Why Medi-Cal And GOP Budget Could Cut Into Republican Gains In California

Here are the morning’s top stories on Thursday, April 3, 2025…

• In last year’s presidential election, Donald Trump improved on his 2020 performance all across California. Voters in every congressional district in the state shifted toward Trump. But the areas moving most toward Republicans also have a lot to lose from the party’s budget plan in Washington.
• Lawmakers are introducing a bill to strengthen existing statewide tenant protections. Not surprisingly, some property owners are not happy.
• San Joaquin Valley has the lowest ratio of doctors to patients in the entire state. A new bill co-authored by Democratic representative Jim Costa of Fresno is aiming to change that.

Here’s How Cuts To Medicaid Could Blunt Republican Gains In California

In 2021, Bakersfield resident Elizabeth Ramirez’s mother broke three bones in a fall, leaving Ramirez with a new set of responsibilities: cooking and cleaning for her mom, bathing her and driving her to appointments. “So I was caregiving for her on top of my kids,” Ramirez said. “It was just a lot.” After a few years of juggling, Ramirez became a registered care provider for her mother through the state’s In-Home Supportive Services, a program provided through Medi-Cal. “So the work I put into making sure she’s safe and healthy, I get paid for it now,” Ramirez said. “It’s such a good support system that keeps people from drowning.”

No congressional seat in California relies more on Medi-Cal than the 22nd District, which follows Interstate 5 and Highway 99 as they stretch southeast from Avenal and Delano, through almond and pistachio orchards, to Bakersfield. Two-thirds of residents are enrolled in Medi-Cal, the state’s Medicaid program, which provides health care to low-income residents, people with disabilities and those living in nursing homes or need of a personal caregiver.

The 22nd District is also experiencing an intense political shift. Back in 2020, voters here supported Joe Biden over Donald Trump in the presidential election by a 55%-42% margin. In November, Trump won the 22nd District, 52%-46% over Kamala Harris. The 19-point shift between 2020 and 2024 was the largest in California, securing incumbent Rep. David Valadao a comfortable victory that helped the GOP maintain control of the House of Representatives.

Across California, Trump made his largest gains in districts like the 22nd — inland, working class, majority-Latino and, according to a KQED analysis, heavily reliant on Medi-Cal. Now, Republicans in Congress are moving ahead with plans to slash the health care program. House Republicans passed a budget resolution in February that set a goal of $2 trillion in spending cuts. It was the first step toward passing a budget that party leaders hope will include over $4.5 trillion in new spending and tax cuts. Top Republicans ruled out reductions to Social Security, Medicare and defense, leaving Medicaid as the most expensive program on the chopping block. And that could impact Congressional seats held by vulnerable Republicans.

California Lawmakers Push to Lower Rent Cap, Expand Protections

A few months before the 2020 pandemic hit, lawmakers approved sweeping statewide protections against evictions and rent increases. Now, a group of legislators wants that law to go further.

On Wednesday, Assemblymember Ash Kalra, D-San José, announced a new bill, AB 1157, dubbed the “Affordable Rent Act,” that would expand the 2019 Tenant Protection Act to more renters, lower the amount rent can increase each year and make those changes permanent by removing a 2030 sunset date. “For many, the rent just keeps rising by the maximum allowed by state law,” Kalra said at a press conference unveiling the bill. “Areas that were once considered affordable are no longer affordable to the average working-class tenant. Rent is an issue in every corner of this state.”

The bill is one of a handful of proposed legislation aimed at strengthening tenants’ rights. As renters continue to make up almost half of the state’s population and are more likely than residents of most other states to spend almost a third of their income on housing costs, tenants’ rights groups say the Affordable Rent Act could help protect millions of renters from displacement. But several real estate and property owner groups are concerned it could make the rental market less attractive for a landlord to enter or stay in and they say it undermines the compromise they struck with tenants’ groups in AB 1482, the Tenant Protection Act.

Bill From California Lawmakers Would Address Doctor Shortages In Rural Areas 

San Joaquin Valley has the lowest ratio of doctors to patients in the entire state. A new bill co-authored by Democratic Congressman Jim Costa of Fresno is aiming to change that.

The legislation would bring federal grant funding to the Valley and other underserved areas to create new doctor training programs and expand existing ones.

“The shortage of doctors in the San Joaquin Valley and across rural America has been a serious issue for far too long, and we must continue to address it,” said Congressman Costa. “My legislation will help build a medical school in the Valley and strengthen our healthcare system. Training and retaining local doctors are key to tackling this crisis and ensuring people access to quality healthcare.”

The legislation is still in committee and would need approval from both chambers of Congress before becoming a law.