WASHINGTON (AP) — Julia Dvorak is increasingly anxious about her 83-year-old mother’s frequent emergency room visits due to seizures, which are rapidly draining her retirement savings and potentially pushing her towards reliance on Medicaid.

Meanwhile, Dvorak, who is 56 and grappling with a persistent knee ailment that requires her to rely on both state and federal assistance, anticipates a rise in her own health care expenses in the coming year.

This kind of financial strain has intensified health care concerns among Americans, as revealed by a recent AP-NORC survey highlighting citizens’ top priorities for governmental action in 2026.

The surge in concern over health care issues far surpasses other commonly cited topics. This shift follows the policies of President Donald Trump’s Republican administration, which included reductions in Medicaid funding—a crucial program for low-income individuals—and the discontinuation of pandemic-era subsidies for the Affordable Care Act. These decisions are set to significantly increase costs for millions of people at the beginning of next year.

These developments are likely to bring health care back to the forefront in the upcoming midterm elections, which will play a pivotal role in determining the future composition of Congress.

“I see how it affects me and my loved ones,” Dvorak, who lives outside Cedar Rapids, Iowa, said about the cost of health care. “But I also know it’s affecting other people, and it’s getting worse.”

But Americans are also less confident that the government will be able to make progress on the important problems facing the country in 2026. About 66% of U.S. adults say they are “slightly” or “not at all confident,” down from 58% last year.

More Americans are focused on health care concerns

About 4 in 10 U.S. adults named health care or health issues in an open-ended question that asked respondents to share up to five issues they want the government to work on in the coming year. That’s up from about one-third last year.

The high cost of health care came as a shock to Republican Joshua Campbell when he and his wife recently sought a medical plan for their young daughter. The 38-year-old small business owner from Hot Springs Village, Arkansas, voted for Trump last year, and he mostly approves of the way Trump is handling his job, particularly on immigration. But health care expenses have become a major priority for him going into 2026.

“Health care costs are pretty crazy,” he said. “I just thought, ‘Man, there’s got to be something better than what we have.’”

Health care is a particularly high concern for adults between the ages of 45 and 59 — people who may have higher health care costs than younger adults but aren’t yet eligible for Medicare.

The poll shows a similar landscape to the one Trump faced at the end of his first year in office during his first term, when health care reform was at the top of many Americans’ minds. But Trump has an added complication now. At the end of 2017, very few mentioned cost of living concerns — now, about one-third do.

Campbell described his politics as conservative, and while he recalled viewing the Affordable Care Act somewhat negatively when it first passed, he said he now views it as a step toward helping improve health care.

“I do think they were at least trying, and at least trying to do something,” he said. “And I don’t really see that — it’s one of the things from the Republican Party as well that I don’t necessarily agree with. Or I think that they should be doing better at.”

Cost and inflation concerns remain pressing

Inflation and the high cost of living have been a top priority for many Americans since the end of 2021. Tommy Carosone is reminded every time his wife returns from the grocery store, especially with their two kids, both teenagers, still at home.

“My wife is spending so much more money on groceries than just a few years ago. Every time she comes home from the grocery store, I hear about it,” said Carosone, from St. Peter’s, Missouri. “She tells me it’s stupid expensive, especially meat. Ground beef, bacon, anything from the deli. It’s outrageous.”

The 44-year-old jet aircraft mechanic, the sole wage earner for his family of four, doesn’t see the cost of living coming down any time soon. He voted for Trump and generally agrees with his tariff agenda as a way to make the U.S. more competitive, and he figures prices will stay higher until the trade war ends.

“In the meantime, what are you going to do, not eat?” he said.

Carosone said he is glad he voted for Trump and had been concerned before Trump took office again about illegal immigration. But it doesn’t register even as a top priority for him now, in light of action the administration is taking.

“It’s a lot better,” he said. “It’s not really one of the main concerns I have now. I mean, don’t stop. That’s for sure. But I don’t think it’s something that’s a top concern.”

About 2 in 10 U.S. adults want the federal government to focus on housing costs next year. That issue has been rising in recent years, with young adults being especially likely to mention it. About one-quarter of adults under age 30 want the government to focus on housing expenses, compared with about 1 in 10 of those 60 or older.

Immigration worries rise slightly among Democrats, decline among Republicans

Many Americans were hoping Trump would bring a hard-line approach to immigration when he returned to the White House in January.

Immigration was the top issue Americans wanted the government to focus on last year, with about half of U.S. adults citing it. A large number, 44%, said they want the government to prioritize immigration this year, too — but Democrats have grown increasingly concerned about the issue, while Republicans and independents have declined.

About 4 in 10 Democrats listed it as a concern this year, an apparent increase from 32% last year. Majorities of Republicans still consider it a priority — about 6 in 10 mentioned it, but that’s down from about 7 in 10 last year.

Roxanna Holper, 64, is worried about the Trump administration’s approach to immigration, even though she believes Democrats have fumbled the issue in the past by failing to curb the “insanity” at the border. The Minnesota native describes herself as not ideological, and she has voted for Republicans as well as Democrats. Lately, she’s been voting Democratic.

“(Trump) campaigned with, you know, ‘We’re going to get the worst of the worst … off the streets,’” she said. “Well, who doesn’t want that?”

She said she believes that’s not what’s actually happening. “You hear stories where a mom was deported with her two children,” she said. “Like, what the hell — well, who are we as a society that we would treat anybody like that? That is so appalling.”

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Beaumont reported from Des Moines, Iowa. Catalini reported from Trenton, N.J. Parwani reported from Columbus, Ohio.

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The AP-NORC poll of 1,146 adults was conducted Dec. 4-8 using a sample drawn from NORC’s probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for adults overall is plus or minus 4 percentage points.