Danielle Velling depends on monthly injections to keep her severe asthma at bay in California’s Central Valley, one of the most polluted regions in the U.S., where asthma rates exceed those in other parts of the state. She receives the medication thanks to Medicaid, the government-funded insurance program, known in California as Medi-Cal. But now she worries she could lose that insurance.
Concern about cuts to health care prompted Velling, and dozens of others, to spend a record hot evening last month campaigning for upstart Democrat Randy Villegas. The college professor and local school board member aims to unseat longtime Republican Rep. David Valadao in a congressional race where access to health care has become a central issue.
For Velling, it’s the difference between the freedom to live fully and having to constantly worry about whether she’ll be able to catch her breath. “One thing that shouldn’t be up and down is your health,” said Velling, 33.
Velling’s concerns highlight the political challenge facing Valadao, a six-term congressman whose district has one of the highest rates of federal Medicaid enrollment in the nation at 62%. Valadao voted for a bill that cuts the health insurance program for low-income people after promising that he would not support such an initiative. Valadao has said the program will continue to serve those who need it most. But an analysis of federal data by the Center for American Progress, a liberal think tank, estimates that more than 60,000 people in the district could lose their coverage starting in January.
Democrats, hoping to capitalize on the changes brought by Proposition 50, the state ballot initiative which rewrote district lines to favor Democrats, have focused on health care and affordability, both pain points for voters in this election cycle. The race offers a rare opening in the majority Latino Central Valley, where the incumbent has repeatedly prevailed over his Democratic rivals, including in 2024 when he won 53.4% of the vote. The heavily agricultural 22nd Congressional District has a long history of conservative voting. It includes Bakersfield, part of Hanford, Porterville, Delano and Wasco, where about half a million people are enrolled in Medi-Cal, according to the Kaiser Family Foundation. Many more have friends or family who rely on the program.
For Villegas, the fight over Medi-Cal is personal.
“I am somebody who actually grew up relying on Medi-Cal and somebody who’s going to fight to restore that funding,” Villegas said the night the Bakersfield campaign office opened. It’s a line he repeats in many of his speeches and at rallies. “Nobody should have to choose between rationing their medicine and going to the doctor and paying for groceries,” he added.
The son of Mexican immigrants, Villegas grew up working weekends at a swap meet and later in his family’s auto repair shop. He became the first in his family to go to college, eventually earning a doctorate degree and becoming a political science professor at College of the Sequoias in Visalia. He says programs such as Medi-Cal and the U.S. Special Supplemental Nutrition Program for Women, Infants and Children (known as WIC) helped make that path possible.
Support for Villegas from volunteers and donors is fueled by their desire to unseat Valadao, whom they accuse of going back on his word.
In February of 2025, incumbent Valadao said publicly that he would not support a bill that included reductions in Medicaid coverage. Five months later he cast the deciding vote for HR 1, the One Big Beautiful Bill Act. That legislation included changes to Medicaid that could eventually result in millions of people losing their insurance nationwide.
Valadao’s campaign office did not respond to calls or emails for this story.
But, in a televised debate between the candidates earlier this month, Valadao defended his vote for President Donald Trump’s signature legislation, arguing that the law will not deny health insurance to anyone the program is intended to help.
“Medicaid was created to protect the most vulnerable, our elderly, our children and people with disabilities,” he said. “This [law] does not in any way shape or form affect anyone it was that the program was originally created for.”
“It requires that people who have the ability to work that they actually show up and they try to work,” he added, referring to the new work requirements that are part of the law. “It’s not an actual cut.”
The Congressional Budget Office estimates that 7.8 million people nationwide would lose insurance coverage by 2034 because of the new Medicaid rules, which include the work requirements, decreased eligibility for legal immigrants and more onerous reporting requirements.
Valadao’s backers applaud his support for a law, which they say will reduce wasteful spending on Medicaid and other social programs while also providing tax breaks for families that need them.
“He’s focused on affordability,” said Matthew Casarez, executive director of the Tulare County Republican Party. “He voted for tax cuts for working families, no tax on tips, no tax on overtime and no tax on social security for seniors.”
Those tax breaks will expire in 2028 unless they are extended by Congress. Overall, the tax relief favors more affluent households, while the lowest-income households lose the most once cuts to Medicaid and food assistance are factored in, according to a report from the Congressional Budget Office.
Casarez also touts Valadao’s strong ties to the residents in the district, and said his background as the son of immigrants and as a farmer are important to those who live in the Central Valley.
In California’s salad bowl, the race has attracted national attention since California voters approved Proposition 50, allowing the state to redraw congressional districts to favor Democrats. The 22nd District was one of five targeted statewide, and The Cook Political Report rates the contest as a “toss up.”
Villegas has aligned himself with the progressive wing of the Democratic Party led by Sen. Bernie Sanders of Vermont and New York’s Rep. Alexandria Ocasio-Cortez, who have both endorsed the Democratic candidate. Sanders, an independent who caucuses with the Democrats, showed up in Bakersfield on Oct. 4 for a “Fight Oligarchy” tour rally, walking on stage to greet Villegas to the “Power to the People” song.
In late September, House Speaker Mike Johnson traveled to California to campaign for Valadao and other Republicans facing challenges in the aftermath of the Proposition 50 redistricting.
It’s too soon to tell if a Villegas win will signal a move to the left on the part of voters — or if it’s a reflection of the anti-establishment mood that has beset voters.
Political analyst Mike Madrid sees the race as part of a broader shift in which voters’ economic concerns are overriding traditional party loyalties. He expects Democrats to win key races like this one, where Valadao is facing voters stressed about making ends meet. “No amount of money can buy you out of bad fundamentals,” said Madrid, a founder of the Lincoln Project, a Republican anti-Trump political organization and an expert on Latino voters.
“People know what they pay at the pump, they know what their health care premiums are, they know what their rent is going up to, they know unemployment is going up,” he added.
Nevertheless, Villegas’ populist message — the Democratic candidate touts his support for Medicare for All and refuses corporate donations — may be helping to draw volunteers from across the district and the state.
And his campaign has also drawn ardent support from those who have connections to the Medi-Cal program. In a district where nearly two-thirds of all residents and 87% of children rely on the program, many voters have used the program themselves, rely on it now or know someone who does.
That includes Andrea Aldaz, 29, who came to Villegas’ Bakersfield campaign office to volunteer last month and continues to knock on doors for the candidate. She grew up on Medi-Cal just like many in her extended family. She now works for the Kern County Department of Human Services, where the majority of her clients are on Medi-Cal.
Her mother is still on Medi-Cal and receives coverage for her diabetes through the program, Aldaz said. Medi-Cal pays for medication and transportation when her mom needs it.
“It’s life,” Aldaz said.
Audrey Chavez, a lifelong Bakersfield resident who runs Martin’s Meats & Deli with her husband, said she actively opposed the “Big Beautiful Bill.” Before the vote last year, she called Valadao’s office to urge him not to support it.
“We can’t have that,” said Chavez, 59. “We have to have someone who’s willing to know our district, who knows the needs of the population and who speaks to those needs regardless of party.”
Chavez, who along with her husband served hot taco plates from behind the food table at the Villegas event, used Medi-Cal during her four pregnancies, including one that ended in a miscarriage.
Her concern now extends to customers and neighbors who depend on the program.
“It doesn’t matter that it may not be me who is on Medi-Cal now,” Chavez said. “But it matters to me that it’s my customer who’s a senior citizen who relies on it or a veteran who relies on it or a young person that’s been unhoused that needs care.”
Capital & Main is a partner of CVJC and The Intersection.
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