Healthcare & the 2026 Midterms: Key Voter Concerns | KFF

As the 2026 midterm elections approach, healthcare costs are emerging as a primary concern for voters across the political spectrum, potentially influencing both voter turnout and candidate selection. A new KFF Health Tracking Poll, published January 29, 2026, reveals that two-thirds of Americans (66%) are worried about affording healthcare for themselves and their families – a higher percentage than those concerned about affording necessities like food, housing, or gas.

The poll indicates that healthcare costs are topping the public’s economic anxieties, with 55% of adults reporting an increase in their healthcare expenses over the past year. Notably, at least one in five of those individuals say these increases have outpaced the rising costs of food and utilities. A majority (56%) also anticipate that healthcare will become even less affordable in the coming year.

ACA Tax Credit Expiration Fuels Concerns

A significant driver of these concerns is the expiration of enhanced Affordable Care Act (ACA) tax credits. Congress’s failure to extend these subsidies, initially implemented under President Joe Biden, has led to higher premiums for many ACA Marketplace enrollees. A follow-up KFF poll revisiting ACA enrollees found that many are facing sharply higher costs, with some unsure if they can afford coverage throughout the year.

Despite these increased costs, the KFF poll found that 69% of those enrolled in ACA plans last year renewed their coverage this year, though often opting for less comprehensive plans. Approximately 9% of enrollees ultimately decided to forgo insurance altogether.

Political Implications and Voter Sentiment

The heightened concern over healthcare affordability is expected to play a significant role in the 2026 midterm elections. Majorities across party lines acknowledge that healthcare costs will impact their vote in November. However, the issue appears to resonate more strongly with Democratic and independent 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.”

KFF Health Tracking Poll, January 29, 2026

The KFF poll also reveals a partisan divide in perceptions of Congress’s handling of the issue. Two-thirds of the public believe Congress “did the wrong thing” by not extending the ACA enhanced tax credits, but Republicans largely disagree, believing Congress “did the right thing.”

Broader Economic Worries

While healthcare costs are the most pressing economic worry for a substantial portion of the population, other expenses are also causing concern. According to the KFF poll, 32% of Americans are “very worried” about affording healthcare, compared to 24% worried about food and groceries, 23% about rent or mortgage, 22% about utilities, and 17% about gasoline and transportation.

The findings suggest that healthcare is not just a health issue, but a significant economic burden for many families, and one that is likely to be a key factor in the upcoming elections. The KFF research provides an early indication of how voters view healthcare issues following recent changes to Medicaid and the expiration of ACA subsidies.

Steve Davis, a 64-year-old retired car salesman from Rogersville, Tennessee, exemplifies the challenges faced by many ACA enrollees. He initially faced an annual premium of approximately $14,000, a cost he couldn’t cover with the available tax credits. However, he was able to secure insurance through a new job at a convenience store, albeit at a slightly higher monthly cost than his previous ACA plan.

“As it happened, the Lord provided and my insurance kicked in through my employer,”

Steve Davis, Rogersville, Tennessee

The KFF poll highlights the uncertainty many consumers faced as they navigated the ACA Marketplace during open enrollment, waiting to see if Congress would act to extend the enhanced premium subsidies. The inaction has now translated into tangible affordability issues for many, potentially creating headwinds for Republicans in competitive districts as the midterm election nears.