Health in the 2026 Midterm Elections


Mapping ACA Marketplace and Medicaid Enrollment by Congressional District 

With an estimated 14 million people expected to become uninsured by 2034 due to major changes to Medicaid and the Affordable Care Act (ACA) Marketplaces in the 2025 reconciliation law plus the expiration of the ACA’s enhanced premium tax credits, KFF’s new interactive maps provide a way to view ACA Marketplace and Medicaid enrollment by congressional district across the U.S.

Share of Congressional District Enrolled in ACA Marketplace, 2026

ACA Marketplace Enrollment by Congressional District

This ACA Marketplace enrollment map shows that more than half of Marketplace enrollees (55%) live in Republican districts. The highest shares of state enrollment are in Florida (16%), Georgia (11%), Texas (10%), and Utah (10%)—states that were all won by President Trump in 2024.

Share of Congressional District Enrolled in Medicaid, 2025

Medicaid Enrollment by Congressional District

This new interactive map illustrates Medicaid enrollment by congressional district and eligibility group. In half of Republican congressional districts, at least 20% of residents are enrolled in Medicaid, and in half of Democratic districts, at least 25% are enrolled.

Event

KFF Midterms Data Presentation: What Do Voters Think About Health Care Now?

Event Date:

Join KFF for a virtual event at Noon ET on Wednesday, October 14, featuring KFF public opinion and survey experts who will provide analysis and insights on the latest findings from recent public opinion surveys about health care issues in advance of the midterms, including current public sentiment about Medicare-for-All and how it compares historically. After the presentation, experts will take questions from attendees. Learn more and register here

Two-Thirds of U.S. Adults Now Favor Medicare-for-All, the Largest Share Since KFF Began Polling on the Plan

Public Opinion on Medicare-for-All

This chart pack summarizes KFF polling data on public opinion on Medicare-for-all and other national health plan proposals. The latest update finds that two-thirds of the public supports Medicare-for-all, while support changes drastically as respondents hear arguments from proponents and critics.

Public Opinion

Democrats Hold a Nearly 2-to-1 Advantage Over Republicans on Handling the Cost of Health Care

Poll: Health Care and Gas Costs Top Voters’ Midterm Concerns 

As the 2026 midterms approach, health care costs remain tied with gas as voters’ top midterm concerns and the Democrats hold a clear edge over the Republicans Party on who voters trust to handle many top electoral issues, including the cost of health care and the cost of living.

Midterm Election Updates

These fact sheets offer background on election-related health care issues.

ACA Marketplaces

More people than ever got coverage through the Affordable Care Act Marketplaces in 2025, but the expiration of enhanced premium tax credits has driven up what people pay and contributed to declining enrollment in 2026.

Vaccine Policy

Federal vaccine policy has shifted toward fewer recommended routine childhood vaccinations, more emphasis on individual decision-making, and greater skepticism about the safety and efficacy of some vaccines.

women's health policy

Women’s Health Care Affordability Challenges

As health care costs dominate the national political conversation, our 2026 KFF Women’s Health Survey shows the toll those costs are taking on women. Our new nationally representative survey of women and men ages 18–64 finds costs remain a major barrier for women, specifically — causing everything from delayed care to rationed medications to cuts in spending on basic needs.

featured videos

How Unaffordable is Health Care? 

Health care affordability is a top issue for many people. Why and how did care get so expensive? In this three-part video series, KFF experts look at the rising cost of health care in the U.S. from the macro level to the issues facing everyday Americans. Drawing on KFF policy analysis and polling, the videos examine the underlying drivers of health care spending, the true cost of employer sponsored health insurance and whether the Affordable Care Act has delivered on its promise. View the videos

Are Health Insurers to Blame for Our Health System Problems? 

Political leaders on both sides point fingers at health insurers for high costs and patient frustrations. How much blame do insurers, in fact, deserve for our health system’s problems? This three-part video series from KFF considers this question and the complicated answer, exploring what’s driving rising insurance premiums, whether insurers provide value, and who we trust to decide what gets covered and at what price. Watch and share →

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  • Share of Congressional District Enrolled in ACA Marketplace, 2026

    How Does ACA Marketplace Enrollment in 2026 Vary Across Congressional Districts?

    Issue Brief

    KFF’s new interactive maps illustrate ACA Marketplace enrollment and changes in enrollment by congressional district and state. Marketplace enrollment declined in most congressional districts between 2025 and 2026, with two-thirds of the decline (67%) occurring in Republican-held congressional districts.

  • KFF Midterms Data Presentation: What Do Voters Think About Health Care Now?

    Event Date:
    Event

    Join KFF for a virtual event at Noon ET on Wednesday, October 14, featuring KFF public opinion and survey experts who will provide analysis and insights on the latest findings from recent public opinion surveys about health care issues in advance of the midterms, including current public sentiment about Medicare-for-All and how it compares historically. After the presentation, experts will take questions from attendees.

  • Number of States Affected by Key Medicaid Provisions in the 2025 Reconciliation Law

    Which States Will Be Affected by Key Medicaid Provisions in the 2025 Reconciliation Law?

    Policy Watch

    The 2025 reconciliation law makes sweeping changes to Medicaid that will affect every state through key eligibility and financing changes, including new work requirements, immigrant eligibility restrictions, and changes to provider taxes and state directed payments. This issue brief explains which states will be affected by each of these key provisions.

  • “…voters’ concerns about health care costs are having a moment, and will continue to do so through 2028, because voters see them as a dimension of their worries about the cost of living, which is their dominant concern right now.” — Drew Altman, KFF Founding President and CEO

    A Guide to the Role of Health in the Midterms

    From Drew Altman

    In a new column, President and CEO Dr. Drew Altman says health care costs are playing a significant role in the midterms as one dimension of voters’ concerns about cost of living, and explains why pollsters, analysts, and candidates should look at it that way, and not as a separate voting issue. He writes, “The ‘issue’ that matters most in this election is cost of living and the cost of health care is a central…

  • Midterm Election Update: Vaccines

    Fact Sheet

    Federal vaccine policy has shifted toward fewer recommended routine childhood vaccinations, more emphasis on individual decision-making, and greater skepticism about the safety and efficacy of some vaccines. The changes coincide with declining childhood vaccination rates, rising exemptions from school vaccine requirements, and a major measles resurgence.

  • Midterm Election Update: The Affordable Care Act Marketplaces

    Fact Sheet

    More people than ever got coverage through the Affordable Care Act (ACA) Marketplaces in 2025, but the expiration of enhanced premium tax credits has driven up what people pay and contributed to declining enrollment in 2026. Law and regulatory changes also tightened ACA eligibility and enrollment requirements. Public opinion of the ACA remains generally favorable, although views remain divided along partisan lines.

  • Democrats Hold a Nearly 2-to-1 Advantage Over Republicans on Handling the Cost of Health Care

    Poll: Cost of Health Care and Gas Top Voters’ Midterm Concerns; Democrats Hold Significant Advantage on Health Care Costs and Cost of Living 

    News Release

    Just a month away from the midterm elections, affordability worries continue to top the public’s list of midterm election issues, with health care costs and gas costs tying as the top economic concern, KFF’s new Health Tracking Poll finds. Voters overall trust Democrats more than Republicans to handle the cost of health care and the cost of living.

  • Democrats Hold a Nearly 2-to-1 Advantage Over Republicans on Handling the Cost of Health Care

    KFF Health Tracking Poll: Health Care Issues in the Lead-Up to the 2026 Midterm Election 

    Poll Finding

    With the 2026 midterms about a month away, health care costs remain tied with gas as voters’ top midterm concerns and the Democrats hold a clear edge over the Republicans Party on who voters trust to handle many top electoral issues, including the cost of health care and the cost of living. Two-thirds of U.S. adults now favor Medicare-for-all, a new high in KFF Polling, but support shifts when competing claims from critics and proponents…