One of the most expensive ads in a South Texas congressional race this cycle opens with a simple pitch: \u201cWhen it comes to your healthcare, Bobby Pulido believes you should be in charge \u2014 not politicians.\u201d<\/p>\n
Pulido, a Tejano musician and Democratic candidate for Congress, is putting healthcare at the forefront of his campaign to defeat U.S. Rep. Monica De La Cruz<\/a> this fall, blasting the Edinburg Republican over her vote for the GOP\u2019s 2025 megabill that cut billions in Medicaid spending. De La Cruz has countered with a spot that fashions her as a boxer punching and weaving in the ring, fighting for \u201caffordable healthcare.\u201d<\/p>\n It is no accident that both candidates are selling their healthcare bona fides in a district centered in the Rio Grande Valley, a predominantly Hispanic and historically underserved corner of the state where more than a quarter of adults lack health coverage, according to<\/a> the U.S. Census Bureau. Uninsured rates are expected to swell<\/a> after the expiration of enhanced premium tax credits, which had lowered out-of-pocket costs for Affordable Care Act enrollees. The federal subsidies lapsed in January after Republicans balked at preserving a policy they saw as a giveaway to insurers. <\/p>\n Without anything to replace them, experts say, the lost subsidies are a hard blow to the Valley, where roughly one in five residents rely on the marketplace for coverage.<\/p>\n This all means healthcare is again top of mind for voters in the Valley, where the uninsured rate is more than double the national average<\/a> and chronic diseases are a disproportionate problem. A decade-long study<\/a> found more than two in five adults in the region suffer from diabetes and one in four from obesity. These are conditions that, like other chronic diseases, require the level of continual care that cash-strapped or uninsured patients often avoid, said Rashmi Chandran, a clinician and hospital administrator in the Valley.<\/p>\n \u201cMost of these patients get one annual visit, or they go when they get sick,\u201d said Chandran, noting that those who skip follow-ups tend to put off refilling prescriptions, a dangerous limbo for the chronically ill.<\/p>\n These health woes are not new to residents in the Valley and surrounding communities. But what\u2019s different this year is that the GOP\u2019s cuts to Medicaid and ACA subsidies have armed Democrats with a potent campaign tool as they campaign on making everyday life more affordable. And South Texas, a region where pocketbook issues drive voters, is blanketed by five competitive U.S. House races, making it a key arbiter of which party will control the narrowly divided chamber.<\/p>\n Despite suffering catastrophic losses<\/a> in the region two years ago, Democrats are optimistic that campaigning on the GOP\u2019s healthcare record \u2014 and their own plans to reverse course \u2014 will resonate with the majority-Hispanic, working-class electorates that make up all five districts.<\/p>\n \u201cI\u2019m old enough to remember when the president said in two weeks he would have a healthcare plan in 2016,\u201d Pulido said in an interview with The Texas Tribune. \u201cNine years have passed since then, and we still don\u2019t have a plan.\u201d<\/p>\n Healthcare-related political ads have become a fixture during commercial breaks across these districts, which include a pair of Democratic seats in the Valley that the GOP is trying to flip and a vacant red-leaning district that spans most of Texas\u2019 southwest border. Across those three races, plus the Pulido-De La Cruz contest, candidates and outside groups have spent more than $3 million on TV, radio and digital ads that mention Medicare, Social Security or other issues tied to healthcare, according to the media tracking firm AdImpact.<\/p>\n The spending is outpacing every other pocketbook issue, from inflation to jobs, and Democrats are steering much of the conversation. The party has more than doubled the GOP\u2019s healthcare ad spending across the four districts, with a playbook that seeks to tie voters\u2019 affordability worries to Republican-backed Medicaid cuts and the healthcare subsidies that expired under the GOP\u2019s watch. <\/p>\n Democrats had teased this very messaging for months, inspired by polling that found far more Texas voters thought<\/a> President Donald Trump\u2019s megabill would raise healthcare costs than those who expected savings. In a Texas Politics Project poll<\/a> earlier this month, 31% of Texas voters said they approved of how Trump was handling healthcare, while 52% voiced disapproval.<\/p>\n Republicans, meanwhile, have leaned more on border security and tax cuts in their South Texas ads. Those who have engaged on healthcare, such as De La Cruz, have promised to protect Medicare and Social Security, focusing on the two biggest entitlement programs that matter especially for older voters.<\/p>\n What stands out to Pulido, though, are findings like what came out of a poll<\/a> conducted earlier this year across the five South Texas congressional battlegrounds, in which voters ranked healthcare as their third most important issue. It was preceded by the related topics of cost of living and \u201cthe economy and jobs\/wages.\u201d<\/p>\n \u201cWhen you make things more expensive, which includes healthcare, what do you think is going to happen?\u201d Pulido said. \u201cPeople are going to revolt because the people over here have already been trying to figure out life with less money.\u201d<\/p>\n The South Texas landscape<\/p>\n Pulido, a first-time political candidate, won his primary in March with help from Blue Dog Action PAC, the campaign arm of the centrist Blue Dog Coalition, which spent more than $560,000 on the ad touting his support for giving people autonomy over their healthcare.<\/p>\n The ad also touched on fighting for affordable healthcare for South Texas families \u2014 a message Pulido is now carrying into the general election against De La Cruz in the 15th Congressional District, which Trump carried by 18 points in 2024.<\/p>\n But Pulido and other Democratic candidates appear to be scrambling Republican gains that reshaped South Texas in recent elections. On Wednesday, the nonpartisan elections forecaster Sabato\u2019s Crystal Ball<\/a> shifted the race from \u201clean Republican\u201d to \u201ctoss-up.\u201d That makes it the second district in the Valley rated by the site as a jump ball, joining the neighboring seat of U.S. Rep. Vicente Gonzalez<\/a>, D-McAllen.<\/p>\n Gonzalez and U.S. Rep. Henry Cuellar<\/a>, D-Laredo, are running for reelection in districts that Texas Republicans reconfigured last summer to add more GOP voters. But while Trump won both Cuellar and Gonzalez\u2019s new seats by 10 points, recent polling<\/a> of the districts found the Democratic incumbents ahead of their GOP challengers, with Cuellar up by a whopping 11 points over Webb County Judge Tano Tijerina, the Republican nominee. Gonzalez had a narrower 3-point lead over his GOP foe, Eric Flores.<\/p>\n Rounding out the South Texas map are a pair of seats that wrap around San Antonio, including the 23rd Congressional District, left vacant since the resignation<\/a> of former GOP Congressman Tony Gonzales<\/a>. There, voters are choosing between Republican Brandon Herrera, a prominent gun-rights activist and YouTuber, and Democrat Katy Padilla Stout, an attorney and former teacher. Although Trump won this district by 17 points in 2024, national Democrats added it to their target list<\/a> earlier this month, in part citing the GOP\u2019s record on healthcare.<\/p>\n Next door, the 35th Congressional District was also drawn by the GOP-controlled Legislature last year to favor a Republican. Trump carried the newly configured district by 10 points in 2024.<\/p>\n De La Cruz is the only incumbent Republican among the five districts, making Pulido the only Democrat who can run ads attacking his opponent\u2019s record on Capitol Hill. He and his allied Democratic groups have aired four separate ads criticizing De La Cruz for backing Republicans\u2019 sweeping tax-and-spending law, known as the One Big Beautiful Bill Act. Every Texas House Republican voted for the law in July 2025. <\/p>\n Among its provisions are an estimated $911 billion in federal Medicaid spending cuts over the next decade, which translates to a loss of $23 billion to $39 billion<\/a> for Texas over the next decade, according to a projection by the nonpartisan health policy organization KFF. The law also created a $50 billion, five-year federal grant program intended for rural healthcare. Yet many of the state\u2019s rural healthcare facilities rely on Medicaid payments, and a majority of them could lose services, according to Kiplinger<\/a>.<\/p>\n In South Texas, which is dotted with sparsely populated towns and ranchlands, Chandran said those who are insured \u2014 typically seniors \u2014 depend on federally funded community clinics that serve under-resourced areas. Chandran, who runs a nonprofit that provides health access to rural areas, said these centers are \u201cfunctioning beyond their saturation level,\u201d leaving little room for ongoing, coordinated care.<\/p>\n On the campaign trail in these sorts of areas, Democrats are pointing to the Medicaid cuts, and the loss of ACA subsidies, in what they see as an opening to tie Republicans to rising healthcare costs. These attacks are also being echoed in districts across the country and are a subset of the party\u2019s broader affordability message.<\/p>\n Particularly in the Valley, healthcare is often intertwined with other economic factors. Chandran recalled how she once treated a construction worker who arrived unconscious and septic after a nail wound in his leg had gone untreated for weeks. Surgeons amputated his leg to save his life. When she asked whether he had realized his leg was rotting, he told her, \u201cIf I don\u2019t go to work one day, I get replaced.\u201d<\/p>\n Pulido argued that healthcare \u201chasn\u2019t appeared to be a priority\u201d for De La Cruz, accusing her of touting the other parts of Trump\u2019s megabill to distract from the Medicaid and ACA changes.<\/p>\n \u201cShe\u2019s saying that she voted for no tax on tips and that this big beautiful bill was awesome, and the people are not stupid,\u201d Pulido said. \u201cThey\u2019re like, \u2018Hold on, my healthcare is more expensive.\u2019\u201d<\/p>\n A spokesperson for De La Cruz\u2019s campaign pushed back against Pulido\u2019s critiques, noting that she voted to extend<\/a> the ACA tax credits \u2014 the only Texas Republican to do so. The bill died in the Senate, failing to garner enough Republican support.<\/p>\n \u201cAs a working mom, Monica knows what one hospital bill can do to a family,\u201d James Shook, De La Cruz\u2019s campaign manager, said in a statement. \u201cShe has taken on DC special interests to protect Medicare and Social Security for our abuelitos and brought home funding for our hospitals.\u201d<\/p>\n The campaign cited the One Big Beautiful Bill Act as evidence of De La Cruz\u2019s work on hospital funding. The law created a $50 billion, five-year federal grant program for rural healthcare, a large sum<\/a> of which was allotted for Texas in late 2025. Many of the state\u2019s rural healthcare facilities rely on Medicaid payments, however, and a majority of them could lose services amid the law\u2019s reductions, according to Kiplinger<\/a>.\u00a0<\/p>\n Additionally, Shook said, De La Cruz\u2019s \u201cbill to expand telemedicine for underserved communities is now the law of the land.\u201d He was referring to the provisions of a 2025 bill De La Cruz sponsored \u2014 called the Supporting Patient Education and Knowledge, or SPEAK Act \u2014 that became law as part of a broader spending package. The measure requires the Department of Health and Human Services to develop guidance on best practices for improving telehealth access for people with limited English language skills, including through the use of interpreters, multilingual materials and patient portals.<\/p>\n Still, Pulido said he hopes the impact of the lost tax credits and Medicaid cuts will prove a political liability for the GOP. The longtime Tejano musician noted that he does not have health coverage himself and travels across the border to Mexico to receive care.<\/p>\n \u201cThe Rio Grande Valley has the lowest [income] per capita in the state. Down here, small-business owners like myself don\u2019t have health insurance because it\u2019s expensive,\u201d he said. \u201cWe should not have to be going to Mexico to go see a doctor.\u201d<\/p>\n Rising costs<\/p>\n The Medicaid cuts mark a deliberate shift in federal policy, said Laura Dague, a health economist and associate professor at Texas A&M University\u2019s Bush School of Government and Public Service.<\/p>\n \u201cThe federal government has clearly signaled through this legislation that they are not interested in continuing to fund Medicaid infinitely, and that\u2019s going to mean that states have to make some new choices about how to cover populations,\u201d Dague said.<\/p>\n While the cuts are spread across a decade, some Texans are feeling the more immediate effect of the lapsed Affordable Care Act tax credits. The subsidies have been around since 2014 and were expanded during the COVID-19 pandemic, providing a temporary financial crutch that lowered monthly premiums for marketplace coverage and extended aid to households that previously earned too much to qualify. Nowhere relied on them more than the Rio Grande Valley, where 98%<\/a> of the region\u2019s marketplace enrollees used the credits to afford coverage, driving enrollment up nearly fourfold from 2021 to 2025.<\/p>\n Because the Valley leaned on the subsidies more than almost anywhere else, Dague said, it stands to feel their loss the most. So far this year, residents in the four Valley counties are paying about double the average out-of-pocket costs for their premiums, with a more than threefold increase in Willacy County.<\/p>\n \u201cWith the current trends, with all the inflation, it\u2019s hard enough for people to even pay what they were paying, now that there are other things that [are] also going away,\u201d like federal food assistance, Chandran said. <\/p>\n Though Texas unexpectedly saw an increase<\/a> in marketplace enrollment at the start of the year, that was followed by a decline<\/a> in the number of people who activated their coverage by paying for their first premium.<\/p>\n \u201cA lot of those folks that were still signed up, maybe they got re-enrolled, or they clicked re-enroll and didn\u2019t pay too much attention \u2014 when they got that first bill, they just didn\u2019t pay it,\u201d Dague said.<\/p>\n \u201cThis seat will be decided on records\u201d<\/p>\n Over in the 34th Congressional District, Democrats are also spending big as they try to make healthcare a defining issue. Gonzalez and supportive outside groups have dropped about $1 million on healthcare-related ads in the race, over three times as much as Republicans, according to AdImpact.<\/p>\n A Gonzalez campaign spokesperson said in a statement that the incumbent \u201chas spent his career lowering [health] costs by taking on Big Pharma to cap insulin at $35 a month, cutting prescription drug prices, and protecting earned Social Security benefits.\u201d<\/p>\n Flores, the lawyer and Army veteran challenging Gonzalez, has not yet aired healthcare-focused ads. Two GOP groups have run ads attacking Gonzalez over his vote against the GOP\u2019s tax-and-spending law, arguing that it would raise taxes on seniors and people receiving Social Security.<\/p>\n Flores\u2019 campaign did not respond to requests for comment.<\/p>\n The gap in healthcare spending was narrowest in the 28th District, where Democrats had poured $400,000 into healthcare-related advertising compared to Republicans\u2019 roughly $270,000. Tijerina, the Republican nominee, is running on his record as the Webb County executive, where his campaign says he opened the Bruni Public Health Facility, brought South Texas its first OnMed CareStation, expanded rural telehealth and broke ground on a new Southern Public Health Facility.<\/p>\n \u201cThis seat will be decided on records: a proven local executive who spent more than a decade delivering health care access and lower costs, against a twenty-year incumbent who has been federally indicted and whose record is defined by scandal and self-dealing,\u201d Tijerina campaign spokesperson Nick Engstrom said in a statement, referring to Cuellar\u2019s federal indictment on charges of bribery, conspiracy and money laundering. The Laredo Democrat denied wrongdoing and was ultimately pardoned by Trump<\/a>.<\/p>\n The 23rd District has yet to see healthcare advertising from Herrera or Padilla Stout, but the campaigns are previewing different approaches.<\/p>\n A spokesperson for Herrera\u2019s campaign said he supports changes intended to expand insurance-plan options, reduce prescription-drug and malpractice-related costs, and allow physician-owned hospitals to accept Medicare and Medicaid patients. He also said he wants to protect rural hospitals from closures.<\/p>\n \u201cRural hospitals are facing an unprecedented rate of closure, creating healthcare deserts that can leave Texans without access to healthcare at all, particularly for the most life-threatening needs,\u201d Kimme Gonzalez, Herrera\u2019s campaign manager, said in a statement.<\/p>\n Stout, meanwhile, is leaning into the affordability message, saying quality healthcare \u201cshould not depend on where you live, where you work, or how much money you make.\u201d<\/p>\n \u201cMaking health care more affordable and accessible is central to my campaign\u2019s broader focus on lowering costs for working families,\u201d she said in a statement to the Tribune.<\/p>\n Disclosure: Texas A&M University has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in The Texas Tribune\u2019s journalism. Find a complete\u00a0list of them here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"One of the most expensive ads in a South Texas congressional race this cycle opens with a simple…\n","protected":false},"author":2,"featured_media":419458,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[2133,15660,148,5023,2424,1472,1474,27,29,28,2566,41750,31814],"class_list":["post-419457","post","type-post","status-publish","format-standard","has-post-thumbnail","category-texas","tag-democrats","tag-henry-cuellar","tag-medicaid","tag-monica-de-la-cruz","tag-republicans","tag-rio-grande-valley","tag-south-texas","tag-texas","tag-texas-headlines","tag-texas-news","tag-tony-gonzales","tag-u-s-census-bureau","tag-vicente-gonzalez"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/419457","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/comments?post=419457"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/419457\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media\/419458"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media?parent=419457"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/categories?post=419457"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/tags?post=419457"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}