Health care costs remain the primary economic concern for U.S. voters heading into the 2026 midterm elections, consistently outranking worries over gasoline, housing, and food prices. While voters express widespread concern about affordability, their priorities for candidate discussions diverge sharply by political party, with Democratic voters focusing on the future of federal programs and Republican voters emphasizing the reduction of government fraud.
Voters Rank Health Costs as Top Economic Anxiety
According to data from the KFF Health Tracking Poll, approximately 62% of adults report being “very” or “somewhat worried” about affording health care costs, including insurance premiums and out-of-pocket expenses for prescription drugs and medical visits. This anxiety persists even as concerns over other household expenses—such as gasoline, rent, and groceries—have fluctuated throughout the year.
The salience of these costs is reflected in what voters want to hear from candidates. Half of all voters (51%) categorize health care costs as an “extremely important” topic for the campaign trail. The future of Medicare (48%) follows closely, while discussions regarding the Affordable Care Act (ACA) and food policy are viewed as top priorities by approximately one-third of the electorate.
Partisan Divides on Fraud and Government Spending
While health costs lead across the board, the focus on fraud is largely driven by Republican voters. For this group, fraud in government health programs is the single most important health issue, with 55% citing it as a top priority. In contrast, Democratic voters prioritize the long-term viability of Medicare (61%), Medicaid (56%), and the ACA (54%).
Public perception of fraud is not limited to health care. Roughly half of voters believe there is “a lot” of fraud in the federal tax system, while 46% identify significant fraud in military and defense contracts. When specifically asked about health programs, 40% of voters perceive high levels of fraud in Medicaid, 36% in Medicare, and 29% in ACA marketplaces. Notably, a majority of voters across all partisan lines attribute potential fraud in Medicare and Medicaid to health care providers and institutions rather than to individual patients.
Impact of Federal Anti-Fraud Initiatives
The current administration has made combatting fraud a central pillar of its health policy, utilizing tools such as Executive Orders, Department of Justice enforcement actions, and the deferral of federal Medicaid payments to states. However, public skepticism regarding these tactics remains high.
Research from KFF indicates that while 61% of voters believe reducing fraud would lower overall federal spending, only 43% believe current administrative efforts to defer payments will effectively save taxpayer money. Furthermore, voters express concern about the consequences of these fiscal crackdowns:
- Access to Care: 65% of voters believe the current approach is motivated more by politics than by a genuine effort to protect programs.
- Beneficiary Impact: 77% of voters state that delaying Medicaid funding to states is likely to cause eligible, low-income individuals to lose access to essential health services.
- Prioritization: When forced to choose between fraud prevention and patient access, 71% of voters—including 84% of Democrats and three in four independent voters—prioritize ensuring that eligible beneficiaries can access care.
Future Outlook for Health Policy
As the midterms approach, the tension between aggressive fraud oversight and the preservation of health care access serves as a major point of contention. While Republican voters are split on the trade-off between fraud prevention and access, the majority of the overall electorate signals that the stability of Medicaid and Medicare coverage is a higher priority than the potential savings gained from stricter, and potentially disruptive, administrative enforcement. Future policy discussions are likely to remain focused on whether these anti-fraud measures can achieve fiscal goals without compromising the health outcomes of vulnerable populations.