Medicaid vote follows Rep. David Valadao into one of the tightest House races in California

Republican Rep. David Valadao has spent more than a decade winning a Central Valley district where Democrats hold a clear edge in voter registration. This year his vote on Medicaid may be the biggest obstacle he has faced. About 6 in 10 people in his California district are covered by the health program for low income residents. His challenger is making that vote the center of the race.

Valadao backed the sweeping Republican tax and spending law that is expected to trim more than $900 billion from Medicaid through 2034. The law adds work requirements for many adults and checks on eligibility twice a year. Those rules do not take effect until after the midterm elections.

Protesters have gathered outside his office in Bakersfield to warn that the changes will mean longer waits for care and lost coverage. A left-leaning think tank estimates about 60,000 more people in the district could be uninsured by 2034 because of the law and the end of extra help for people who buy coverage on the health law marketplaces. Statewide researchers expect more than 2 million Californians to lose coverage and the state to give up roughly $30 billion a year, more than any other state.

Two very different visions

Valadao insists the law does not cut anything. In a televised debate on Oct. 6 he said he helped negotiate the provisions that ask certain adults on Medicaid to work, train for a job or volunteer. He argued that asking people to make a fair effort to support themselves and take part in their community is reasonable.

His Democratic opponent, Randy Villegas, is a political science professor and former school board member who supports a single government health plan for everyone and has the backing of Sen. Bernie Sanders. Villegas says the vote will strip health care from Valley families and argues Americans pay about twice as much for care as people in other countries while getting worse results.

A survivor in a new district

Valadao was first elected in 2012 and has won six of his seven races there, losing only in 2018 when Democrats hammered him over votes to repeal the Affordable Care Act. He has held on by focusing on water, farming and oil, the industries that drive the local economy. He has also kept his distance from national party fights. He is the last House Republican still seeking reelection who voted to impeach the president after the Jan. 6 riot at the Capitol.

This time the ground has shifted under him. California redrew its congressional map last year during a national fight over mid-decade redistricting and his seat now leans more toward Democrats than before. A local political scientist said the new mix of voters and a sour mood toward incumbents could flip the district.

Money pours in

Both sides see the seat as key to control of the House. Republicans and Democrats have each reserved more than $16 million in advertising there through Election Day, an unusually large sum for a single House district. House Speaker Mike Johnson headlined a $1,000-a-ticket fundraiser for Valadao in Bakersfield at the end of September.

Health costs are a top worry for voters nationwide. A poll last month found Americans trust Democrats over Republicans on the issue by about 2 to 1. Election Day is Nov. 3.