Planned Parenthood Action Fund, the abortion rights group’s political action committee, is entering the Democratic primary for California’s 22nd Congressional District, throwing itself behind establishment Democrat Jasmeet Bains.

Bains is running a close race against progressive populist Randy Villegas. Both Democrats hope to unseat the district’s longtime Republican congressman, David Valadao.

Health care has emerged as perhaps the most important issue in the 22nd District, a largely agrarian district with high rates of poverty where around 90 percent of polled residents say Medi-Cal (California’s Medicaid program) is important to them. The district is home to the agricultural and oil industries; pesticide- and pollution-based illness has long been a concern to residents. In 2025, Valadao voted for the One Big Beautiful Bill, which slashed Medicaid by nearly $1 trillion over ten years, even after expressing concern about the bill’s consequences for his constituents.

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The 22nd District is an epicenter of “valley fever,” a fungal infection caused by fungi in the soil of the San Joaquin Valley. Anything that disturbs the soil—farming, construction, even heavy winds—can send the fungal spores into the air and into residents’ lungs, causing chest pain, chills, and sometimes chronic illness.

A physician, Bains has received the support of a number of health care–related PACs, including 314 Action, FamMedPAC, and Ob-GynPAC. Her identity as a doctor has played a major role in her campaign. Her campaign website opens with a photo of her in a white coat with a pink stethoscope slung across her neck. Her campaign logo is the representation of a heartbeat on an EKG. “It’s time to call in the doctor,” reads one slogan on the site.

Despite her identity as a doctor and its centrality to her campaign, Bains has a mixed record on health care issues.

During her campaign, Bains has flip-flopped on Medicare for All, which Villegas supports. In a meeting with the Fresno County Young Democrats, Bains said, “I do support Medicare for All.”

Despite her identity as a doctor and its centrality to her campaign, Bains has a mixed record on health care issues.

Later, however, she walked those statements back, issuing a statement that criticized Villegas’s support for the policy: “Radical Randy is at it again,” the statement began. “Randy Villegas has endorsed socialist-run healthcare which would dissolve Medicare, make employer sponsored health insurance illegal, and double taxes.”

Bains, a member of the State Assembly since 2022, has a history of not voting on controversial bills, including many related to health care.

In 2024, Bains was the only Democrat to vote against a bill aimed at countering health care consolidation and private equity ownership of hospitals. If enacted, the bill would have required private equity groups and hedge funds to provide written notice to the attorney general before acquiring a hospital. The bill passed, but Gov. Gavin Newsom vetoed it, arguing that an existing state office was already overseeing that work.

Bains has abstained from a number of other health care– and pollution-related votes. She wasn’t present to vote on a bill that would require the Department of Pesticide Regulation to re-evaluate the herbicide paraquat dichloride.

Nor did she vote on a bill that would require pollution-producing facilities (like refineries that produce asphalt and jet fuel) to install an air monitoring system along their perimeter.

Most notably, Bains did not vote on the Cancer Prevention Act in September 2023, which would have required that schools send out health information advising children to be vaccinated for human papillomavirus (HPV) before eighth grade. (Bains voted for other legislation that day.)

HPV is a sexually transmitted infection that is a major cause of cervical cancer. In March 2024, Bains acknowledged that herself in a “Doctor’s Note” section of her newsletter to constituents: “HPV is the cause of nearly all cervical cancers. Getting vaccinated against HPV infection is your best protection from cervical cancer,” she wrote.

Explaining her decision not to vote on the Cancer Prevention Act, her campaign spokesperson, Ben Rodriguez, said, “Dr. Bains approaches every bill as a physician and Valley representative first. If legislation is flawed, carries unintended consequences, or fails to address the realities facing the Central Valley, she is willing to buck consensus, withhold support, and fight for a better solution.”

The Cancer Prevention Act was supported by Planned Parenthood Affiliates of California, the California Democratic Party, and a number of other health care and reproductive health care advocacy organizations.

Planned Parenthood Action Fund did not return a request for comment about their support for Bains.

“Trump and RKF Jr. have a special disdain for women’s healthcare. I am honored to stand with Planned Parenthood against Washington Republicans’ war on women. The Valley has never elected a Democratic woman to Congress. Now is the time to make history,” Bains said in a statement to the Prospect.

Planned Parenthood Federal PAC’s contribution is the latest in a streak of financial wins for Bains. On May 4, Bains was selected for the Democratic Congressional Campaign Committee’s “Red to Blue” program, which supports a handful of Democrats running for office in swing districts.

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Villegas criticized the DCCC’s decision to anoint Bains: “It is undemocratic to see DC elites putting their thumb on the scale in this race,” he said in a statement.

Days later, Democratic Majority for Israel, a pro-Israel PAC, took out an ad buy for Bains that did not mention Israel or foreign policy, and instead attacked Villegas. Bains has switched her tone on support for Israel, calling the country’s actions in Gaza a “genocide” before quickly walking that statement back.

Villegas is running to Bains’s left, adopting a progressive populist stance that he thinks will resonate in this majority-Latino working-class district. The race pits two visions for the future of the Democratic Party against each other. Villegas aims to unseat the Republican incumbent, David Valadao, by running to his left. Bains’s strategy is to run a centrist, establishment-backed campaign.

Republicans have inserted themselves into the competition between Bains and Villegas now, too. Following the recent injections of money to Bains’s campaign, Republicans are trying to weaken her by boosting Villegas, suggesting that Republicans see Villegas as easier to beat in the general election.

The Congressional Leadership Fund, a Republican-aligned PAC, released a mailer calling Villegas a “lifelong Democrat,” emphasizing his endorsement from Sen. Bernie Sanders and his opposition to President Trump’s policies.

According to a Data for Progress poll released Tuesday, Villegas leads Bains at 25 percent to her 21 percent in the upcoming jungle primary, where candidates of all parties appear on the same ballot. Valadao had the support of 44 percent of respondents. So far, Valadao dominates fundraising with nearly $3 million in cash on hand. Villegas and Bains are close behind, with Villegas narrowly leading.

Valadao will almost certainly advance to the general election. Whichever Democrat comes in second in the June 2 primary is guaranteed to run a close race against Valadao.

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Emma Janssen is a writing fellow at The American Prospect, where she reports on anti-poverty policy, health, and political power. Before joining the Prospect, she was at UChicago studying political philosophy, editing for The Chicago Maroon, and freelancing for the Hyde Park Herald.