The U.S. House of Representatives passed the “Big Beautiful Bill” on Wednesday by a narrow vote of 218 to 214. The bill had already passed the Senate earlier in the week.

The bill includes permanent tax cuts, increased spending for border security and defense, and major changes to federal programs like Medicaid and food assistance. It also adds new work requirements for people receiving certain types of public aid.

Rep. David Valadao (CA-22) voted in favor of the bill, even though his constituents asked him to save Medicaid and he had previously criticized parts of it. Valadao had also voted for the bill before it went to the Senate.

“It was not an easy decision for me, but I voted yes on the budget reconciliation bill,” said Valadao in a statement on the House budget reconciliation vote.

Following the vote, several groups in California’s Central Valley criticized Valadao’s decision. Many residents had contacted his office, held rallies, and protested to ask him to vote no.

Camila Chavez, Executive Director of the Dolores Huerta Foundation, told Kern Sol News the vote would lead to major health care cuts that would affect people in the Central Valley who rely on Medi-Cal, California’s Medicaid program.

“He betrayed his community by ignoring that his own neighbors asked him to oppose these cuts. Thousands of constituents made calls, sent postcards, visited his offices, fasted, and protested outside his office for days and weeks,” she said.

“Despite the countless pleas by his constituents, Congressman Valadao voted to pass a bill that will unleash catastrophic cuts to Medicaid, leaving the Central Valley’s most vulnerable to fend for themselves,” Chavez said. “His vote is not just disappointing, it signals his alignment with cruel policies designed to finance enormous tax handouts for greedy CEOs on the backs of those most in need.”

The Kern County Democratic Party and local Democratic clubs also released a statement that said that the bill could cause nearly 20 million people to lose health coverage nationwide.

California’s 22nd Congressional District, represented by Valadao, has the highest percentage of people in the state who rely on Medi-Cal. About 67% of residents in the district use the program for health coverage.

The changes to Medicaid and other programs in the bill are expected to begin in 2026.