Rising health costs could shift midterm voters toward Democrats, survey shows

A KFF poll released on Jan. 29, 2026 found health costs on the minds of voters in advance of the midterms. (Photo by Yin Yang/Getty Images)

Americans feel their health care costs are going up faster than other household expenses, hold President Donald Trump and congressional Republicans responsible and say the issue will factor into their votes in this year’s midterm elections, according to a poll published Thursday by the nonpartisan health research organization KFF. 

Three-quarters of voters polled, including majorities of Democrats, Republicans and independents, said the price of health care would have a minor or major impact on whom they choose to vote for in congressional elections in the fall. 

While voters of all parties said the issue would affect their vote, Democrats held a substantial advantage when those surveyed were asked which party voters trusted on several health costs questions.

Voters also blamed Trump and congressional Republicans for allowing tax credits for Affordable Care Act marketplace plans to expire. Two-thirds of respondents, including 72% of independents, said Congress did the wrong thing in letting those credits go away as of Jan. 1. Among those who said it was a mistake not to renew the credits, 80% said Trump or Republicans in Congress were most to blame.

“Republicans won the legislative battle to let the enhanced ACA tax credits expire, but that helped make health costs more of an economic worry and voting issue, and Democrats are well positioned to capitalize on that in the midterms,” KFF President and CEO Drew Altman said in a statement.

Health insurance premium costs

The cost of health insurance premiums and out-of-pocket expenses topped the list of respondents’ economic worries, with 66% of those surveyed saying they worried about affording care for themselves and their families. That group was larger than those who said the same about all other categories, including housing, utilities and food.

Four in 10 independents and two-thirds of Democrats surveyed said the cost of health care would have a “major impact” on who they vote for in the upcoming elections, which will determine control of Congress for the final two years of Trump’s second term.

Among all voters, Democrats held a 13-point advantage over Republicans on the question of who voters trust to handle the cost of health care.

Democrats were favored by double digits on other health policy questions, with the lone exception being who voters trusted to lower prescription drug prices. Democrats still led Republicans on that issue, which Trump has emphasized, but by a narrower 35%-30% margin.

Affordability focus

In limited major elections in 2025, Democratic candidates found success in campaign messages focused on affordability, an issue that Trump has also sought to address.

Thursday’s poll shows the issue may remain salient in this year’s elections. One-half of respondents said their household expenses had increased “a lot.” A supermajority, 82%, said costs had gone up at least “a little.” Though lower, at 75%, for Republicans, the trend was true across the partisanship of respondents.

A clear majority, 71%, said Trump was focusing not enough on domestic affairs like lowering health care costs. 

That number included 89% of Democrats, 76% of independents and 66% of Republicans who do not consider themselves supporters of Trump’s Make America Great Again, or MAGA, movement. Among MAGA Republicans, 6 in 10 thought Trump was focusing about the right amount on domestic issues.