Hanford, faces mounting pressure from constituents to reject proposed budget cuts that could threaten federal funding for Medicaid. The program provides health care for up to two-thirds of his district’s residents.

For Representative David Valadao of California and other Republicans whose constituents depend on Medicaid, a vote for their party’s budget could be politically fatal. President Trump’s agenda hangs in the balance.

The California Health Care Foundation, an independent nonprofit group that studies health issues, estimates that two-thirds of all residents in the district get help from Medi-Cal. Valadao represents a majority Latino district that includes most of Kings County and slices of Tulare and Kern counties.