Key Takeaways
Table of Contents
- Key Takeaways
- Health Care costs Top Public’s Concerns During Moment of Economic Anxiety
- Democrats Have an Advantage on Health Care Issues, But no Party Has an Advantage on the Cost of Living
- Amid the ACA Tax Credits Debate, Favorability of the ACA and ACA Marketplace Remains High, but Has Declined Among Republicans
- Most Say Congress Did the “Wrong Thing” Not Extending the ACA Tax Credits
- The cost of health care, including paying for health insurance and out-of-pocket expenses, tops the list of the public’s economic anxieties, rising well above other necessities. Two-thirds of the public (66%) say they worry about being able to afford health care for them and thier family, ranking higher than utilities, food and groceries, housing, and gas.In addition, most adults (55%) say their health care costs have gone up in the past year, including at least one in five who say they have increased at a faster rate than food or utilities. A majority (56%) of the public say they expect health care costs for them and their families to become even less affordable in the coming year.
- With health care costs topping the list of economic worries across partisans and key groups, voters expect the issue to play a major role in their decisions to turnout in November’s midterm elections and also wich candidates they support. Majorities across partisans say health care costs will impact their vote in November,but the issue is resonating more with Democratic voters and self-reliant voters. More than three-quarters of Democratic voters and independent voters say health care costs will impact both their decision to vote and which party’s candidate they will vote for in the election, compared to about half of Republican voters. In fact, two-thirds of Democratic voters and more than four in ten independent voters say health care costs will have a “major impact” on their 2026 voting decisions.
- the Democratic Party has the advantage when it comes to which party voters trust to handle most health care issues, including health care costs, on which the Democrats have a 13-point advantage over Republicans. The one exception is prescription drug prices, an issue president Trump has focused on in his second term, and on which similar shares of voters say they trust the democratic Party (35%) and the Republican Party (30%). Among independent voters, the Democratic Party has an edge over the Republican Party on health care issues, but many independent voters also say they don’t trust either party.
- The public’s anxiety around health care costs comes at a time when the Senate and President Trump seem unlikely to revive the ACA enhanced premium tax credits, which expired on January 1st.Most (67%) of the public say Congress did the “wrong thing” by not extending the credits, including large majorities of Democrats (89%) and independents (72%).But majorities of Republicans (63%) including MAGA supporters (64%) say Congress did the “right thing” by not extending the ACA enhanced premium tax credits. While overall popularity of the ACA and the marketplaces is still high, given the recent debate around the ACA enhanced tax credit debates, favorability has declined among Republicans.
Health Care costs Top Public’s Concerns During Moment of Economic Anxiety
One year into the second term of President Trump and less than ten months before the 2026 midterm elections, the public remains concerned about the top issue of the 2025 election – the economy. Eight in ten (82%) adults say their cost of living has increased in the past year, including half who say it has increased “a lot.” Vrey few say their
Majorities across partisanship worry about affording health care costs,with 76% of Democrats,72% of independents,and 60% of Republicans expressing concern. This includes one in four MAGA Republicans (23%) and non-MAGA Republicans (24%).
One reason why health care expenses might potentially be topping the list of household worries is that most adults say their health care costs have increased in the past year, including a substantial share who say these costs have increased at a faster rate than other household expenses.
more than half (55%) of adults say their health care costs have increased in the past year. This includes about two-thirds of people with employer-based health insurance (64%) and those who purchase their own coverage (66%), as well as about half (53%) of medicare enrollees 65 and older. perceptions about the increase of health care costs persist across partisanship, with about half or more across partisans saying their health care costs have increased in the past year, including 58% of Democrats, 56% of independents, and 51% of Republicans, including 47% of MAGA Republicans.
Notably, about one in five of all adults say their health care costs have increased at a faster rate than other necessities like utilities (23%) and food and groceries (21%).This includes similar shares among partisans and MAGA supporters, as well as at least one in four with employer-sponsored insurance and about a third who purchase their own insurance. Smaller shares of adults who receive health insurance through Medicaid and Medicare say their health care costs have increased at a faster rate than utilities and food and groceries, suggesting those with government coverage are more insulated from the rising cost of health care.
Looking ahead to the next year, a majority (56%) of adults expect their family’s health care costs to become less affordable, while about a third (35%) expect them to stay about the same, and one in ten (9%) expect them to be more affordable. Most Democrats (62%) and independents (58%) expect health care costs to become less affordable, while Republicans, including those who identify as MAGA Republicans are split, with similar shares saying they expect them to become less affordable or expect them to say about the same. Majorities across insurance types expect their health care costs to become less affordable. This includes two-thirds of those who self-purchase (64%) or have employer-sponsored insurance (60%) and majorities of those who are uninsured (57%) or who have coverage through Medicaid (55%).
Democrats Have an Advantage on Health Care Issues, But no Party Has an Advantage on the Cost of Living
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Most voters express limited confidence in both parties and President Trump’s ability to address the rising cost of living. A recent poll shows 64% have ”not too much” or “no” confidence in Republicans in Congress, while 63% feel the same about Democrats in Congress and 61% about President Trump. Only 38% express ”a lot” or “some” confidence in President Trump, compared to 37% for Democrats and 36% for Republicans.
Amid the ACA Tax Credits Debate, Favorability of the ACA and ACA Marketplace Remains High, but Has Declined Among Republicans
Despite ongoing debate surrounding the Affordable Care Act (ACA) tax credits, a majority of Americans continue to view the ACA favorably. However,Republican favorability has decreased following recent discussions about extending the enhanced tax credits and criticisms from Republican lawmakers. Overall ACA favorability has dropped to 58%, with 41% holding an unfavorable view, down from 64% favorable and 35% unfavorable in September 2025. This decline is primarily driven by Republicans, with only 22% now expressing a favorable view, compared to 36% in September. Democrats (91%) and independents (62%), along with those who purchase their own health coverage (64%), maintain positive views of the ACA.
Favorable views of the ACA marketplaces have also declined, moving from 70% in September 2025 to 62% in the latest poll.This shift mirrors the trend in overall ACA favorability, with Republicans driving the change (41% now vs. 59% in September 2025). Democrats (81%), independents (64%), and those who self-purchase insurance (64%) continue to view the marketplaces favorably.
Most Say Congress Did the “Wrong Thing” Not Extending the ACA Tax Credits
