Voters Chose Republicans This Year in Spite of Differences on Health Care

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President Trump won a decisive victory in Tuesday’s election, propelled largely by voters’ concerns about inflation and the economy. Republicans also gained control of the Senate, and as of this writing look likely to keep control of the House. Despite these victories, there are signs in the polling that voters are not necessarily aligned with some of the policies Republicans may pursue when it comes to health care.

• While Republican policymakers tend to favor less government involvement in health care, KFF analysis of AP VoteCast shows three-quarters of voters, including two-thirds of Republicans, want to see more government involvement in lowering the cost of prescription drugs. Six in ten voters overall and about four in ten Republicans want the government more involved in forgiving medical debt and ensuring that Americans have health care coverage.

• Republicans, including President-elect Trump and House Speaker Mike Johnson, have continued to talk about repealing or scaling back the Affordable Care Act (ACA), but KFF polling finds the law is more popular than ever. VoteCast data also show that in three of the states that have yet to adopt the ACA’s Medicaid expansion (Alabama, Kansas, and Mississippi), at least seven in ten voters favor expanding Medicaid in their state.
• Republican lawmakers have tended to favor restrictions on abortion access, though toward the end of the 2024 campaign many publicly expressed opposition to a nationwide abortion ban. This may reflect popular opinion, as VoteCast data shows nearly two-thirds of voters want abortion to be legal in all or most cases.

As is often the case with public opinion data, these findings don’t necessarily reflect the political realities of attempts to do things like passing drug pricing legislation or repealing the ACA. But they do suggest something about voters’ priorities and the constraints they may place on Republican lawmakers as they seek to implement a health care agenda in 2025. And even as votes are still being counted in this week’s election, these data also give an indication of where voters’ thoughts may be as this election cycle wraps up and attention starts shifting toward the 2026 midterms.