Former White House Deputy Chief of Staff Karl Rove cautioned that the GOP risks serious losses in the 2026 midterms if it fails to present a clear health care plan alongside a strong economic agenda.
Rove Urges Republicans To Prioritize Health Care
In a Saturday interview on Fox News's Journal Editorial Report, Rove stressed that Republicans must outline policies that directly address voters' economic and health care concerns.
"If the Republicans want to maximize their victories in 2026, they need to go back in the way-back machine to 1992 and remember the immortal words of that great strategist, James Carville: ‘It's the economy, stupid,'" Rove said.
He added, "And you got to have an agenda that is forward-looking."
GOP Faces Pressure As ACA Subsidies Expire
Rove urged GOP candidates to focus on "pro-growth policies" and emphasized that health care cannot be ignored.
"The Republicans have got to have a health care agenda, otherwise they're going to be in deep trouble," he added.
Health care has been a contentious issue this year, highlighted by a record-long government shutdown over Affordable Care Act subsidies.
The enhanced subsidies are set to expire at year's end, potentially raising premiums for millions of Americans—a development that could directly affect Republican voters.
Rove also warned that cracks are forming within the Republican Party as lawmakers grow anxious about midterm outcomes, especially given that voters have yet to see the full impact of President Donald Trump's tax and spending bill.
"If the president's ‘big, beautiful bill' was as instantaneously positive as he thinks, his approval numbers on the economy wouldn't be in the 30s, and his overall approval wouldn't be in the low 40s," Rove said.
Republican Health Care Debate Heats Up Ahead Of 2026 Midterms
Last week, President Trump said he did not want to extend Obamacare subsidies, though the White House explored short-term options to prevent premium hikes.
He rejected a two-year renewal of expanded ACA subsidies but left open the possibility of some form of extension.
Last month, Former Transportation Secretary Pete Buttigieg criticized Trump's policies as a "bad deal" that could raise premiums by up to 10% in 2026.
He also called the president's attacks on air traffic controllers a distraction from economic pressures on Americans.
In October, Rep. Marjorie Taylor Greene (R-Ga.) accused House Speaker Mike Johnson (R-La.) of withholding details of a GOP plan to replace the ACA and pressed for specifics on expiring subsidies.
She also urged Senate leadership to consider drastic measures to pass funding legislation.
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