For Representative David Valadao of California and other Republicans whose constituents depend on Medicaid, a vote for their party’s budget could be politically fatal. President Trump’s agenda hangs in the balance.
To understand the conundrum House Republicans have gotten themselves into as they try to pass their budget plan next week, look no further than Representative David Valadao of California.
Almost nowhere in the nation relies as heavily on Medicaid as his district here in the Central Valley, where nearly two-thirds of the population depends on the program for health care, from low-income nursing home patients to the parents of developmentally disabled children to veterans with chronic conditions.
So it comes as little surprise that Mr. Valadao, one of the most politically vulnerable Republicans in the country, has appeared uneasy about the prospect of voting for his party’s budget blueprint, a measure that would pay for $4.5 trillion in tax cuts in part through deep cuts to Medicaid.
To pass their budget plan and smooth the way for enactment of President Trump’s sprawling agenda, House Republican leaders will need to muster near unanimity from their members. Under the outline, Medicaid cuts would have to make up nearly half of the required $2 trillion in spending cuts, if Medicare is left untouched as Republicans have said it will be.
But they are finding it is one thing to hypothetically entertain spending cuts on a spreadsheet, and entirely another to ask lawmakers to cast a vote that would have real-life consequences in their districts.
In a recent letter to House G.O.P. leaders, Mr. Valadao and other Hispanic lawmakers argued that such cuts “would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open.”