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:

During this virtual event, KFF public opinion and survey experts provided 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.

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.

Medicaid

Major federal changes to Medicaid eligibility and financing from the 2025 reconciliation law are coming, including new work requirements that will affect millions of Medicaid enrollees.

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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  • KFF Health Tracking Poll: MAHA and the Midterms

    Poll Finding

    This KFF Health Tracking Poll finds that the cost of health care is a more prominent focus for Make America Healthy Again (MAHA) voters than issues like food and vaccine policy. Four in ten MAHA voters (42%) choose lowering health costs as the most important health priority, outranking other MAHA priorities.

  • Reaching Voters on Health

    From Drew Altman

    What do voters want to see most on health from candidates? A plan? That they feel their pain? In a new column, Dr. Drew Altman, Founding President and CEO, discusses findings from a new KFF poll and writes: “Voters say what matters most to them is to see candidates show some 'fight' by taking on drug and insurance companies they have come to see as villains."

  • Poll: The Cost of Health Care Remains at the Top of the Public’s List of Economic Concerns, Even as Concerns About Gas Prices Climb

    News Release

    Health care costs continue to top the public’s list of economic anxieties, even as fuel prices and economic uncertainty rose following the start of the Iran war, a new KFF Health Tracking poll finds. Nearly two-thirds (64%) of U.S. adults are worried about being able to afford health care costs, including three in ten who say they are “very worried.” The same share (64%) are worried about gasoline or other transportation costs, up from about…

  • A One-Pager on What’s Wrong with U.S. Health Care

    From Drew Altman

    Asked for a one-pager on what's wrong with the U.S. health system, Dr. Drew Altman, Founding President and CEO, explains the top issues in this piece, published today as his latest column. Altman explains, "We have neither a competitive health care system nor a regulated one—we have a fragmented, micromanaged health system that fails to control costs and makes both patients and health professionals more miserable than they should be..."

  • A Preview of the Role Health Care May Play in the 2026 Election

    Issue Brief

    Ahead of the 2026 midterm elections, this KFF issue brief examines the role health care has played in previous elections and what that may suggest about its potential role in 2026. KFF polls have consistently found that the cost of health care is an important part of voters’ economic concerns.

  • The New Ideas Conundrum in Health Policy

    From Drew Altman

    In a new column, President and CEO Dr. Drew Altman writes about the "conundrum of health policy ideas" facing Democrats searching for new proposals because of competing, and complex, priorities: rebuilding Medicaid and the ACA after trillion-dollar cuts, reconstructing federal health agencies, and tackling underlying health care costs, when candidates want simple ideas they can campaign on and voters want their costs to come down.

  • The Midterms Lurk Behind Every Health Policy Move Now

    From Drew Altman

    In his latest column, President and CEO Dr. Drew Altman discusses how midterm political strategy will shape health policy in 2026, focusing on recent moves by President Trump. He writes: “Democrats start out with a significant advantage on health in the midterms, but rather than cut and run to other issues, Trump wants Republicans to try to erode that advantage where they can.”

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

    Poll Finding

    Looking ahead to the midterm elections, health care costs are the public’s top economic concern, and many voters say the issue will have a major impact on their vote. On health care issues, including the cost of health care, voters currently trust Democrats more than Republicans, though neither party has an advantage on addressing the overall cost of living. Following the expiration of the ACA enhanced tax credits, two-thirds of the public say Congress did…