Democrats seized control of both the House and Senate in the 2026 midterms and flipped at least four governorships, riding a 19-point trust advantage on health care — nearly triple the 7-point edge Kamala Harris held over Donald Trump in 2024 — as 54% of voters said the Trump administration’s policies made their own health care costs worse, according to KFF’s post-election analysis reported this week.
Health care affordability, not abstract ideology, sat at the center of the electorate’s decision. KFF’s 2026 Voter Poll, conducted by SSRS, found that 49% of midterm voters trusted Democrats to handle health care versus 30% for Republicans. The gap widened steadily through the year: KFF polling showed an 11-point Democratic edge in April, a 20-point edge in September, and the final 19-point margin after Election Day. The shift extended beyond health care — Democrats also took a narrow 43%-to-37% lead on the economy, reversing Trump’s 10-point advantage among 2024 voters.
Voters Cite Health Care Costs as Top Affordability Worry
- If you felt your health care bills go up under the current administration, you were far from alone — more than half of all voters said the same, and they broke for Democratic House candidates by 5-to-1.
- Health insurance premiums and prescription drug prices ranked shoulder-to-shoulder with gas prices as voters’ top affordability worry.
- The enhanced Affordable Care Act premium tax credits expired, and Medicaid spending was cut in the 2025 reconciliation law — both moves Democrats campaigned on aggressively.
Health Care Costs Became the Bridge Issue in an Affordability Election
Six in 10 voters told KFF they are worried about affording health care, including insurance premiums and out-of-pocket costs for office visits and prescriptions, The Hill reported. Roughly half said it was “extremely important” for candidates to address health care costs, and health costs tied with gas prices as the most important affordability issue — a pattern consistent across polls for much of the year.
The personal stakes showed up in the vote itself. Among voters who said Trump’s policies worsened their health care costs, 82% backed the Democratic House candidate against 16% for the Republican. The pattern held among independents: 69% of independents who felt costs worsened voted Democratic. “I think it really is a reflection that this is an affordability election, and Democrats are campaigning on that, whereas Republicans seem to be talking more about fraud, waste, and abuse,” said Shannon Schumacher, a senior survey analyst at KFF and lead author of the poll.
“Of all the cost-of-living worries hitting voters now, a big health care bill is the least predictable, and that’s a big reason why health care costs are right up there with gas prices and the costs of food and housing on voters’ minds,” said KFF President and CEO Drew Altman.
From Expired Premium Credits to Medicaid Cuts: The Policies Voters Weighed
Democratic candidates hammered two specific Republican actions: allowing the enhanced ACA premium tax credits to lapse, which raised premiums for subsidized enrollees, and the Medicaid spending reductions embedded in the 2025 reconciliation law, H.R.1 — the “One Big Beautiful Bill,” as Republicans branded it. In battleground states, ads tied those votes directly to voters’ rising costs.
The public appetite for systemic change remained high. KFF’s poll found 66% support for Medicare for All, the highest level since 2016, though support dropped when respondents heard criticisms about taxes and wait times — a partisan divide in how to fix the system that persists even as concern about costs cuts across party lines.
| Measure | Democrats | Republicans | Margin |
|---|---|---|---|
| Trust on health care, 2024 presidential vote (Harris vs. Trump) | — | — | Dem +7 pts |
| Trust on health care, September 2026 | 42% | 22% | Dem +20 pts |
| Trust on health care, 2026 midterm voters | 49% | 30% | Dem +19 pts |
| Trust on the economy, 2024 presidential vote | — | — | GOP +10 pts |
Who Faces the Steepest Cost Cliff — and What to Watch Next
Voters most exposed to the policy shifts — subsidized ACA marketplace enrollees facing the loss of enhanced premium tax credits and Medicaid beneficiaries affected by H.R.1’s spending reductions — are the ones whose costs the poll measured rising. Just 10% of voters said Trump’s policies improved their costs. What happens next depends on the new Congress: Democrats campaigned on restoring affordability, and the expiring credits and Medicaid cuts are now legislative items a Democratic majority can move on. Individual races varied, and issues were one factor among many, but the affordability message clearly resonated.
Asked what they wanted to hear from candidates on health costs, voters across parties converged on one demand: concrete plans to lower costs. “Lowering [health care costs] for people who can’t afford to pay expensive costs for health care,” said a 40-year-old Republican from Arkansas.
References
- KFF, “2026 Voter Poll” conducted by SSRS, and KFF Quick Takes on the 2026 midterms
- The Hill, “Health care remains a top affordability concern for voters”
