OPINION:
As a pollster, I have learned to listen closely when voters speak with clarity. On health care costs, voters in battleground congressional districts are speaking louder than ever. They do not like what Democrats have delivered over the past 15 years on health care, and they are increasingly supportive of the reforms being advanced by President Trump and Republicans in Congress.
This is a real political shift.
In a January survey of 1,000 likely voters in battleground congressional districts, 66% ranked the rising cost of health insurance as their single biggest health care concern. That dwarfs concerns about the quality of care they receive (18%) and the cost of prescription drugs (7%). For families, health care is a kitchen-table issue because it directly affects monthly budgets and long-term financial security.
Democrats, aided by a friendly media, are trying to pin rising costs on Republicans. Voters aren’t buying it. They understand that policies such as Obamacare and its expansion under President Biden, combined with a close alliance between Washington and large corporate insurers, have driven today’s affordability crisis.
Pouring hundreds of billions of dollars more in subsidies into the same system does not pass the smell test for families already stretched thin.
Voters increasingly see themselves as victims of a system that has become unaffordable, unaccountable and unresponsive. When asked who is most to blame for rising health care costs, voters point first to big health insurance companies. Thirty-nine percent name health insurers as the top driver of higher costs, slightly more than those who blame Congress and the federal government (36%) and far above drug developers (8%) and hospitals (5%). This pattern holds across Republicans, Democrats and independents.
That distinction matters. Voters see insurers getting richer and growing larger and more powerful through consolidation, while families face higher premiums, rising deductibles, narrower networks and delayed care. They see a captive system where prices are negotiated behind closed doors and complexity shields corporate middlemen from real scrutiny. They also see little accountability when costs rise or care is denied.
The data also shows what voters want done.
Across party lines, voters express overwhelming concern about waste, fraud and abuse in the health care system. Eighty-five percent support aggressive action to crack down on insurers and middlemen. More than 90% support full price transparency so patients know the cost of care before receiving treatment.
These are commonsense expectations, especially when many families find it cheaper to pay cash for services or medicines than to use their own insurance. Many of these reforms align with the Most Favored Patient policy blueprint released by economists Steve Moore and Steve Forbes this year.
Unlike big insurers, American drug developers responded when Mr. Trump demanded action. Price negotiation deals have been reached, and companies will soon be allowed to bypass insurer middlemen to sell medicines directly to patients or through TrumpRx at lower costs.
Drug companies have also committed more than $500 billion in U.S. investments in manufacturing and jobs. Meanwhile, insurers warn families that premiums will rise unless taxpayers continue underwriting the same broken model.
Voters also understand that competition matters. When markets lack competition, prices rise and service suffers. That is exactly what voters believe is happening in health insurance today, where large insurers also own pharmacies, physician and emergency care practices, surgical centers, offshore pricing middlemen, home health services and nursing homes.
This concentration reduces choice and weakens accountability. It also explains why voters are skeptical of policies that further reduce competition and innovation, such as drug price controls, and leave families stuck with fewer options that cost more and deliver less.
Mr. Trump has consistently argued that health care should work for patients, not entrenched corporate interests, and the polling shows that voters agree. They want accountability, competition and transparency from large integrated insurers, which now derive up to 80% of their revenue from government and taxpayers, compared with roughly 20% before Obamacare and the Biden expansion in 2020. At the same time, patients and seniors face higher out-of-pocket costs and fewer real choices.
Timing matters. These voters will be casting ballots in the midterm elections, and health care costs are not fading as a concern. They are intensifying. Premiums and out-of-pocket expenses hit families every month, not just during campaign season. Voters will remember who listened and who protected the status quo.
From a polling perspective, the warning signs are clear. Candidates who ignore the role big insurers play in driving up costs do so at their own risk. Voters expect action that reflects their priorities, not a political protection system they believe has failed them. Republicans would be wise to join Mr. Trump and go on the offensive. Let Democrats defend big insurers and the failures of Obamacare and its expansion, and voters will make their voices heard loud and clear.
• Jim McLaughlin is president and CEO of McLaughlin & Associates.
Correction: A previous version of this piece misnamed the Most Favored Patient blueprint.
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