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

The KFF/AP Rural Voters Survey examines the views and political priorities of voters living in rural areas across the United States ahead of the 2026 midterm elections. The survey gauges rural voters’ top election issues, growing struggles with cost of living and health care costs, as well as views on the Trump administration’s health care policies.

The MIDTERMS

“...the search for a single top issue through polling questions — whether it’s health costs, or gas prices, or the cost of food — is artificial. People worry about and experience these costs together. There is no top issue, unless that issue is the catchall, ‘cost of living.’” — Drew Altman, KFF Founding President and CEO

Are Health Care Costs THE Top Issue for Voters?

In a new column, Dr. Drew Altman, Founding President and CEO, analyzes the polling on health costs as a voting issue and concludes that there is no one top voting issue. He writes: “I have come to the conclusion that the search for a single top issue through polling questions—whether it’s health costs, or gas prices, or the cost of food—is artificial. People worry about and experience these costs together. There is no top issue, unless that issue is the catchall, “cost of living.”

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  • The Economy and Medical Care

    Perspective

    Various market watchers have reported that the use of health care services has not been growing recently as it had in the past, resulting in lower than expected health care claims for people with private insurance and higher than expected earnings for insurers. A look at physician office visits by nonelderly patients with private insurance over the past decade illustrates the change in the use of services (See the chart below). (This analysis was prepared…

  • A Closer Look at the $50 Billion Rural Health Transformation Program

    Issue Brief

    The 2025 budget reconciliation created the Rural Health Transformation Program, which will award $50 billion in state grants over a five-year period. This brief provides an overview of the program, describing its structure, how funds can be used, how funding compares to Medicaid spending reductions in the reconciliation law, and how the funds are being distributed across and within states.

  • Health Care Costs Keep Rising … Why and Who Pays?

    Video

    The U.S. spends more on health care than other large, wealthy countries. Concerns about rising costs aren't new, yet somehow we keep paying the bill. In this video, KFF’s Larry Levitt explains how we got here, who bears the consequences and why reining in spending systematically may be central to the next big health care debate.

  • What’s Driving Rising Health Premiums?

    Video

    Costly health insurance premiums are straining employers and consumers alike. But, it’s underlying health care spending, especially for hospital care, that’s driving costs. KFF’s Larry Levitt looks at how hospital consolidation and employer demands for broad networks affect insurers’ ability, and willingness, to control prices in this first video of a three-part series on health insurers and rising health care costs.

  • What Do We Get for the Cut Health Insurers Take?

    Video

    Insurers take a cut of every premium dollar for overhead and profit. The question isn't just whether they profit, but also whether we’re getting value in return. KFF’s Larry Levitt breaks down how much goes to administrative costs and profit and how that varies across private insurance markets and Medicare, and considers what a Medicare-for-all system, which would be operated by the government, would address and what might be left unresolved in this second video…

  • Did the Affordable Care Act Make Health Care More Affordable?

    Video

    The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees.KFF’s Cynthia Cox examines the ACA's record and the broader underlying question it raises: what's a fair price for Americans people to pay for health care?

  • What Your Employer-Based Health Coverage Really Costs

    Video

    More people get health coverage through their job than from any other source. The deduction workers see in each paycheck for their share of the premium is only a fraction of the total cost. In this video, KFF’s Matt Rae unpacks the full cost of employer-sponsored insurance and why it may be the biggest health care affordability story hiding in plain sight.

  • Paying for Prescribed Drugs in Medicaid: Current Policy and Upcoming Changes

    Issue Brief

    The federal government has proposed new rules that aim to make Medicaid outpatient drug reimbursement policies more closely match the cost of obtaining and filling prescriptions. However, the change in policy may have varying effects on reimbursement, depending on the state’s current approach and the type of drug in question. This paper explains current Medicaid pharmacy reimbursement methodology and examines the potential effect of the proposed rule changes.

  • Prescription Drug Costs Remain Atop the Public’s National Health Care Agenda, Well Ahead of Affordable Care Act Revisions and Repeal

    News Release

    28% of Public Report Asking Doctor about a Drug They Saw Advertised, and 12% Say Their Doctor Prescribed It Few Workers Expect Raises if Employers Reduce Health Benefits to Avoid Cadillac Tax as Many Economists Predict With some presidential candidates laying out details of their health care platforms, the cost of prescription drugs remains at the top of the public's health care priority list for the President and Congress, the October Kaiser Health Tracking Poll…