Valadao's District Exempt From New Medicaid Work Rules

Federal Medicaid work rules that take effect in January will not apply to residents of U.S. Rep. David Valadao's district in California.

The One Big Beautiful Bill Act, signed into law last summer, mandates that nondisabled adults in 43 states and Washington, D.C., work, volunteer, or attend school for at least 80 hours per month to retain coverage. However, the legislation includes a hardship exception for counties with high unemployment rates. Based on current data, every county in Valadao's Central Valley district qualifies for this exemption. His campaign website states that the waiver ensures residents who are trying to work but face limited opportunities will not be required to meet the mandate.

Valadao previously defended his vote for the bill, citing a provision that reduces Medicare spending by billions. He described the work requirement as "not an unreasonable ask" for those capable of working. Despite his public stance that enrollees should "put in a fair day's work," his district is shielded from the immediate burden due to local economic conditions. The congressman and campaign spokesperson Paige Ash declined to comment on the specific impact of the exemption for his constituents.

Valadao is one of at least 21 Republican lawmakers representing counties that may qualify for the hardship exception. Approximately 60% of residents in his district are enrolled in Medi-Cal, the state's Medicaid program. Researchers estimate that 60,000 additional residents in CA-22 could lose coverage by 2034 due to the new bill and the expiration of enhanced Affordable Care Act premium tax credits. The exemption may protect these individuals from the specific work-hour requirement, though they remain subject to other changes in the law.

The administration of the exception remains uncertain. The law allows states to apply for short-term relief if county unemployment is at least 8% or 1.5 times the national rate, whichever is lower. The Centers for Medicare & Medicaid Services (CMS) has not specified which time frame of unemployment data states should submit. Using July 2026 monthly rates, 95 U.S. counties qualify for the exception. If the 12-month average is used, the number rises to 120 counties. Sixty-four counties have high unemployment rates that likely qualify them regardless of the data metric used.

California has requested permission to use state unemployment data, which officials argue is more timely than federal figures. A spokesperson for the California Department of Health Care Services, Griselda Melgoza, said the state is waiting for a response from CMS and for details on the duration of exemptions. Five Democratic-led states have asked the federal government to delay the work requirements, citing insufficient time to comply before the end of the year. Indiana, Iowa, and Missouri have indicated they do not plan to seek the hardship exception.

Valadao faces Democrat Randy Villegas in a district redrawn last year to lean more blue. Both candidates have booked over $16 million in advertising through Election Day. Democratic challengers nationwide have made the Republican vote for the Medicaid work rules a central campaign issue, arguing that most enrollees are already working, disabled, or caregiving. The political dynamics are complicated by the fact that many Republican districts, including Valadao's, are exempt from the strictest provisions of the law due to local unemployment statistics.