Rep. Jim Costa, D-Fresno, pushed back on Republican criticism over his opposition to President Donald Trump’s “One Big Beautiful Bill” and its proposed cuts to Medicaid and Medi-Cal.

Costa held a news conference Wednesday at the United Health Centers clinic in downtown Fresno, advocating against cuts to the medical insurance safety net. He said more than 456,000 people in his congressional district rely on Medi-Cal, and that half could lose coverage under the proposed cuts.

Medi-Cal is California’s version of the federal Medicaid. State and local funding supplement the federal dollars provided. The reduced funding is set to begin in 2028.

“When you look at the totality of this legislation, I think an apt description for many of us is ‘One Big Ugly Bill.’ This is the largest cut to Medicaid in U.S. history,” Costa said.

2026 Opponent Responds

Lorenzo Rios, a Clovis Republican running against Costa in 2026, said his party is “fighting to protect Medicaid for those it was meant to serve.”

He blamed Costa and Democrats for prioritizing illegal immigrants.

“His remarks today miss the mark and fail to address the very crisis he helped to create. Medicaid was never meant to subsidize Jim Costa and Gavin Newsom’s open-border agenda or provide benefits to those in the country illegally. It’s time to put the needs of legal residents and struggling families in the Central Valley first,” Rios said.

Unsurprisingly, the National Republican Congressional Committee also criticized Costa.

“Costa’s latest partisan fearmongering is nothing but a desperate attempt to protect a broken status quo, one that prioritizes taxpayer-funded benefits for illegal immigrants over the needs of Californians,” NRCC spokesman Christian Martinez said.

Costa Says Farmers Want Health Care for Their Workers

Costa said Republicans “don’t know what they are talking about.”

“A society is judged upon how we treat one another,” Costa said, praising undocumented workers.

He also said that farm employers want their workers to have access to health care.

“Have those Republicans come here into the Valley and tell our farmers, our ranchers and our dairymen that, no, we don’t want you to give health care to these people because they’re not documented, because we think that’s just the right thing to do, but they can go ahead and still work,” Costa said.

A Call for Bipartisan Immigration Reform

Costa wants Republicans to help fix the immigration issue.

“They should join in in the bipartisan comprehensive Farm Worker Modernization Act that does have bipartisan support, and we can fix this broken integration system instead of pontificating and politicizing this issue,” Costa said.

Costa, along with Central Valley congressmembers David Valadao, R-Hanford, and Adam Gray, D-Merced, are cosponsors.

Martinez also criticized Costa for not supporting the bill backed by President Donald Trump that provides $50 billion for hospitals.

Costa said the $50 billion is insufficient because the impact of the cuts could reach $200 billion for rural health care nationwide.

A Doomsday Scenario

Justin Preas, CEO of UHC, joined Costa at the news conference, calling any cuts to Medi-Cal “devastating.”

“This shouldn’t be contingent upon income, ZIP code, immigration status — everyone deserves to be healthy,” Preas said. “We’re already trying to do more with less.”

Preas said up to 70% of UHC patients are on Medi-Cal. He is unsure how deep the impacts of Medi-Cal cuts will be.

“Without the Medi-Cal program being available to many of our patients, our emergency room is going to become even further overburdened and overwhelmed,” Preas said.

Preas urged people to reach out to members of Congress to reverse the cuts.

Dr. Sharareh Shabafrooz said patients losing Medi-Cal may not seek regular health care treatments, “and ultimately it costs the health systems more.”

(Note: The original story identified the doctor by a different name. It has since been updated.)

Preas downplayed GOP arguments of fraud and abuse.

“Those aren’t the things that I’m worried about. I understand those arguments, but we don’t see that. What we see is people and patients,” Preas said.