Rep. David Valadao, R-Hanford, and other Republicans in Medicaid-dependent districts, sent a letter to Senate Majority Leader John Thune and House Speaker Mike Johnson saying they can’t support the Senate’s version of President Donald Trump’s “Big Beautiful Bill.”

“Protecting Medicaid is essential for the vulnerable constituents we were elected to represent,” wrote Valadao and 15 other Republican House members on June 24. “Therefore, we cannot support a final bill that threatens access to coverage or jeopardizes the stability of our hospitals and providers. The House’s approach reflects a more pragmatic and compassionate standard, and we urge that it be retained in the final bill.”

Republicans hold 220 seats in the House while the Democrats have 212. Three seats are vacant because of the deaths of Democrats Raúl Grijalva (Arizona), Gerry Connolly (Virginia), and Sylvester Turner (Texas).

Trump has said numerous times that he wants the bill on his desk for signing by July 4, which is Friday.

Valadao Voted for $700 Billion in Medicaid Cuts

It should be noted that Valadao and the other letter-signers voted for a version of the bill that includes $700 billion in Medicaid cuts over the next decade. An  analysis from the Center for American Progress estimated that Valadao’s 22nd Congressional District could potentially lose more than $5 billion in funding and see 67,000 fewer enrollees per year. About 67% of the rural California district’s residents are enrolled in Medicaid.

When the House passed its version of Trump’s domestic policy bill, Valadao pushed back against critics. “It’s simply the first step in the process before committees begin drafting legislation to determine priorities. I’ve made clear to House leadership that I will only support a final bill that protects essential resources like Medicaid or SNAP for Central Valley families,” Valadao said in a post on X.

It’s simply the first step in the process before committees begin drafting legislation to determine priorities. I’ve made clear to House leadership that I will only support a final bill that protects essential resources like Medicaid or SNAP for Central Valley families. pic.twitter.com/bFdZ10yMst

— Rep. David Valadao (@RepDavidValadao) February 26, 2025

Nearly 16 Million People Could Lose Coverage

The Urban Institute estimates that reducing the federal medical assistance percentage for Medicaid expansion enrollees could result in 15.9 million people losing Medicaid and CHIP coverage in 2026 if states cannot make up the shortfall.

The letter to House and Senate leadership also stated:

“We are also concerned about rushed implementation timelines, penalties for expansion states, changes to the community engagement requirements for adults with dependents, and cuts to
emergency Medicaid funding. These changes would place additional burdens on hospitals already stretched thin by legal and moral obligations to provide care.”

The House bill imposes work requirements on Medicaid expansion enrollees ages 19 to 64 while providing an exemption to parents with dependent children; the Senate version imposes work requirements on parents with children over age 14.