US midterm elections 2026: How healthcare costs is emerging as key concern for voters ahead of Nov polls | Explained

US midterm elections 2026: The United States midterm elections 2026 are set to be held in less than 10 days. On November 3, all 435 seats of the US House of Representatives will be up for grabs, as well as one-third of the 100-seat US Senate. Other state level positions can be on the ballot too.

With millions of Americans struggling with the rising costs, healthcare costs remain a key concern among voters in this year’s midterm elections.

The voters will decide the composition of Congress for the final two years of President Donald Trump’s current term. All 435 seats in the House of Representatives and 35 of the 100 Senate seats will be contested.

The outcome will determine the political balance in Congress from January 2027 and, in turn, the legislative environment in which the Trump administration will operate for the remainder of its term.

The election comes as Trump’s approval rating stands at 32 per cent, according to a Reuters/Ipsos poll published on September 21. The poll found 43 per cent of respondents backing a Democratic candidate for Congress and 35 per cent a Republican candidate. It surveyed 1,277 US adults and had a margin of error of three percentage points.

Healthcare costs a major concern for voters ahead of midterms

Trump said on October 2 the government will send a USD 90 payment to 20.8 million people ⁠enrolled in Medicare Part B, the medical-insurance portion of the government's health plan for seniors, Reuters reported.

The White House said the one-time payments will help to offset rising healthcare costs. The money will be drawn from a USD 2 billion fund meant to improve the programme.

Most of the 70.6 million Americans enrolled in Medicare will not get these checks. Low-income people whose Part B premiums are covered by the program, high-income people who pay an extra fee, and those enrolled in privately run Medicare Advantage programs will not qualify. The standard Part B premium is USD 202.90 per month, the Reuters report added.

This will be at least the second benefit Trump has targeted at seniors, a politically influential group who vote at high levels in midterm elections. Trump's sweeping One Big Beautiful Bill Act enacted last year included a tax break for people over 65, fulfilling a promise he made during the 2024 presidential campaign.

$500 checks to some Obamacare users

The administration has also sent payments of USD 500 to 950,000 people who buy health insurance ‌from the ⁠government-run healthcare.gov portal. Many of these people have seen their premiums rise sharply after the Republican-controlled Congress allowed a subsidy package to expire at the end of 2025, the Reuters report added.

The White House says the payments are a refund for what it describes as excessive fees set under former Democratic President Joe Biden.

Like the Medicare payments, these checks will not go to all 19 million people who rely on Obamacare — people who get subsidized coverage and people in the 20 states that run their own marketplaces do not qualify.

Some 71 per cent of those who qualify ⁠live in states that are holding competitive elections for US Senate or governor, according to a Reuters analysis of government data.

How the US election cycle works

The US holds congressional elections every two years, while presidential elections are held every four years. Midterm elections take place halfway through a president’s four-year term and do not involve a vote for president.

Congress is made up of two chambers, the House of Representatives and the Senate. The House has 435 members, each elected for a two-year term from a congressional district. The number of representatives allotted to each state is based on its population.

The Senate has 100 members, with two senators representing each state. Senators serve six-year terms, but their terms are staggered into three groups, meaning roughly one-third of the Senate is elected every two years.

(With inputs from Reuters)