KFF/AP Survey Probes Rural Voters’ Increasing Anxieties About the Rising Cost of Living, Including Health Costs, Heading into the Midterm Elections

Rural voters’ frustrations about the cost of living in their community are growing and appear to be chipping away at Republicans’ enthusiasm to vote as the midterm elections near, a new KFF/Associated Press (AP) Survey of Rural Voters finds.

The survey of more than 2,000 rural voters probes the views and experiences of a group who have been strong supporters of President Trump and Republicans but are feeling economically stressed and facing higher health care costs. The project includes a polling analysis from KFF, which often partners with media organizations on surveys, and reporting from journalists at the AP and KFF Health News. Additional stories drawing on the poll findings and rural voters’ perspectives will come out in the coming weeks.

The survey’s key takeaways include:

• Cost of living concerns are increasing, and Republicans maintain an edge with rural voters. Rural voters overwhelmingly name the cost of living as the top issue they want candidates to talk about, and three quarters now rate the cost of living in their area as either “fair” or “poor,” a 25-percentage point increase from 2017. When it comes to household expenses, rural voters worry most about health costs and gas prices. More rural voters prefer the Republican Party than the Democratic Party to best address the cost of living (40% v. 25%), though a quarter (27%), including most independents, trust neither party.
• Cost of living concerns are increasing, and Republicans maintain an edge with rural voters. Rural voters overwhelmingly name the cost of living as the top issue they want candidates to talk about, and three quarters now rate the cost of living in their area as either “fair” or “poor,” a 25-percentage point increase from 2017. When it comes to household expenses, rural voters worry most about health costs and gas prices. More rural voters prefer the Republican Party than the Democratic Party to best address the cost of living (40% v. 25%), though a quarter (27%), including most independents, trust neither party.
• Cost of living concerns are increasing, and Republicans maintain an edge with rural voters. Rural voters overwhelmingly name the cost of living as the top issue they want candidates to talk about, and three quarters now rate the cost of living in their area as either “fair” or “poor,” a 25-percentage point increase from 2017. When it comes to household expenses, rural voters worry most about health costs and gas prices. More rural voters prefer the Republican Party than the Democratic Party to best address the cost of living (40% v. 25%), though a quarter (27%), including most independents, trust neither party.
• Cost of living concerns are increasing, and Republicans maintain an edge with rural voters. Rural voters overwhelmingly name the cost of living as the top issue they want candidates to talk about, and three quarters now rate the cost of living in their area as either “fair” or “poor,” a 25-percentage point increase from 2017. When it comes to household expenses, rural voters worry most about health costs and gas prices. More rural voters prefer the Republican Party than the Democratic Party to best address the cost of living (40% v. 25%), though a quarter (27%), including most independents, trust neither party.

The survey also examines rural voters’ views about job opportunities and safety in their community, who they trust to handle key economic and health care issues, and health care access issues in their communities, including provider and hospital shortages.

METHODOLOGY

Designed and analyzed by public opinion researchers at KFF and the Associated Press, this survey was conducted August 12-24, 2026, online and by telephone among a nationally representative sample of 2,241 U.S. adults registered to vote in rural areas of the country. The margin of sampling error is plus or minus three percentage points for the full sample of rural voters. For results based on other subgroups, the margin of sampling error may be higher. The survey was conducted in English and Spanish.

About KFF

KFF is the independent source for health policy research, polling, and journalism. Its mission is to serve as a nonpartisan source of information for policymakers, the media, the health policy community, and the public. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF.

About the Associated Press

The Associated Press is an independent global news organization dedicated to factual reporting. Founded in 1846, AP today remains the most trusted source of fast, accurate, unbiased news in all formats and the essential provider of the technology and services vital to the news business. More than half the world’s population sees AP journalism every day. Online: http://www.ap.org