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July 1, 2025
The Honorable David Valadao
U.S. House of Representatives
2465 Rayburn House Office Building
Washington, DC 20515
RE: Vote NO on the Reconciliation Bill with Deadly Medicaid Cuts
Dear Representative Valadao,
On April 14, 2025, you promised to oppose any budget bill that reduces Medicaid coverage for vulnerable populations.[1] We write as members and advocates in the California disability community—many of whom are your constituents—to demand that you honor this promise.
Since you made that promise, your colleagues in the Senate have endorsed even deeper health care cuts. Projections from the Congressional Budget Office (CBO) for the Senate bill[2] show 17 million people losing health insurance within 10 years, and the federal debt increasing by well over three trillion dollars. An estimated 51,000 people will die each year[3] due to the loss of healthcare coverage caused by the bill. Up to 3.4 million Californians will lose coverage, including thousands in your district with and without disabilities.
Past experience shows us that there is no way to carve disabled people out of job loss penalties and healthcare cuts. People with disabilities will be lost in bureaucracy, especially those who need assistance with paperwork. Those with new disabilities or undiagnosed disabilities will have a difficult time proving that they have a disability that makes them exempt from work requirements. Moreover, research shows that when states lose Medicaid dollars, they invariably make cuts to home and community-based services (including IHSS).[4] Disabled people will be unnecessarily institutionalized, and many will lose their lives as a result. Caregivers and personal attendants, subjected to many more bureaucratic requirements[5], will lose their access to healthcare, and many will be unable to continue caregiving work.
As you know, California is being targeted with steeper cuts that will sharply reduce our share of federal Medicaid dollars from our Federal Medical Assistance Percentage (FMAP) and the provider tax. These huge losses to Medi-Cal are being made because our state chose to expand Medicaid and further chose to provide healthcare to the immigrants who have contributed so much to our state’s economic power and health. It is estimated that 6,569 Californians will die as a result of FMAP cuts alone.[6]
It is impossible for such deep cuts to Medi-Cal not to be experienced by all enrollees, including the high numbers of Medi-Cal enrollees in the 22nd District. 67% of your constituents are covered by Medi-Cal, and another 2% rely on healthcare through Covered California.[7] The number of children who rely on Medi-Cal in your district is even higher: “as many as 3 in 4 children are enrolled in Medicaid/CHIP; in California’s 22nd Congressional District, nearly 75 percent of children under 6 years old were covered by Medicaid/CHIP in 2023.”[8]
Your constituents are “asking for changes to the healthcare system that will strengthen the healthcare workforce, offer low-income, working-class families expanded opportunities to save for medical expenses, support rural and underserved communities, and help new mothers,” according to your April letter. Yet, the current budget bill will increase medical debt[9], require the state to spend millions of dollars on infrastructure[10] for tracking work requirements, and take away healthcare from Medicaid enrollees who are already working, while doing nothing to help disabled people who are actively looking for employment but need healthcare to stay well enough to work.[11]
Your constituents want a fair chance to create a life for themselves, their families, and their communities. They include many people with disabilities and those who support them. We are counting on you to uphold your promise to them. Do the right thing.
Signed,
California Foundation for Independent Living Centers
Disability Rights California
Disability Rights Education and Defense Fund
Disability Voices United
Hand in Hand: The Domestic Employers Network
California Alliance of Retired Americans
Senior and Disability Action
[1] https://www.aamc.org/media/82746/download?attachment
[2] https://www.cbo.gov/publication/61534
[3] https://www.sanders.senate.gov/wp-content/uploads/LDI-Yale-Letter-Final-1.pdf
[4] https://www.healthaffairs.org/content/forefront/history-repeats-faced-medicaid-cuts-states-reduced-support-older-adults-and-disabled
[5] https://www.milbank.org/quarterly/opinions/whos-affected-by-medicaid-work-requirements-its-not-who-you-think/
[6] https://www.americanprogress.org/article/congressional-republicans-proposals-to-slash-medicaid-could-cost-tens-of-thousands-of-lives/
[7] https://www.chcf.org/resource/how-many-congressional-district-get-medi-cal-premium-subsidy-through-covered-california/
[8] https://www.governing.com/policy/medicaid-and-chip-coverage-mapped-by-congressional-district#:~:text=In%20some%20districts%2C%20as%20many%20as%203,were%20covered%20by%20Medicaid/CHIP%20nationwide%20in%202023.
[9] https://www.cnbc.com/2025/06/23/big-beautiful-bill-health-care-cuts-may-add-to-medical-debts-report.html
[10] https://www.nytimes.com/2025/06/28/upshot/republicans-medicaid-work-requirement.html
[11] https://www.rwjf.org/en/insights/our-research/2025/04/work-requirements-threaten-health-and-increase-costs.html