South Texas voters are hearing more about health‑care affordability than ever as the 2026 midterm campaigns heat up in the Rio Grande Valley. In the 15th Congressional District, Tejano singer‑turned‑Democrat Bobby Pulido has centered his campaign on giving families control over their own health‑care, directly attacking incumbent Rep. Monica De La Cruz for supporting the Trump administration’s 2025 megabill that slashes billions from Medicaid.
Medicaid cuts and lost ACA subsidies hit the Valley hard
The district, which President Trump carried by 18 points in 2024, already struggles with high uninsured rates—more than a quarter of adults lack coverage, according to the U.S. Census Bureau. The situation is set to worsen after the expiration of enhanced premium tax credits that lowered out‑of‑pocket costs for Affordable Care Act enrollees. Those subsidies lapsed in January when Republicans, citing fiscal responsibility, chose not to preserve the program.
Without a federal replacement, experts warn that the loss will be a “hard blow” to a region where roughly one in five residents rely on the marketplace for insurance. The Valley also faces disproportionate rates of chronic disease: more than two‑in‑five adults have diabetes and one‑in‑four are obese, conditions that require ongoing medical care that many uninsured residents cannot afford.
Campaigns turn health‑care into a ballot issue
Both parties are using health‑care to rally voters. Pulido’s ads stress that “you should be in charge— not politicians,” while De La Cruz counters with a boxing‑ring metaphor, promising to fight for “affordable health‑care.” Across the five competitive South Texas districts, candidates and outside groups have spent over $3 million on television, radio, and digital ads that mention Medicare, Social Security, or Medicaid.
Democrats have more than doubled Republican ad spending on health‑care in these races, tying the GOP’s Medicaid cuts to rising costs for families. A Texas Politics Project poll found that 31 % of voters approve of President Trump’s handling of health‑care, while 52 % disapprove, indicating that the administration’s policies are a potent line of attack for Democrats.
Local voters prioritize health‑care
Polling conducted earlier this year across the five South Texas battlegrounds placed health‑care third among the most important issues for voters, behind cost of living and the economy. “When you make things more expensive, which includes health‑care, people are going to revolt,” Pulido warned, noting the strain on families already coping with limited incomes.
The races also feature other high‑stakes dynamics. The 15th District, the only seat held by a Republican incumbent, was recently re‑rated a “toss‑up” by Sabato’s Crystal Ball. Neighboring districts held by Democrats Vicente González and Henry Cuellar were redrawn to add more GOP voters, yet recent polls show both incumbents ahead of their challengers.
What’s at stake for South Texas families
If the Trump administration’s megabill proceeds without reversal, the estimated $911 billion in Medicaid cuts over the next decade could leave thousands of Valley residents without essential health services. Democrats argue that restoring the premium tax credits and opposing the cuts would ease the financial burden on working‑class families and improve health outcomes for a region already grappling with diabetes and obesity.
As the November election approaches, health‑care will remain a defining issue for South Texas voters, shaping the balance of power in a narrowly divided House and determining how the federal government will address the medical needs of one of the state’s most vulnerable populations.
Original reporting: Texas Tribune (HLL/CB) — read the source article.
