WASHINGTON — Facing a challenging re-election bid, seven-term Rep. Scott Perry, R-Pa., says he’s not surprised that voters distrust the Republican Party to improve their healthcare.
“I can’t say that Republicans have done much about it,” Perry told NBC News before the House left last week for a lengthy election recess. “We’ve even passed some things here, but they don’t make it anywhere in the Senate. So, you know, people want results, not talk.”
Healthcare is shaping up to be a vulnerability for the GOP in the 2026 midterm elections, when Democrats hope to capture the House and the Senate. According to this month’s NBC News poll, voters trust Democrats over Republicans on healthcare by 22 points. A New York Times-Siena College poll similarly found that likely voters preferred Democrats by 24 points on the issue.
Still, Republicans are leaning in and highlighting the issue, with many of them using populist rhetoric criticizing insurance and drug companies. The goal, according to three GOP strategists, is more about trying to narrow the Democratic advantage than expecting to win on the issue.
In ultracompetitive Michigan, Senate candidate Mike Rogers is running an ad inveighing against high prescription drug costs relative to Canada. Rogers, a former Republican congressman who is calling for price transparency rules for hospitals and insurers, held an event Saturday attacking Democratic rival Abdul El-Sayed’s “Medicare for All” proposal.
“I just can’t think of a more important issue to the people of Michigan than healthcare — their costs, their rising costs and how we get to the bottom of it,” Rogers said at the healthcare-focused event in Taylor. “He wants Medicare for all. I want Medicare for seniors. They’ve earned it, they’ve worked for it, let’s improve it, let’s get it going.”
In Iowa, Republican Senate candidate Ashley Hinson launched an ad in May saying “healthcare companies are ripping you off” and that she’s “working with President Trump to take on big insurance companies.”
In a New Jersey swing district, Republican Rep. Tom Kean is running an ad lamenting that too many families “suffer because of big insurance companies.” Kean, who missed four months of work in the House citing treatment for depression, touted his bill to boost Labor Department authority to enforce mental health rules for insurance plans.
Even in deep red Kansas, Republican Sen. Roger Marshall is running an ad that credits him for “standing up to big insurance.”
Democrats are blasting the $1 trillion in Medicaid spending cuts that Republicans passed on party lines in President Donald Trump’s “big, beautiful bill,” as well as a pot of Obamacare funding that Republicans successfully pushed to end last year. Those two moves are estimated to cause more than 10 million people in the U.S. to lose coverage or, for those on that Affordable Care Act, pay more for insurance. House Minority Leader Hakeem Jeffries, D-N.Y., has vowed to restore the Medicaid and ACA funds as Democrats’ top priority if they capture House control.
“When you scratch the surface, healthcare is always an important issue to voters. And it’s an issue to try to talk to swing women voters and other subgroups of swing voters,” said Republican pollster Bill McInturff, who co-conducts the NBC News poll with Democratic pollster Jeff Horwitt.
“Republicans need to make up a deficit with women voters, and when you ask women what they are most focused on, healthcare always scores very high,” McInturff said, while adding: “You don’t have to win an issue. You just have to compete on the issue.”
According to NBC News polling, Democrats have consistently led on healthcare since the early 1990s. Their edge topped 30 points in 2008, ahead of a blue wave, and it fell to as little as 7 points in 2010, a red wave year.
And while Republicans spent much of the last decade, including Trump’s first term, attempting to repeal or undo the ACA, the party has never coalesced around an alternative. The party has long favored curtailing healthcare funding to align with its support for tax cuts, a position that is coming into conflict with its growing reliance on working-class voters.
Hinson, Kean and Marshall all voted for the Medicaid cuts. All but Kean voted against resurrecting ACA money. Rogers, who left Congress in 2015, has not said whether he’d support reviving the ACA funds, and his campaign had no comment about how he’d vote on reversing Medicaid cuts in Trump’s megabill last year.
“Michiganders see through Mike Rogers’ B.S. and understand that if he’s elected to the Senate, Rogers will eagerly continue his life’s work as Big Pharma’s greatest champion,” said Cole Wozniak, a spokesperson for El-Sayed, who has also vowed to restore the Medicaid and ACA money. “Michiganders deserve far better, which is why Dr. Abdul El-Sayed is running to fight back against Big Pharma and deliver Medicare for All.”
The White House’s internal polling shows that the administration’s work to lower drug prices is one of its most popular second-term achievements, and it has encouraged Republican candidates to run on those issues, according to a senior White House official.
But when Trump held an event Friday to tout his most-favored-nation pricing policies for certain drugs under Medicaid, his message was drowned out by his just-announced decision to ban some news outlets from the White House.
Republicans who write healthcare legislation have also not made clear what they would do about healthcare if they maintain control of Congress.
Sen. Mike Crapo, R-Idaho, the chair of the Finance Committee that oversees healthcare policy, told NBC News his agenda next year will include “PBM fixes” — referring to third-party pharmacy benefit managers — and tackling “inefficiencies.”
Beyond that, he didn’t provide specifics.
“Our healthcare system is broken. I’m not going to tell you what the solutions are yet,” Crapo said. “So, I guess my response would be that we’re going to need to continue diving into the various issues from A to Z, and try to address the shortfalls and fix them. I think we’ve got a lot of good minds working on it.”
