Bakersfield, California
Even when he was a baby, healthcare was prime of thoughts for Humberto Rico.
Like many kids who grew up in the Central Valley — identified for having a few of the worst air quality in the nation — he had bronchial asthma that may generally depart him bedridden for days. He nonetheless helps his immigrant mother and father schedule their docs’ appointments. And he has relations who depend upon Medicaid for medical insurance.
“In the Central Valley, it’s not really something we have the privilege to ignore,” stated Rico, a 26-year-old Bakersfield native who works with farm employees as an organizer.
Healthcare can also be a key challenge shaping his assist in California’s twenty second Congressional District. Rico spent a latest Saturday afternoon canvassing for Randy Villegas, a pro-Medicare for All progressive and one in every of two Democrats looking for to unseat GOP Rep. David Valadao. State Assemblywoman Jasmeet Bains, who lately gained the assist of House Democrats’ marketing campaign arm, can also be working.
Since Valadao was first elected in 2012, Democrats have solely been capable of beat him as soon as: in 2018, after he voted for his celebration’s failed effort to repeal the Affordable Care Act.
This 12 months, Democrats are betting voters in the district — which was redrawn final 12 months to barely favor their celebration — shall be equally pissed off along with his vote in 2025 for President Donald Trump’s sweeping tax and spending cuts laws, also called the “One Big Beautiful Bill Act.” Starting subsequent 12 months, the regulation will increase the frequency of Medicaid eligibility verifications and imposes a brand new work requirement. Those modifications will impression California’s twenty second District, which has one of many highest concentrations of Medicaid enrollees in the nation.
Fifty-nine % of residents in the district are insured by this system, according to data collected by the New York University Grossman School of Medicine and the Robert Wood Johnson Foundation primarily based on the seat’s 2025 boundaries. Nearly 57,000 folks in the district might lose their Medicaid protection as soon as the brand new eligibility necessities go into impact, according to an analysis of Congressional Budget Office information by Democrats on the Joint Economic Committee.
Republicans argue that critics are misrepresenting the impression of the modifications to Medicaid, which they are saying are supposed to push able-bodied folks into the workforce. The regulation offers exemptions from work necessities, together with for folks with substance abuse, extreme psychological well being or different vital medical points, and pregnant folks. States might also request a brief exemption for enrollees in counties the place the unemployment charge is both 8% or 1.5 instances the nationwide common. Much of the district at present meets that threshold — Kern County, which makes up the most important a part of it, had an unemployment charge of 9.5% in March.
Valadao stated in a press release to NCS that the laws was designed to protect Medicaid long-term.
“One of my goals representing the Central Valley is to protect Medicaid for those who truly need it the most: seniors, vulnerable children, and disabled Americans,” the assertion reads. “That’s why I voted to include commonsense exemptions for Californians facing serious medical issues, economic hardship, or high unemployment.”
But healthcare suppliers who work in the district warn that they’re already feeling the impression of Trump’s agenda invoice, as hospitals and healthcare facilities start making modifications to their budgets.
“What’s happening now is that they’re facing reductions in resources, reductions in options in medications, reductions in options in physicians and programs,” stated Tina Croxton, a behavioral well being nurse and member of the Service Employees International Union California, which has backed Bains.
Diana Alvarado, a 29-year-old medical interpreter and translator who was visited by the Villegas marketing campaign, stated she’s already seeing modifications at her office. She’s additionally fearful about undocumented migrants. California, which pays the complete price of Medicaid protection for income-eligible undocumented folks, paused new enrollment for undocumented sufferers ages 19 and up this 12 months.
While she’s planning to vote for a Democrat in the June 2 non-partisan main, she hasn’t selected which one.
Before Democrats can tackle Valadao, they’ve to decide on between two candidates with completely different bases of assist.
Villegas is working a populist marketing campaign backed by Vermont impartial Sen. Bernie Sanders. He’s talked about his private expertise relying on the social security internet applications hit by final 12 months’s tax and spending cuts regulation. On the marketing campaign path, he frames the race as a battle – not between the left and the appropriate – however between the highest and the underside.
“I’ve told people from day one — cancer, valley fever, diabetes doesn’t give a shit who you voted for in the last election,” Villegas informed NCS. “It does not care what your party ID is, but we know that everybody gets sick, which is why we need health care for all.”
Villegas has been backed by National Nurses United, a progressive union that can also be advocating for a single-payer authorities well being care system. At a latest canvass launch and Mother’s Day celebration, Villegas was joined by about half a dozen members of the union and some different supporters, together with Olivia Calderón, the mayor of the close by city of Arvin.
“This is a time where we don’t have the luxury of being on the sidelines,” she stated. “We have to be out there and be very clear about what we stand for, what we are about, because our families and because our communities — there’s real suffering and fear and anxiety.”
Villegas has criticized Bains for not agreeing to a debate with him and for her marketing campaign donations from the oil and gasoline and pharmaceutical industries as a state meeting member. Over the weekend, canvassers for his marketing campaign informed voters that pro-Israel cash was flowing into the race to spice up Bains. The Democratic Majority for Israel is planning to spend $500,000 attacking Villegas, in response to a latest Federal Election Commission submitting.
Bains, a medical physician who nonetheless works at a clinic in her hometown of Delano treating Medicaid sufferers, has pointed to her years of expertise as a physician, a well being coverage professional and lawmaker as proof she’s essentially the most certified to enact actual change.
“She knows what the patients need here, and the needs are great,” Croxton stated.
Bains has hit Villegas on not residing in the district — Visalia, the place he serves as a faculty board trustee, is simply exterior of the twenty second — and has defended her donations, saying her vote can’t be purchased. She’s additionally expressed a broader frustration with the concept a candidate who lacks the identical legislative expertise {and professional} background as her is arguing he’s higher fitted to the job.
“I could have the medical degree. I could have the position in the assembly, yet there’s going to be a man that’s going to say he can do it better,” Bains informed NCS. “I’m sorry. I’m fed up. I’m tired. I am exhausted.”
Regardless of which challenger advances, the Democratic Party’s messaging in the race is obvious. Both candidates cited Valadao’s choice to vote for Trump’s agenda invoice as a motivating issue in their campaigns.
“We’ve seen him stand up for the valley before, so I had full faith —everybody else had full faith — that he was going to do the right thing,” Bains informed NCS. “And I didn’t jump in to run until after I saw him vote on my 40th birthday … it was the worst birthday in my life.”
While healthcare price Valadao his seat in 2018, his allies say this time is completely different. The dairy farmer-turned-lawmaker has grow to be much more of a family identify in the district, stated Brandon Herreman, the political director of the California Republican Party and a former Valadao aide.
To counter Democratic assaults, the congressman and his allies must stress the Trump agenda regulation’s exemptions, significantly for counties in the district with excessive unemployment, Herreman stated.
“They’re going to say Valadao slashed Medicaid, he’s not there for Central Valley families,” Herreman stated. “But the messaging on this is crucial.”
Valadao has sought to border himself as a protector of the district’s healthcare all through Trump’s second time period. He was one in every of a dozen Republicans who signed onto a letter in April 2025 opposing cuts to Medicaid, warning they may harm susceptible populations and hospitals, significantly in rural areas.
“Balancing the federal budget must not come at the expense of those who depend on these benefits for their health and economic security,” they wrote.
After the vote, Valadao stated in a press release it wasn’t a straightforward choice, however that he’d labored to dam provisions that may have been extra dangerous for his district. He additionally touted the $50 billion positioned into the Rural Health Transformation Fund, a five-year grant program for states to modernize rural healthcare. The Centers for Medicare and Medicaid Services introduced late final 12 months that California would obtain $233 million in 2026. Valadao appeared with the company’s administrator, Mehmet Oz, to tout the funding earlier this 12 months.
But half of the funding shall be divided equally among the many states, placing bigger states like California at an obstacle. And specialists be aware that the $50 billion fund gained’t absolutely cowl the income states are anticipated to lose.
For some in the district, the efforts to restrict the impression of the Trump agenda invoice fall brief. Nataly Santamaria, a group chief — generally known as a promotora — in the district who helps folks entry well being care stated Valadao hadn’t achieved sufficient to clarify what the trail ahead seems like.
“As a constituent, because I am his constituent, I feel he betrayed us,” she stated.