With less than a month until Election Day, a new KFF poll finds health care affordability is a leading financial concern, while looming GOP Medicaid cuts and rising insurance premiums threaten to become major election liabilities as President Donald Trump is promising voters taxpayer-funded bribes if they support Republican candidates.

On the day Trump endorsed him for re-election, Representative Tom Kean Jr. was missing in action for the 12th week, but the President did not discuss his absence in his endorsement.

“Tom is working tirelessly to Keep our Border SECURE, Stop Migrant Crime, Grow our Economy, Cut Taxes and Regulations, Champion Small Business, Unleash American Energy DOMINANCE, Support our Brave Military and Veterans, and Protect our always under siege Second Amendment,” Trump wrote on Truth Social.

The New Jersey Republican had not been seen publicly in Washington or in New Jersey for nearly three months, and although he did not announce it at the time, he was in a psychiatric facility recovering from a nervous breakdown.

As a missing person in New Jersey’s seventh district, Kean Jr. might have been able to fend off a congressional primary challenge and trade stocks—or post deceptive social media comments and issue press releases that make it look like the absentee lawmaker is hard at work—but he could not be the tireless advocate for his constituents that the lying tyrant falsely claimed he is.

Trump also endorsed Republican incumbents Jeff Van Drew, a turncoat first elected as a Democrat, and Chris Smith, who has been serving as the U.S. representative for New Jersey’s 4th congressional district since 1981.

Trump has an unbroken streak in New Jersey following his endorsements of Bob Hugin, who lost the 2018 Senate election; Christine Serrano Glassner, who lost her 2024 Senate primary; and Giacchino Michael ‘Jack’ Ciattarelli, who lost the 2025 gubernatorial elections, but his prospects are particularly grim this year.

Roughly 55% of the population in New Jersey’s 4th congressional district are 45 years old or younger, so they were not yet born when Smith was initially elected to the House of Representatives.

With the Nov. 3 midterm elections less than a month away, rising health care costs have emerged as a major concern for American voters, according to a KFF poll that suggests Democrats hold a significant political advantage over Republicans on an issue that could help determine control of Congress.

Trump and those congressional Republicans have slashed healthcare, taking away coverage from struggling Americans and driving up premiums across the country.

Trump is attempting to narrow that gap by promoting agreements with pharmaceutical companies and offering payments to some Medicare and Affordable Care Act enrollees.

But health policy analysts question whether the administration’s limited financial relief can offset the rising insurance premiums, medical bills and anticipated coverage losses confronting millions of Americans.

On the other hand, Democrats are trying to shoot themselves in the foot at every turn.

House Democratic Leader Hakeem Jeffries visited Linden’s Greater Mt. Moriah Baptist Church on Friday evening to bolster Rebecca Bennett’s campaign.

Democrats seem intent on self-sabotage. Bennett said Jeffries would have her vote for Speaker if she wins the seat a month after he confirmed that he is not a co-sponsor of single-payer Medicare for All and won’t bring such legislation to a floor vote if Democrats retake the House.

The latest KFF Health Tracking Poll found that health care expenses rank among voters’ most pressing financial worries, surpassing concerns about food, utilities and housing costs and tying gasoline prices.

The findings suggest that health care affordability could become a defining issue in an election increasingly shaped by public frustration over the cost of living.

The survey also found that Americans trust Democrats more than Republicans to address health care costs, continuing a longstanding political advantage for the party that enacted the Affordable Care Act.

The political stakes were examined during the Oct. 8 edition of KFF Health News’ “What the Health?” podcast, hosted by chief Washington correspondent Julie Rovner.

Panelists from Bloomberg News, Politico and The Washington Sun discussed how the administration’s efforts to demonstrate progress on health care affordability are colliding with the consequences of Republican-backed legislation that reduces federal health spending.

“When asked about their biggest financial concern, health costs topped things like food, utilities, and rent, and tied with the cost of gas,” Rovner said.

She cited KFF President and CEO Drew Altman’s assessment that Americans worry about medical expenses not simply because costs have increased, but because those expenses are unpredictable and can become financially catastrophic.

Trump offers bribes as medical costs climb

The Trump administration has sought to counter voters’ dissatisfaction by highlighting pharmaceutical pricing agreements and payments intended to provide financial relief to selected Medicare and Affordable Care Act beneficiaries.

Some payments have been described as refunds, although the administration’s initiatives are not equivalent to reversing the increases in premiums and other medical expenses many patients have experienced during 2026.

The panelists questioned whether such payments could meaningfully change public perceptions of Republican health care policies.

Paige Winfield Cunningham of The Washington Sun said the administration is emphasizing individual financial benefits while largely avoiding discussion of the unpopular health spending reductions contained in the Republican budget legislation enacted in 2025.

Cunningham characterized the checks as temporary measures rather than lasting solutions to rising medical expenses.

Alice Miranda Ollstein of Politico suggested that the administration’s decision to offer payments reflects growing concern among Republicans about the electoral consequences of their policies.

“I think the sudden rush to mail out checks to a bunch of people who’ve been impacted by Republican healthcare policies is a sign that they’re sweating the impact of those Republican healthcare policies,” Ollstein said.

She said Republicans are facing competitive races in traditionally conservative states where voters are experiencing higher health care costs and losing insurance coverage.

Anna Edney of Bloomberg News questioned whether the administration’s claims about reducing prescription drug prices match what Americans are seeing in their household budgets.

Despite Trump’s repeated promises of dramatic reductions in drug costs, Edney said, patients are not necessarily experiencing corresponding savings when they pay their medical bills.

Medicaid cuts hitting before Republicans expected

One of the most consequential political developments involves the Republican budget law Trump signed in 2025, commonly called the One Big Beautiful Bill Act.

Republican lawmakers structured many of its Medicaid changes to take effect after the 2026 elections, potentially delaying some of the political backlash associated with reducing federal health spending.

But hospitals, clinics and state governments are already responding to anticipated reductions in federal funding, accelerating the consequences of legislation whose most significant provisions have yet to take effect.

Health care providers must prepare budgets and make staffing decisions well before federal funding reductions arrive.

As a result, some facilities are eliminating services, closing maternity wards and considering shutting down entirely.

States are also making spending reductions in anticipation of receiving less federal Medicaid assistance.

Ollstein said the political strategy of postponing implementation has not prevented Democrats from campaigning against the legislation.

“States have to make their budgets now, and so they’re making these deep cuts to services in anticipation of losing all that Medicaid money,” she said.

The consequences are particularly serious for rural hospitals and communities with limited access to alternative medical facilities.

Meanwhile, millions of Americans purchasing insurance through Affordable Care Act marketplaces have faced substantial premium increases following the expiration of enhanced federal premium tax credits.

The failure to extend those subsidies has become another major point of contention between the parties.

Some Republicans supported extending the assistance, but negotiations collapsed, leaving many consumers facing considerably higher monthly premiums.

Medicaid work requirements threaten coverage

The Republican budget law also imposes new work-reporting requirements on certain Medicaid beneficiaries, with broader implementation scheduled for 2027.

Some states, however, have already begun implementing requirements or notifying beneficiaries about the documentation they will need to maintain coverage.

Early evidence from Nebraska suggests that administrative difficulties may be causing eligible people to lose insurance.

According to the KFF discussion, hundreds of Nebraska residents have already lost coverage, with most of the reported losses attributed to procedural problems rather than findings that beneficiaries failed to meet eligibility requirements.

That distinction is significant because people who are working or otherwise qualify for exemptions can still lose coverage if they fail to submit paperwork, misunderstand deadlines or encounter problems navigating state reporting systems.

The panelists also described confusion surrounding implementation in Montana, where beneficiaries have struggled to understand documentation requirements and reporting deadlines.

States have considerable discretion over how they administer the new requirements, potentially producing sharply different outcomes depending on where beneficiaries live.

Some states are allowing temporary flexibility for people with serious medical conditions, while others are requiring immediate documentation.

Ollstein warned that Nebraska’s experience could foreshadow widespread coverage losses as the requirements expand.

The experience also raises questions about whether the administrative costs of enforcing work requirements will undermine the legislation’s stated objectives.

Poll finds growing support for Medicare for All

KFF HEALTH TRACKING POLL · SEPTEMBER 16-21, 2026

42% vs. 22%

Trust Democrats vs. Republicans on health care costs

66%

Of adults support Medicare for All

60%

Of voters worry about affording health care

63% vs. 38%

Democrats vs. Republicans more motivated to vote than usual

Source: KFF Health Tracking Poll.

The survey also found growing public support for a more fundamental restructuring of the American health care system.

Sixty-six percent of adults favor Medicare for All, a national health insurance system that would provide government-sponsored coverage to all Americans. That represents an increase from 53% in 2020 and the highest level of support recorded in KFF polling since 2016.

Support includes 84% of Democrats and 72% of independents, while 66% of Republicans oppose the proposal.

The findings suggest that mounting frustration with private insurance premiums, deductibles, copayments and medical debt may be increasing public willingness to consider alternatives to the current system.

However, support varies considerably depending on how the proposal is described.

Opposition increases when respondents are told Medicare for All could result in higher taxes, longer waits for medical treatment or changes to the existing Medicare program.

Conversely, support rises when respondents are told the system could guarantee health coverage as a right or eliminate premiums and cost-sharing.

Notably, 52% now favor Medicare for All even when told it would eliminate private health insurance companies, compared with 37% in 2020.

The findings present an opportunity for progressive Democrats who have long advocated replacing the country’s fragmented public-private insurance system with universal coverage.

But the proposal remains politically contentious, including among Democrats who favor expanding existing programs rather than replacing private insurance.

Small rebates, enormous expenses

The administration’s financial relief initiatives illustrate the difference between temporary payments and lasting reductions in health care expenses.

More than 20 million eligible Medicare beneficiaries are receiving one-time $90 payments intended to offset Part B premium costs. The administration is also distributing $500 Affordable Care Act refund checks to nearly 1 million people.

The Medicare payments, financed through the Medicare Improvement Fund, total approximately $2 billion. Eligibility restrictions exclude certain beneficiaries, including those enrolled in Medicare Advantage.

Although the payments provide some financial assistance, they are considerably smaller than the annual medical expenses faced by many Americans and do not permanently reduce insurance premiums, deductibles or prescription drug prices.

Health care worries extend beyond insurance

The KFF discussion also examined the nation’s growing measles outbreaks, including more than 1,000 cases reported in Pennsylvania.

Health experts warned that measles can produce serious complications even among previously healthy individuals and can weaken immune defenses against other infections through a phenomenon known as immune amnesia.

The panel also discussed the Food and Drug Administration’s continuing review of the abortion medication mifepristone.

According to a federal court filing, the administration expects to complete data collection by December and release its assessment in March 2027, after the midterm elections.

The review could have nationwide implications for access to medication abortion, including in states where abortion remains legal.

Separately, KFF Health News highlighted the financial consequences of hospital billing practices through the case of an Illinois woman who received a $410 emergency room bill despite leaving after four hours in a waiting room without receiving treatment from a physician.

Her experience illustrates how patients can face substantial charges even when they do not receive the medical services they sought.

An election shaped by medical bills

The KFF findings reveal a potentially consequential enthusiasm gap heading into November.

Among Democratic voters, 63% said they were more motivated to vote than usual, compared with 38% of Republicans.

The Democratic advantage on health care affordability has also widened considerably since April, when the party led Republicans by 11 percentage points on trust to address medical costs. That advantage has now grown to 20 points.

Among independent voters, Democrats lead Republicans 38% to 9% on health care affordability, although many independents say they trust neither party.

Those findings do not guarantee Democratic victories. Turnout, individual candidates and other national issues will help determine the election results.

But they underscore a growing challenge for Republicans who must defend their health care record while voters are confronting rising costs and providers are preparing for substantial federal funding reductions.

For the Trump administration, the immediate strategy emphasizes drug pricing agreements, one-time payments and promises of financial relief.

For Democrats, the campaign centers on the consequences of Medicaid reductions, higher insurance premiums and the argument that Republicans have made health care less affordable.

For millions of Americans, the stakes are more immediate than the political competition in Washington: whether they can afford insurance, obtain necessary treatment and pay their medical bills without sacrificing other basic necessities.

With Election Day approaching, the central question may be whether voters believe a temporary government check is meaningful relief — or whether they are ready to demand more lasting changes to the American health care system.