The United States Capitol in Washington, DC, USA, on Tuesday, January 27, 2026.
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Health costs have become the top financial anxiety for American households, according to a new survey. It's a dynamic that experts say could pose a threat to the Republican majority in Congress during this year's midterm elections, in which affordability is expected to be a key focus for voters.
Two in three Americans surveyed, 66%, are worried about paying for health care, more so than other household needs such as utilities, food, housing and rent, and gas and transportation, according to a survey released Thursday by KFF, a nonpartisan health policy research group.
According to KFF, health care includes the cost of health insurance and out-of-pocket expenses for office visits and prescription medications, for example.
Among those concerned about health costs, 32% said they were “very concerned” and 34% were “somewhat concerned.” KFF surveyed 1,426 American adults earlier this month.
“This could very well be the No. 1 issue for Americans at the polls in November,” said Nick Fabrizio, a health policy expert and associate teaching professor at Cornell University.
Health care perceptions emerge as ACA subsidies expire
KFF conducted its survey Jan. 13-20, just weeks after the expiration of enhanced federal subsidies for health insurance premiums purchased on the Affordable Care Act marketplace.
About 22 million people (more than 90% of ACA enrollees) received those enhanced subsidies in 2025. As a result, KFF estimates that the average recipient will see their insurance premiums more than double this year, from $888 to $1,904 per month.
Democrats have pushed to expand subsidies, but most Republicans in Congress have so far stymied those efforts.
Health care is typically ranked as a “second-tier election issue” in KFF's regular polls, said Shannon Schumacher, senior polling analyst.
But not this year, he said.
One likely reason: Most adults said their health care costs have increased in the past year, including a “substantial share” (more than 20%) who said their health costs have increased at a faster rate than other expenses like utilities or food, KFF found.
The survey found that most people with employer-sponsored health insurance, Medicare and those who buy their insurance themselves, most of whom buy coverage on the ACA marketplace, report increases in health costs over the past year.
“Health care has always been a priority and one of the top five issues for Americans for the past 20 years,” Fabrizio said. “It makes sense that concerns would peak now, with all the focus on the overall rise [health-care] cost.”
The cost worries the different parties
Perceptions of health care affordability are largely consistent regardless of the party affiliation of the voters surveyed, Schumacher said.
For example, 57% of people surveyed who identify as Republicans said they were worried about facing health care costs, compared to 68% of independents and 71% of Democrats, according to KFF.
“What strikes me is that health care costs are the number one economic concern for everyone, whether they're Democrats, independents or Republicans,” Schumacher said.
The issue is emerging as a key factor in the November midterm elections, experts said.
Republicans currently have a trifecta in the federal government, controlling the House of Representatives, the Senate and the White House. However, Republicans have a slim majority in the House.
More than 4 out of 10 voters Respondents (43%) said the cost of health care will have a major impact on which candidate they support in the midterm elections, according to KFF.
Democrats have 'advantage' on most healthcare cost issues
The United States Capitol at dusk in Washington, DC, United States, on December 23, 2025.
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Democrats currently “have an advantage over Republicans” on health care cost issues, Schumacher said.
They hold a double-digit lead over Republicans in who voters said they trust to determine the future of Medicaid (43% vs. 25%), address the future of the ACA (42% vs. 26%), determine the future of Medicare (40% vs. 26%), and address the cost of health care (40% vs. 27%), according to the KFF poll.
However, they are more divided over which party would best address the cost of prescription drugs, an issue that President Donald Trump has focused on during his second term, he said.
Importantly, while independents surveyed, a key voting bloc, said they generally trust Democrats more on most health care issues, “a sizable percentage of independent voters (between about a third and four in ten) said they trust 'neither' of the parties,” according to KFF's survey analysis.
“This remains an issue that could become a battleground among independent voters,” Schumacher said.
