2026 Midterms

Yesterday, the U.S. House of Representatives finally voted on a clean, 3-year extension of the enhanced ACA tax credits which had been in place for the prior five years, and which over 22 million Americans (myself included) were relying on to keep their health insurance premiums at affordable levels until they expired at the end of December 2025.

In the end, 17 House Republicans voted with all 213 House Democrats to extend the improved tax credit formula through the end of 2028. Thirteen of the seventeen GOP "Yea" votes represent swing districts (the remaining four were Maria Elvira Salazar in FL-27, Andrew Garbarino of NY-02, David Joyce of OH-14 and Monica DeLa Cruz of TX-15).

There are 43 U.S. House districts where the Republican nominee won by 15 points or less. Of those, one (WA-04) doesn't really count since there were 2 Republicans running in the general election (Washington State has "jungle primaries"). Four others were won by Donald Trump by between 16 - 20 points (AZ-08, CO-04, TX-15 & WI-08).

That leaves 38 GOP-held House seats where the Republican won by 15 pts or less and where either Kamala Harris won, or Donald Trump also won by 15 points or less. The table below breaks these out with both margins, while also listing my estimate of how many residents of each district are enrolled in ACA coverage.

(h/t Ballotpedia & The DownBallot)

There's a couple of important caveats to keep in mind here:

Americans for a Balanced Budget is a conservative think tank. Earlier today they published the results of a poll taken by Trump/Republican pollster John McLaughlin which finds...well...

Americans for a Balanced Budget released the findings of a national survey of 800 likely voters on November 18, 2025, conducted by pollster John McLaughlin of McLaughlin & Associates, across 16 GOP-held battleground districts rated Toss Up or Lean Republican by the Cook Political Report.

How to support my healthcare wonkery:

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