As the 2026 midterm elections loom on the horizon, Democrats are seizing the opportunity presented by President Trump’s massive tax-and-spending bill. The legislation, which targets Medicaid—a vital program providing health insurance to tens of millions of low-income and elderly Americans—has sparked a fierce debate over affordability and healthcare access. House Minority Leader Hakeem Jeffries delivered an impassioned speech opposing the bill, labeling it as both "cruel and dangerous."
Jeffries and other Democratic leaders are particularly focused on the nearly $1 trillion in cuts to Medicaid, which aim to offset the extensive costs associated with Trump's tax cut extension. "This bill represents the largest cut to healthcare in American history," Jeffries stated. "It's an all-out assault on the health care of the American people."
In response, Trump has initiated his own messaging campaign, positioning the tax-and-spending bill as a signature achievement for his potential second term. In a recent social media post, he proclaimed, "THE ONE BIG BEAUTIFUL DEAL IS ALL ABOUT GROWTH." He asserted that if the bill passes, "AMERICA WILL HAVE AN ECONOMIC RENAISSANCE LIKE NEVER BEFORE." Trump’s promotional event in Iowa, held just before Independence Day, featured fireworks and launched the year-long celebration of America’s 250th birthday, dubbed America250.
During this event, Trump touted the legislation as a significant victory for the nation. "There can be no better birthday present for America than the phenomenal victory we achieved just hours ago," he remarked, referring to the bill's passage. Trump signaled his readiness to leverage this legislation in the upcoming midterm elections, expressing disdain for Democrats who did not support the bill. "I think we'll use it in the campaign that's coming up—because we've got to beat them," he declared, adding, "But all of the things that we've given and they wouldn't vote, only because they hate Trump."
Despite Trump's enthusiasm, Republicans are grappling with unfavorable public opinion regarding the bill. Recent polling indicates that a higher percentage of people oppose the legislation than support it. However, the White House highlights that provisions like work requirements for Medicaid receive more favorable feedback. The political narrative surrounding the bill will significantly influence its acceptance, as Republicans struggle to effectively argue against a negative proposition—namely, that failing to pass the bill would result in tax increases.
A significant challenge for Republicans lies in the tangible impact of cuts to Medicaid. According to the Kaiser Family Foundation (KFF), nearly 70% of individuals report that they, a family member, or a close friend has benefited from the program. KFF’s findings reveal that 83% of respondents maintain a favorable view of Medicaid, while 82% believe funding should either be increased or maintained. Furthermore, 69% perceive the program as effective for low-income individuals, and 62% see it as primarily a government health insurance initiative rather than a welfare program. However, a majority of Republicans classify it as a welfare program, which may fuel misconceptions surrounding its beneficiaries.
There are several widely held but incorrect perceptions about Medicaid. Notably, 62% believe that most working-age adults on Medicaid are unemployed, a belief prevalent among 75% of Trump voters and half of Democrats. Additionally, nearly half of respondents mistakenly think that immigrants without permanent legal status are eligible for Medicaid. Despite Republican claims of targeting waste, fraud, and abuse, the Congressional Budget Office (CBO) projects that around 12 million individuals may lose their health insurance over the next decade.
Healthcare has consistently been a pivotal issue in midterm elections. For instance, in 2010, Democrats lost control of the House partly due to conservative backlash against the Affordable Care Act (ACA). During the peak of the Tea Party movement, only 35% of the public held a favorable view of the ACA. However, public sentiment shifted over time, with the law achieving its highest favorability rating of 66% as of last month.
In the 2018 midterms, healthcare played a crucial role in helping Democrats regain control of the House. This occurred exactly eight years after late Senator John McCain's dramatic vote against a GOP attempt to repeal the ACA, effectively thwarting efforts to dismantle the legislation. Now, as Democrats look to capitalize on Republicans' declining popularity, they face their own challenges. Recent polls indicate that Trump holds a 43% approval rating, while Congressional Republicans have only a 35% approval rating. In contrast, Congressional Democrats are experiencing even lower approval, with only 27% of the public expressing satisfaction with their performance.
To regain control of the House in the upcoming midterm elections, Democrats must address their internal challenges and unify their messaging. The dissatisfaction within their ranks may pose a significant obstacle as they strive to counteract Republican narratives and capitalize on the ongoing healthcare debate. Ultimately, the effectiveness of their strategies in the lead-up to the elections will determine their ability to mobilize support and reclaim political power.
