With "medical expenses," not groceries or housing costs, emerging as the biggest economic anxiety American households feel, the burden of health care costs is rapidly rising as a key variable in this year's midterm elections. As medical expenses are perceived as the greatest household pressure point amid an inflationary phase, analysts say they are directly swaying voters' decisions.
According to a poll released on the 29th (local time) by the bipartisan health policy organization Kaiser Family Foundation (KFF), three-quarters of all respondents said health care costs would influence their vote in the November election. As overall living costs such as groceries, housing, and utility bills have mounted and "affordability" has emerged as the top issue, the burden of medical expenses has risen as the most consequential concern.
Ashley Kirzinger, a researcher who led the KFF poll, said, "Voters still see the 'economy' as the most important election issue, but this year the burden of medical expenses stands out among economic concerns," adding, "Health care costs are no longer a secondary issue; they are actually moving voters' choices." Kirzinger said the public is demanding strong political solutions that can practically rein in rising medical costs.
Debate over health care costs flared in October in Congress as conflict erupted over extending Affordable Care Act (ACA) subsidies. As the two parties failed to bridge differences, Congress failed to pass a spending bill, leading to a 43-day federal government shutdown, and ultimately millions of ACA enrollees directly shouldered higher premiums. According to CNN, average ACA premiums jumped 26%.
The problem is that the burden of medical expenses is not limited to ACA enrollees. Many Americans rely on employer-sponsored private health insurance, and they, too, have been unable to avoid the burden as their out-of-pocket costs have surged with rising expense. According to KFF, over the past five years, family coverage costs for employer plans rose 26% to $27,000 a year (about 38 million won), while worker contributions climbed to around $7,000.
In the survey, the public also expressed strong concern about the rising trend in medical expenses. Among respondents, 56% said "our family's medical costs will get worse over the next year," and 32% said they were "very worried" about medical expenses. That far exceeded the proportion of respondents concerned about grocery prices (24%) or rent and mortgage loan expense (23%).
Politically, Democrats appear to hold a relative edge on health care. Asked which party they trust more on overall health policy, Democrats posted a response rate 13 percentage points higher than Republicans. Previously, the Republican-led Congress repeatedly opposed extending ACA subsidies, ultimately leading to the end of the benefit.
However, the conservative camp's rebuttal is clear. Brian Blase, president of the conservative-leaning think tank Paragon Health Institute, said, "Medical expenses not only squeeze the household but also widen the federal deficit," arguing, "Government subsidies and regulations protect inefficient incumbent providers and big hospitals and stifle competition." He said the health care cost issue should be approached as a distortion of market structure, not through government intervention.
Voters, however, while recognizing the seriousness of health care costs, appear deeply distrustful of both parties' solutions. According to KFF, in every health-related question, at least a quarter of respondents said "neither party would handle this issue better."
Experts are voicing concern that insured people are avoiding visits or treatment because of expense. Ezekiel Emanuel, a professor of medical ethics at the University of Pennsylvania, said, "The current situation shows the U.S. health care system has reached a structural limit," adding, "It is nationally very dangerous when people debate whether to call an ambulance or go to the hospital because of the cost."