Key facts
- Republican candidates are running ads on healthcare issues like Medicaid fraud, rural hospitals, and affordability.
- The One Big Beautiful Bill Act reduced funding for state health programs.
- Approximately 10 million fewer people are projected to have health insurance by 2034.
- Around 3 million fewer people were enrolled in health insurance exchanges in early 2026 compared to before the bill's passage.
- A KFF poll indicated only a third of voters approve of the Trump administration's handling of healthcare costs.
- Rep. Mike Lawler ran ads claiming the Medicaid reform law reduced able-bodied individuals in the program and falsely stated undocumented immigrants can no longer receive benefits.
Republican candidates are shifting their messaging on healthcare, running ads that focus on issues such as Medicaid fraud, rural hospitals, and affordability. This pivot comes after facing criticism for cuts enacted through the One Big Beautiful Bill Act, which has led to stiffer insurance requirements and reduced funding for state programs.
An analysis by NPR of YouTube video ads found that many Republican candidates in swing districts are highlighting these healthcare topics. This strategy represents a change from previous years, when repealing the Affordable Care Act (ACA) was a primary focus for the party. According to Jonathan Oberlander, a healthcare policy expert, the backlash against ACA repeal efforts contributed to Republicans losing their House majority in 2018.
The One Big Beautiful Bill Act is projected to result in approximately 10 million fewer people having health insurance by 2034, according to the Congressional Budget Office. Data from the Centers for Medicare & Medicaid also indicated that about 3 million fewer people were enrolled through health insurance exchanges in early 2026 compared to before the bill's passage. Public approval of the Trump administration's handling of healthcare costs remains low, with only a third of voters approving, according to a KFF poll.
Political science professor Daniel Hopkins noted that Republicans are proactively addressing the issue to counter potential attacks from challengers. Rep. Mike Lawler, a Republican running in a competitive district, has run ads focusing on Medicaid reform, claiming the law reduced able-bodied individuals in the program and falsely stating that undocumented immigrants are ineligible for benefits. KFF data suggests that Republicans are perceived by voters as more effective in addressing fraud and waste in government healthcare programs, a point that resonates with the Republican base.