The title of KFF’s press release launching the Foundation’s January 2026 Health Tracking Poll clearly observes, “Health Care Costs Tops the Public’s Economic Worries as the Runup to the Midterms Begins.”
I’ve pulled out the key details to share my lens on the 2026 midterm and 2028 Presidential election forecast, which I believe will turn out to be (in part) The Patients’ Elections. 
Here’s the top-line title finding — where most people in the U.S. — 2 in 3 people (66%) — are worried more about health care costs compared with other major household expenses. That means people cite health care expenses above food and groceries, housing costs (rent, mortgage), utilities and energy costs, and gas or other transportation costs. 
And Americans don’t expect their household challenges with health care affordability to improve in the next year. 56% of U.S. adults expect health care to become less affordable in the next year — most Democrats and Independents, and 46% of Republicans. On the GOP front, see that most non-MAGA supporters expect health care affordability problems to continue to challenge in the next year, compared with 42% of MAGA supporters. 
Health Populi’s Hot Points: Worries about affording health care cross political party ID in the U.S. While 7 in 10 Democrats and Independents worry about their ability to afford health care, over one-half of Republicans do, too — at 57% of those identifying with the `gop.
Filling the breach between covered-care and spending out-of-pocket for self-care and primary care, many consumers look to retail health channels for medicines (over-the-counter and discount coupons at the point-of-purchase pharmacy), food-as-medicine and for well-being at the grocery store, and immunizations at retail. We’ve been witness the hockey-stick growth of direct-to-patient platforms for medicines and virtual care (such as the uptake of self-driven GLP-1s to tele-mental health).
This week, Walmart announced plans to increase pay for pharmacists to address this shifting demand, and also joined a collaboration with CVS Health, Kroger Health, Giant Eagle, Ahold Delhaize, and the National Community Pharmacists Association to #fillhealthcaregaps to support pharmacist-led health care. Here’s a video to fill in your knowledge about this promising program:
We are now in an era where most health feels like retail given peoples’ sense of lack of affordability — driving more U.S. patients and health citizens to vote with health care on their minds, in 2026 midterms and in 2028.





Thanks to Jennifer Castenson for
Jane joined host Dr. Geeta "Dr. G" Nayyar and colleagues to brainstorm the value of vaccines for public and individual health in this challenging environment for health literacy, health politics, and health citizen grievance.
I'm grateful to be part of the Duke Corporate Education faculty, sharing perspectives on the future of health care with health and life science companies. Once again, I'll be brainstorming the future of health care with a cohort of executives working in a global pharmaceutical company.