanic Americans.

“Slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open,” the letter said.

The eight Republicans raised concerns about other parts of the budget plan as well, but Medicaid cuts would hit Valadao’s district particularly hard. Valadao has spoken to the speaker about the concerns, and more meetings are planned. Johnson so far has said the current level of spending reductions won’t change.

The budget the House is considering calls for $880 billion over the next 10 years in deficit reduction from programs whose legislation can be written by the House Energy and Commerce Committee.

Medicaid is one of those programs. If the House passes the budget, the committee will write a detailed plan that would then need full congressional approval. That process is likely to take months.

Medicaid funding comes from both the state and federal governments. Medi-Cal’s budget for fiscal 2025, the current fiscal year, is $174.6 billion. That includes $107.5 billion in federal money.

Valadao and close elections

Valadao is a veteran of close House races over the years and has shown some streaks of independence from the Republican Party.

He was one of 10 Republican House members in 2021 to vote to impeach President Donald Trump. But he voted for a committee to look into the Jan. 6 Capitol riot, and then later voted against it after complaining that the commission was stacked with Democrats. He has been largely silent on the riot since then.

Valadao won his 2024 race by 7 percentage points over former Democratic Assemblyman Rudy Salas. Valadao won his 2022 seat over Salas by 3 percentage points and won by less than 1 percentage point in 2020. He lost the seat in 2018.

The Senate last week passed its version of the federal budget for fiscal 2026, which begins Oct. 1. It did not have specific instructions for Medicaid cuts; the Senate plans to deal with that in a separate budget outline later this year.

The House budget is more inclusive, and getting it approved is going to be more difficult. The House currently has 218 Republicans and 215 Democrats, meaning two Republican defections will mean defeat.

House leaders have a thorny problem. If they don’t agree to big spending reductions, staunch conservatives may not vote for the budget. But if they do go along with potential cuts to social programs, they could lose Valadao and his allies.

“It’s going to be very hard, if not impossible, to keep everyone satisfied,” Kondik said.

The Valadao group is not making any specific threats or promises.

But, they said in their letter, they’re hoping for “a responsible approach to these budget discussions where we can both eliminate government waste while ensuring we do not undermine programs that support working-class Americans.”

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