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By Associated Press

SACRAMENTO, Calif. — Lilian Serrano’s mother-in-law had lots of stomach problems, but she always blamed food.

Doctors at a San Diego-area clinic suspected Genoveva Angeles might have cancer, but they could not say for sure because they did not have the equipment to test for it and Angeles, who had been in the country illegally for 20 years, could not afford to see a specialist and did not qualify for state assistance because of her immigration status.

In September, Angeles finally learned she had gallbladder cancer. Serrano said she was in the hospital room when Angeles, in her late 60s, died about two weeks later.

“We don’t know if she would have survived treatment, but she was not even able to access it,” said Serrano, chairwoman of the San Diego Immigrant Rights Consortium.

“She never had a chance to fight cancer.”

Stories like that have prompted California lawmakers to consider proposals that would make the state the first in the nation to offer government-funded health care to adult immigrants living in the country illegally. But the decision on who to cover may come down to cost.

Democratic Gov. Gavin Newsom wants to spend about $98 million a year to cover low-income immigrants between the ages of 19 and 25 who are living in the country illegally.

The state Assembly has a bill that would cover all immigrants in California living in the country illegally over the age of 19. But Newsom has balked at that plan because of its estimated $3.4 billion price.

“There’s 3.4 billion reasons why it is a challenge,” he said.

The state Senate wants to cover adults ages 19 to 25, plus seniors 65 and older. That bill’s sponsor, Sen. Maria Elana Durazo, scoffed at cost concerns, noting the state has a projected $21.5 billion budget surplus.

“When we have, you know, a good budget, then what’s the reason for not addressing it?” she said.

The Senate and Assembly will finalize their budget proposals this week before beginning negotiations with the governor. State law says a budget has to be passed by June 15 or lawmaker forfeit their pay.

At stake, according to legislative staffers, are the 3 million people left in California who don’t have health insurance. About 1.8 million of them are immigrants in the country illegally. Of those, about 1.26 million have incomes low enough to qualify them for the Medi-Cal program.

“Symbolically, this is quite significant. This would be establishing California as a counter to federal policies, both around health care and immigration,” said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation.

If enacted, it could prompt yet another collision with the Trump administration, which has proposed a rule that could hinder immigrants’ residency applications if they rely on public assistance programs such as Medicaid.

The proposed rule from the Department of Homeland Security says the goal is to make sure “foreign nationals do not become dependent on public benefits for support.”

California is also considering a measure requiring everyone in the state to purchase health insurance. People who refuse would have to pay a penalty, and the money would go toward helping middle-income residents purchase private health insurance plans.

“We’re going to penalize the citizens of this state that have followed the rules, but we’re going to let somebody who has not followed the rules come in here and get the services for free. I just think that’s wrong,” Republican state Sen. Jeff Stone said about coverage of people in the U.S. illegally.

Many immigrants who are in the country illegally are already enrolled for some government-funded programs, but they only cover emergencies and pregnancies.

Serrano was one of hundreds of immigrant activists who came to the Capitol on Monday for “Immigrant Day of Action.” She and her husband spent the day meeting with lawmakers, sharing the story of Angeles.

“The conversation that I have is about the cost,” she said, describing her interactions with lawmakers. “The conversation we want to have is about our families.”

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Group that backed AOC’s election looks for upset against Dem in neighboring district

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The progressive group that helped put Alexandria Ocasio-Cortez in Congress is turning its sights on the congressional district next door, backing a middle school principal in a Democratic primary challenge against Rep. Eliot Engel.

The Bronx-based district is the next battleground in the simmering civil war between the insurgent-left and the party’s establishment, including the Democratic Congressional Campaign Committee, which has vowed to back all incumbents.

Justice Democrats and allied groups are focusing this year on targeting moderate Democrats in safe blue districts, rather than emphasizing trying to win swing seats. Last week, the group announced it was also supporting a primary challenger to Rep. Henry Cuellar, D-Texas.

Jamaal Bowman launched his campaign in New York’s 16th congressional district with a spirited launch video discussing his family, professional background, and his case for taking on his opponent: 30-year incumbent Eliot Engel.Jamaal Bowman for Congress / via YouTube

Jamaal Bowman, a former New York City public school teacher and activist, is launching his campaign Tuesday with the endorsement of Justice Democrats, the group that recruited Ocasio-Cortez last year to take on Joe Crowley, the district’s longtime Democratic representative.

“Our grassroots movement shocked the country last year with AOC’s upset victory, and we are prepared to do it again in New York’s 16th District,” said Alexandra Rojas, executive director of Justice Democrats. “It’s time to usher in a new generation of progressive leadership into the Democratic Party.”

Engel has represented a safe Democratic seat in Congress for 30 years and faced primary challenges before, including in last year’s midterms. He won that race in a landslide, before cruising to re-election unopposed.

But that was before Ocasio-Cortez’s rise. And his tenure has given Engel a long record of votes that Bowman plans to highlight.

“Over those 30 years, my opponent voted for an unjust war in Iraq, deregulating Wall Street, school privatization and building more prisons. While the very few at the top continue to build their wealth and power, the majority of us continue to struggle,” Bowman says in his launch video.

Engel’s district, which also includes parts of Westchester County, is one of the few congressional districts in the country with a majority of nonwhites that is represented by a white person.

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Carrie Symonds: Will Boris Johnson’s girlfriend support ‘Bozzie bear’ at BBC TV debate

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FRONTRUNNER Boris Johnson is on route to make it through to the BBC’s live Tory leadership debate tonight. Will his girlfriend Carrie Symonds be there to cheer on ‘Bozzie Bear’ as he faces questions from the public?

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Trump’s worst enemy as he kicks off his re-election bid may be himself

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CHARLESTON, S.C. — On the surface, Chris Moody and Steve Neal don’t have much in common, except for this: They’re excited about voting for President Donald Trump again in 2020.

Moody, a white 24-year-old day-care worker and recent Marshall University graduate from Charleston, West Virginia, is something of a walking billboard for the president’s re-election. He strolled into the King’s Leaf Cigar Lounge here Saturday wearing a T-Shirt bearing an impressionistic version of Trump’s visage and these words: “If Trump is not your president this is not your country. You are not a tree. Move.”

He is very tapped into a powerful sentiment stoked by Trump and shared by many of his voters — that Trump is under constant and unfair attack from Democrats, the media and establishment forces in Washington.

“I can’t stand the way people talk about him,” Moody said.

Neal, a black 49-year-old automotive finance consultant who uses his sparkling white Lexus to drive Uber routes on the side, said his support for Trump is a source of ribbing inside his family of hard-core Democrats in this Charleston and that he seldom talks about his politics unless he’s asked.

“My vote speaks strong enough for itself,” Neal said.

These two types figure to factor heavily into Trump’s success or failure as he seeks a second term in the presidency that few would have predicted possible when he first descended an escalator at his namesake Manhattan skyscraper four years ago without ever having won a single vote for any office.

Now the undisputed center of the political universe, Trump is set to kick off his re-election campaign Tuesday at Orlando’s Amway Center having redefined the Republican Party, the tenor of American public discourse and perceptions of the country at home and abroad. He’ll do so with the shadow of a possible high-stakes House impeachment looming over his shoulder — a prospect that carries peril for him in its potential to publicize special counsel Robert Mueller’s findings in painful fashion and, conversely, one that offers the hope that he can rally new voters to his side in the name of defending his presidency from overzealous opponents.

Because while Trump has formed the most loyal base of supporters in modern history, he has also alienated and mobilized large swaths of the electorate, from liberal city-dwelling Democrats to ex-Republican suburbanites turned off by his crass manner, hard-line positions on social policy, and views of executive power and nationalism that rattle pillars of Western democratic governance.

The biggest challenge facing Trump on the electoral battlefield is turning the energy of his own base into the kind of wave that brings out new voters. While a big part of that will come down to the efficacy of a cutting-edge data operation focused on adding to his base by finding and turning out supporters who don’t normally vote, some of it will hinge on the evangelism of people like Moody and Neal who were there for him last time.

In that way, Trump may be his own worst enemy.

Neal said he’s pleased with the economy and having “more of a strong arm” on foreign policy. But the “stupid stuff” Trump says makes it so difficult to advocate effectively on his behalf that Neal doesn’t really try.

“The problem is Trump’s whole persona,” he said.

Modern history and more recent polling suggest Trump has little margin for error in a nation sharply and bitterly divided in its political loyalties. Like George W. Bush, Trump managed to win a first term while losing the popular vote, and public and private surveys show that he has his work cut out for him if he is to claim victory again.

In the last week, polls from Fox News and Quinnipiac University have shown Trump trailing a series of Democratic rivals — with former Vice President Joe Biden leading by 10 points and 13 points, respectively.

More troubling, at least from a public relations perspective, the recent reporting of internal Trump polling from March by ABC News and the New York Times showed him behind Biden in nearly every important swing state. Biden held double-digit leads in Florida, Wisconsin, Michigan and Pennsylvania — states that collectively account for more than his margin of victory in 2016 — and NBC reported Sunday that Trump has cut ties to two people who were involved in his polling operations in the aftermath of the data becoming public.

The campaign’s top pollster, Tony Fabrizio, said the numbers amounted to a “worst-case scenario” involving a bad turnout model, suggesting they don’t reflect the actual state of the race.

The modeling is particularly important when it comes to Trump because his strategy is necessarily built around changing the set of people who show up to the polls in 2020 — and he’ll be trying to do that at the same time Democrats are working to counter him both with a surge of their own and by locking down past Trump voters who have been turned off by his presidency to this point.

Trump’s approval rating has been in negative territory for almost the entirety of his presidency, and the most recent tabulation by the number-crunchers at FiveThirtyEight.com pegs it at 42.6 percent. But his allies say he is in great shape as he gears up for the Orlando rally and the race ahead of him.

And Chris Wilson, a veteran Republican pollster and political data analyst, said he doesn’t put much stock in the traditional surveys he’s seeing now because they base their turnout models on recent elections — which may not reflect the reality of 2020 if Trump is successful in targeting and turning out new voters.

“I’m very skeptical of any survey today drawing their sample by asking people whether or not they’re going to vote,” he said. He recently conducted polling, based on voter-data modeling, that showed Trump in much better position — including holding small leads in Florida and Wisconsin — in key swing states.

The other factor that’s impossible to measure right now is the effect of Trump’s campaigning against his eventual Democratic opponent, Wilson said.

“Donald Trump is going to have several months, five or six, to make the nominee entirely unpalatable,” he said.

Trump’s penchant for personal attack may ultimately rally his own base and depress excitement among Democrats, but there’s also a risk that it could have the opposite effect.

After years of Twitter feuds and spoken insults of everyone from world leaders to professional athletes, there’s a bit of a social stigma attached to Trump in certain circles that could make it harder for him to reap the benefits of the full-throated support from his army of partisans.

Moreover, the president’s comportment can alienate voters who are comfortable with his policies.

While that matters less in Moody’s home state of West Virginia and Neal’s South Carolina, where Trump is sure to win handily, it could be a significant factor in the handful of swing states that will determine who sits in the Oval Office come January of 2021.

Tom Oestreich, 64, of Tucson, Ariz., said in an interview with NBC News that he chose Trump because he couldn’t vote for Clinton. He would have voted for former Vice President Joe Biden in 2016 had Biden been the Democratic nominee, he said, but he now sees the Democratic front-runner as “tripping” on the campaign trail and “a little bit too old.”

A self-described moderate Republican, Oestreich said he is leaning toward Trump because of the state of the economy and his handling of foreign policy but is bothered by what he describes as the president sounding like he has “a fifth-grade education.” He’s giving a second look to South Bend Mayor Pete Buttigieg.

“I’m not crazy about Buttigieg, but he’s got a great pedigree, a great resume,” Oestreich said of the Rhodes scholar and Afghanistan War veteran. “If it comes down to the two of them … there’s a very good possibility I could vote for him.”

Democrats believe they have a shot at turning Arizona in their favor for the second time since Harry Truman won it in 1948, in part because Trump carried the state by only three-and-a-half percentage points in 2016 and in part because they captured a Senate race there last year for the first time since 1988.

But as has been the case since early in his first presidential run, Trump can count on unflinching support from a loyal base that is more than willing to take on anyone who stands in his way — whether that means Democrats or wavering Republicans. Many of them cast him as their champion in almost epic terms.

“I think he’s doing good,” Trump voter Kitty Klipstine of Dayton, Ohio, said in an interview for Hardball’s “The Deciders,” which will air on MSNBC at 10 p.m. ET Monday. “It’s just he’s fighting Congress, fighting both parties, really, which is a shame because the Republicans should back him all the way.”

Like Klipstine, Roger Carey of Ankeny, Iowa, is proud of the job Trump has done and sees any shortcomings as a function of the resistance he’s met in Washington.

“I like that he has accomplished the things that he ran on,” Carey said. “I like that he wants to support our borders, guarding our borders. Positive things for the country — would like to see Congress back him, though, and get things done.”

The trick for the president is to convince anyone who agrees with Carey — but didn’t cast a vote for Trump last time around — to back his bid to hold on to the job.

— Maura Barrett reported from Boone, Iowa, and Cal Perry reported from Dayton, Ohio

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