Healthcare expenses have emerged as the primary economic concern for Americans, surpassing the costs of food, housing, and utilities as the country enters a critical midterm election year, a new KFF survey released on Thursday showed.
The KFF Health Tracking Poll found that 66% of U.S. adults worry about their ability to afford health care for themselves and their families, ranking it higher than other essential household needs. This anxiety comes as most adults—55%—report that their healthcare costs increased over the past year, with one in five noting these expenses rose faster than the price of food or utilities.
The survey, conducted one year into President Donald Trump’s second term, highlights a growing disconnect between the administration’s focus and public priorities. A significant majority of the public, 71%, believes President Trump is not focusing enough on domestic affairs, such as the cost of living. Conversely, 55% of respondents said the administration is spending “too much” effort on foreign affairs, specifically citing actions in Venezuela, Ukraine, and Gaza.
Midterm Stakes and the Trust Gap
The rising cost of medical care is poised to be a decisive factor in the 2026 midterm elections. According to the poll, majorities across the political spectrum say healthcare costs will impact their voting decisions in November. However, the issue resonates most strongly with Democratic and independent voters, more than three-quarters of whom say healthcare costs will influence both their decision to turn out and which candidate they support.
Voters currently give the Democratic Party a 13-point advantage over Republicans regarding which party they trust to handle healthcare costs. The Democrats also maintain double-digit leads in trust regarding the future of Medicaid (43% to 25%), the Affordable Care Act (42% to 26%), and Medicare (40% to 26%).
The only area where the Republican Party remains competitive is on prescription drug prices, a central focus of Trump’s second-term rhetoric. On this issue, 35% of voters trust Democrats while 30% trust Republicans. Among the critical independent voting bloc, many remain skeptical of both sides; more independents said they trust neither party to address drug costs than those who chose one party over the other.
Expiration of ACA Tax Credits
Public frustration is fueled in part by the expiration of enhanced Affordable Care Act (ACA) premium tax credits on January 1. These credits had previously lowered insurance costs for those purchasing coverage through federal and state marketplaces.
Two-thirds of the public, 67%, told KFF that Congress did the “wrong thing” by allowing these credits to expire. This sentiment is shared by 89% of Democrats and 72% of independents. While 63% of Republicans—including 64% of those identifying with the MAGA movement—backed the decision to let the credits lapse, nearly four in ten Republicans (37%) viewed the expiration as a mistake.
The blame for the expiration is largely partisan. Among those who wanted the credits extended, 42% blame the president and 38% blame congressional Republicans. However, among the minority of Republicans who think the credits should have been maintained, 64% blame congressional Democrats for the outcome.
The financial impact is already being felt: 64% of people who self-purchase insurance and 60% of those with employer-sponsored plans expect their healthcare to become even less affordable in the coming year.
Shifting Views on the ACA
While the Affordable Care Act remains generally popular with a 58% favorability rating, the law has seen a decline in support among Republicans. Republican favorability for the ACA dropped from 36% in September 2025 to just 22% in the latest poll. Similarly, positive views of the ACA marketplaces among Republicans fell from 59% to 41% over the same period.
Despite this partisan cooling, 62% of the total public still maintains a favorable view of the ACA marketplaces. Among those who purchase their own insurance, 67% say the expiration of the tax credits will impact who they vote for in the midterms.
Economic Pessimism
The poll reflects a broader sense of economic unease, with 82% of adults stating their cost of living has increased in the past year. Half of all respondents say it has increased “a lot.”
Confidence in political leadership to address these general living costs is low across the board. Only 38% of voters express confidence in President Trump’s ability to address the cost of living, with similar low marks for Democrats in Congress (37%) and Republicans in Congress (36%).
The survey highlights that while government coverage provides some protection, it is not an absolute shield. Those on Medicaid and Medicare were less likely to report that their health costs grew faster than food prices compared to those with private insurance, yet 53% of Medicare enrollees still reported an overall increase in health expenses over the last year.
The KFF Health Tracking Poll was conducted January 13-20, 2026, among a nationally representative sample of 1,426 U.S. adults. The survey was administered online and by telephone in English and Spanish. The margin of sampling error is plus or minus 3 percentage points for the full sample.