*

Republican budget cut proposals could fall heavily on SNAP

and

Medicaid

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California congress member David Valadao feels the heat at

home

from cuts proposed in Washington

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Local hospitals and clinics could be at risk, if budget

cuts are

passed

By Renee Hickman and Andy Sullivan

Bakersfield, California, April 1 (Reuters) - When Blair

Isbell's food aid benefits arrive each month, the community

college student and mother of two starts planning how to spend

the roughly $7 per person per day she gets for groceries.

Isbell has an app on her phone for every grocery store in her

area of California's Central Valley, and uses them to find the

best deals. She favors pasta and rice combinations, stretching

the meat and vegetables as far as she can for her sons, ages 4

and 8.

Without those food benefits, paid through the federal

government's Supplementary Nutrition Assistance Program, Isbell

said she would have had to drop out of the degree program she

hopes will eventually lead to a good job as an occupational

therapist.

"I wouldn't be able to be in school," she said. "I also, if

I'm being honest, don't really know how I would make ends meet

either."

SNAP, which provided food aid to 41.7 million Americans last

year, and Medicaid, the federal health plan which provides

coverage to 72 million low-income and disabled people, could

face sweeping cuts under a budget plan taking shape in Congress.

A Republican blueprint passed by the House of Representatives in

February seeks to lower taxes by $4.5 trillion over the coming

decade, partially offsetting that lost revenue with $1.5

trillion in spending cuts.

Those proposed cuts - which may not be finalized for weeks

or months - would likely fall heavily on this part of the

Central Valley, a vast expanse of orchards, vineyards and cattle

ranches that produces a significant portion of the United

States' fruits, vegetables and nuts. It also has some of the

highest poverty rates in the country.

That puts Isbell's congressman, Republican David Valadao, in

a tricky position in a competitive district that is among the

top Democratic targets in 2026.

Republicans are struggling over how to pare back the federal

budget without alienating working-class voters whose support is

crucial to retaining control of Congress. Republicans are hoping

to expand their narrow lead in two special elections in Florida

on Tuesday.

More than half of Valadao's constituents receive Medicaid or

Medi-Cal as it's known in California, which college student

Isbell also uses. Some 28% get SNAP, or Cal-Fresh. Those are

among the highest percentages for any congressional district in

the nation, according to a Reuters review of Census data.

Valadao voted for the budget cuts in February - and then

days later called on his colleagues to produce a final bill that

"strengthens critical programs like Medicaid and SNAP."

Valadao's office did not respond to requests for comment

from Reuters.

The son of local dairy farmers, Valadao has built a

reputation as one of his party's most moderate members since he

was first elected in 2012. He backed bipartisan efforts to

overhaul immigration laws - a priority for farmers who rely on

immigrant labor - and focused on bread-and-butter issues like

irrigation infrastructure, steering clear of the culture wars

that have occupied many of his colleagues.

Valadao was one of just 10 House Republicans to vote for

Trump's impeachment following the Jan. 6, 2021 attack on the

U.S. Capitol, and one of only two still in office.

But he has faced protests against the Republican budget

proposals at his office in Bakersfield.

"If he votes to cut Medi-Cal, it's going to affect him at the

ballot box, because people are going to have a long memory if he

takes away their health care," Sandy Reding, a registered nurse

and a president of the California Nurses Association who joined

the protests, told Reuters.

SAFETY-NET PROGRAMS IN SIGHTS

President Trump has ruled out cuts to Social Security and

Medicare, the ballooning retirement and health care programs for

the elderly, while calling for increased spending on defense and

border security.

That puts nearly half of the $6.8 trillion budget off

limits, pointing Republicans to weigh cuts to other safety-net

programs.

The House plan does not explicitly call for Medicaid cuts,

but it would be impossible to get to the party's goal of $880

billion in spending reductions without touching the program,

according to the Congressional Budget Office.

It would also be difficult to cut $230 billion in

agricultural spending, as the blueprint proposes, without

affecting SNAP, the department's biggest program.

Congress is unlikely to finalize its budget plan for weeks,

as the Senate must pass its own version and then the two must be

reconciled.

The offices of Senate Republican Leader John Thune and House

Speaker Mike Johnson declined requests for comment. But House

Republicans have in the past downplayed the possibility of steep

benefit cuts, saying they will find savings by cracking down on

waste and fraud and narrowing the focus to single mothers and

others who most need benefits.

Across Valadao's district, several hospitals and clinics are

at risk of closure if those cuts are made, according to Jason

Wells, president of Adventist Health's Central California

Network of healthcare facilities, one of the largest health

systems in the region.

Raul Ayala, who oversees outpatient and other care for

Adventist, said Medicaid cuts would be "catastrophic" for a

rural region that is already short on health resources and

doctors.

Medicaid cuts could also affect health care delivered

through the school system, including childhood immunization

programs.

At Pioneer School in the farming town of Delano, school nurse

Linda Hinojosa presides over a vision clinic for children

operating from a room with a rack of colorful children's glasses

on one wall.

School nurses are mandated to test hearing and vision in

certain grades - but without the clinic they couldn't do much

beyond moving children to the front of the class, Hinjosa said.

"It was so very frustrating to send a letter home and say

'you're child failed and they can't see, but there was no place

for a family to go," Hinjosa said.

So in 2018 the school began to provide the service through a

local nonprofit relying on Medicaid reimbursements.

"If you can't see, you can't learn," Hinojosa said. "If we

lost Medicaid or the ability to provide those services, it would

be devastating."