Health care affordability has surged to the top of Americans’ worries in 2026, but Congress remains deeply divided as millions brace for higher insurance bills.
As 2026 begins, Americans are increasingly focused on two pressures that directly affect household stability: immigration and the rising cost of living. Now, health insurance affordability has joined them as a top concern — and public confidence that Washington can respond is slipping.
A December survey by the Associated Press–NORC Center for Public Affairs Research shows that roughly four in ten U.S. adults now name health care or health-related issues among the problems they want the federal government to address this year. That share has grown noticeably since last year, reflecting anxiety that is no longer theoretical. For many families, higher premiums are already arriving.
At the same time, Americans are becoming more skeptical that lawmakers will act. About two-thirds of adults say they are only slightly confident — or not confident at all — that the federal government can make progress on major issues in 2026, including health care costs and immigration. That erosion of trust matters, particularly as cost pressures touch nearly every household budget.
Why Health Insurance Is Back at the Center of the Debate
Health care has cycled in and out of political focus for decades, but its renewed prominence reflects a convergence of forces. Pandemic-era policies that helped cushion insurance costs have expired, inflation has strained household finances, and many Americans are confronting premium increases just as other expenses remain high.
The AP-NORC data show that concern is especially pronounced among adults ages 45 to 59 — a group often managing rising medical needs while still years away from Medicare eligibility. For working families, this age bracket is also likely to carry mortgages, caregiving responsibilities, or dependent children, making insurance costs harder to absorb.
For Latino households in particular, health insurance affordability often intersects with employment patterns. Latinos are disproportionately represented among small business owners, independent contractors, and workers in industries where employer-sponsored coverage is limited or inconsistent. Rising premiums can quickly translate into difficult tradeoffs — not because of culture, but because of how the U.S. labor and insurance systems are structured.
What’s Driving the Latest Insurance Price Increases
At the center of the current spike is the expiration of enhanced Affordable Care Act premium tax credits, which were expanded during the COVID-19 pandemic to lower monthly costs for people buying insurance through the marketplaces.
Those subsidies reduced premiums for millions of Americans across income levels. With their expiration at the start of 2026, many enrollees are now facing sharp increases — in some cases, premiums that are double what they paid just a year earlier.
The impact is uneven but widespread. Middle-income households that previously qualified for assistance are among those seeing the steepest hikes. Small business owners and self-employed workers, who often rely on individual marketplace plans, are particularly exposed.
Congress Knows the Problem — But Action Is Uncertain
Lawmakers are well aware of the fallout. Democrats have pushed to extend the subsidies, arguing that allowing them to lapse undermines coverage gains made over the past decade. Republicans remain divided, with some expressing concern about rising costs for constituents while others oppose extending pandemic-era spending without broader reforms.
A vote in the House on a temporary extension is expected, but its outcome is far from guaranteed in a narrowly divided Congress. Even if the House acts, prospects in the Senate remain unclear, especially absent a bipartisan agreement on how to offset the cost.
More ambitious proposals — such as restructuring how insurance prices are set or addressing underlying drivers of health care inflation — face even steeper odds. Those debates tend to stall over ideology, industry influence, and the sheer complexity of the U.S. health system.
For now, the most realistic option remains a limited extension of subsidies. Without it, analysts warn that some Americans will drop coverage altogether, not because they no longer value insurance, but because they simply cannot afford it.
Confidence Is Falling — and That Has Political Consequences
The AP-NORC poll reveals not only rising concern, but growing resignation. Confidence in government problem-solving has fallen sharply compared with last year, suggesting voters are bracing for inaction.
That skepticism could shape the political landscape heading into the 2026 midterms. Cost-of-living pressures — including health insurance — consistently rank among the issues most likely to influence voter behavior. When combined with immigration concerns, they create a potent mix of economic anxiety and institutional distrust.
For Latino voters, these issues are often experienced simultaneously. Immigration debates affect family stability and labor markets, while insurance costs affect access to care, entrepreneurship, and financial resilience. The connection is structural, not symbolic.
Who Feels the Pressure Most
Health insurance cost increases do not hit all Americans equally. Families without employer-sponsored plans, workers in volatile industries, and people managing chronic conditions face the highest stakes.
Small employers are also under strain. Some are reconsidering whether they can continue offering coverage at all, a decision that ripples through local economies and workforces. For communities with high rates of small business ownership — including many Latino-majority areas — those decisions carry outsized consequences.
Where Things Stand Now
As 2026 unfolds, the policy outlook remains unsettled. Congress could still act to blunt the impact of rising premiums, but the window is narrowing. Each month of delay increases the likelihood that higher costs become the new normal rather than a temporary disruption.
For millions of Americans, health insurance affordability is no longer an abstract policy debate. It is a line item in the household budget — one that now competes directly with housing, food, and education.
Whether Washington responds may determine not only coverage levels, but how much faith Americans retain in their institutions to address the pressures shaping everyday life.
