Health Care Costs Cited as Key Voter Concern Ahead of 2026 Midterms

By Ireland Owens, Daily Caller News Foundation

Health care costs have emerged as a notable issue for voters in advance of the November 2026 midterm elections, according to analysts from KFF, a nonpartisan health policy research organization. Surveys indicate that affordability concerns related to medical care rank highly among economic worries, though other polls show the broader economy and inflation as leading voter priorities.

“Health care costs will likely play a major role in the midterms this fall,” Shannon Schumacher, senior survey analyst for KFF’s public opinion and survey research program, told the Daily Caller News Foundation (DCNF). “The economy is usually a top electoral issue, and this year we’re seeing health care costs rise to the top of people’s economic concerns.”

Schumacher cited KFF’s January 2026 poll, in which more respondents expressed worry about affording health care costs than other necessities such as food, groceries or housing. “Looking ahead to the midterms, health care costs are motivating voters across party lines, with substantial shares of voters saying the issue will have a ‘major impact’ on their decisions this fall,” she said.

The same KFF poll found that Democratic and independent voters currently view health care costs as a stronger motivator than Republican voters do, though a majority of Republicans also said the issue would influence their vote choice. On trust to handle health care and prescription drug costs, the poll showed Democrats holding an advantage over Republicans overall, with independents favoring Democrats by a wider margin.

A separate February 2026 Deseret News/Morning Consult poll identified the economy and jobs (25% of respondents) and inflation (17%) as the top issues for midterm voters nationally, with health care ranking at 17% or lower in that and similar surveys (9-11% in others).

In 2024, U.S. health care spending increased by 7.2% to $5.3 trillion, or $15,474 per person, according to the Centers for Medicare & Medicaid Services (CMS). This represented 18% of gross domestic product. Health spending growth has averaged above 4% annually across multiple administrations; for example, it rose 10.5% from 2019 to 2020 during the Trump administration, with comparable rates in subsequent years.

Projections indicate a 7.6% rise in national health care costs for 2026, according to a Time Magazine report from October 2025.

Many Americans, particularly those enrolled in Affordable Care Act (ACA) Marketplace plans, report adjusting household budgets to cover medical expenses, per Lunna Lopes, senior survey manager for KFF’s public opinion and survey research program. “People who get health insurance from the ACA Marketplaces are a small share of overall voters, but with the expiration of the enhanced premium tax credits, they are feeling the rising cost of health care more acutely than most,” Lopes told the DCNF.

KFF’s recent survey found that 51% of returning Marketplace enrollees described their premiums, deductibles or copays as “a lot higher” this year, with 55% reporting cutbacks on food and other basic expenses to afford care. The enhanced premium tax credits originated in the American Rescue Plan Act of 2021 under President Joe Biden and were extended through 2025 via the Inflation Reduction Act; they are set to expire at the end of 2025 unless renewed. President Donald Trump has stated he will not extend them.

Uninsured Americans are roughly twice as likely as those with insurance to report difficulty affording health care, according to a January 2026 report from the Lown Institute, a nonpartisan health care think tank.

Lack of competition in hospital and insurance markets contributes to higher costs, Robert Moffit, senior research fellow on health and welfare policy at the Heritage Foundation, told the DCNF. “Ninety percent of our hospital markets are highly concentrated, dominated by [a] few giant hospital corporations; health insurance markets are often dominated by one or two or three huge insurance companies,” Moffit said. “Where there is no competition, there is no choice. Where there is no choice or competition, there is no way to control cost, unless the option — like ‘single-payer’ — is to set a hard global budget and then deny, delay or ration medical care.”

Moffit added that large hospital and insurance corporations benefit from concentrated markets, particularly when patients lack incentives for cost-efficient choices. He noted that health care affordability has ranked near the top of voter concerns in polls since the 1960s.

As of 2022, U.S. prescription drug prices were 2.78 times higher than in other high-income countries, per a January 2024 report from the Office of the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services.

Democrats are developing messaging on health care as they aim to regain control of the Senate and House in November. Republican strategists acknowledge Democrats’ historical edge on the issue in public opinion surveys.

“Polling shows Republicans have some very strong health care [messaging] around challenging insurance companies, reversing the policies that have driven massive consolidation of the insurers, [pharmacy benefit managers] and the giant tax-exempt hospital systems, and bringing real choice and competition,” Phil Kerpen, president of American Commitment, a conservative advocacy group, told the DCNF. “Their problem is they never talk about health care or really push these ideas except defensively when Democrats are pressing the issue, which is why Democrats usually have an advantage on the health care issue.”

Kerpen suggested Republicans include key health care measures in budget reconciliation legislation this year to advance such policies.

In January 2026, President Trump announced a health care plan intended to reduce drug prices, lower insurance premiums, increase accountability for insurers and enhance price transparency.

The Trump administration could address affordability by curtailing improper subsidies, ending automatic enrollment in certain plans and expanding lower-cost options, according to Thomas Savidge, an economist at the American Institute for Economic Research, a free-market think tank. “The best way the president and CMS can improve health care affordability is by cracking down on improper subsidies, ending automatic enrollment, and changing rules to expand lower-cost plan options,” Savidge said. He referenced a proposed 2027 CMS Notice of Benefit and Payment Parameters as aligning with these steps. Savidge cautioned that rising costs could draw voters toward candidates offering subsidies and new regulations, despite his view that such policies contribute to the issue.

A February 2024 KFF analysis estimated that 14 million Americans carried medical debt exceeding $1,000, with about 3 million owing more than $10,000.

Democratic National Committee Chairman Ken Martin stated on Monday that his party rejects “a status quo where Americans delay treatment or ration their prescriptions because they can’t afford the skyrocketing health care costs caused by Donald Trump and Republicans.”

Republican Rep. Ashley Hinson of Iowa, who is running for Senate, wrote in a January 8, 2026, post on X (formerly Twitter) that she “will not support the status quo of health care in America today, it’s a disaster.” Hinson added, “both parties are to blame for this mess.”

*(Photo captions from original: TOPSHOT – A billboard for healthcare pricing shows an image of US President Donald Trump wearing boxing gloves... (Photo by MANDEL NGAN/AFP via Getty Images); US President Donald Trump (L) arrives for a roundtable... (Photo by Brendan SMIALOWSKI / AFP via Getty Images); U.S. Rep. Ashley Hinson speaks... (Photo by Scott Olson/Getty Images))*

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