KFF Health Tracking Poll: Health Care Costs, Expiring ACA Tax Credits, and the 2026 Midterms

Authors: Shannon Schumacher, Audrey Kearney, Mardet Mulugeta, Isabelle Valdes, Ashley Kirzinger, and Liz Hamel

Published: Jan 29, 2026

Findings

Key Takeaways

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 their 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 as well as which 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 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. 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 1^st. 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.

Source: KFF (Kaiser Family Foundation). “KFF Health Tracking Poll: Health Care Costs, Expiring ACA Tax Credits, and the 2026 Midterms” KFF.org. Accessed February6, 2026. https://www.kff.org/public-opinion/kff-health-tracking-poll-health-care-costs-expiring-aca-tax-credits-and-the-2026-midterms/