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Karl Rove Warns GOP: No Health-Care Agenda Could Spell 'Deep Trouble' in 2026 Midterms

08:58 AM, 12/01/2025

Karl Rove warned that Republicans must present a credible health-care proposal and a clear economic agenda to improve their prospects in the 2026 midterms. He invoked James Carville’s line, 'It’s the economy, stupid,' and urged the GOP to pursue progrowth policies that help families. Rove highlighted the looming expiration of enhanced ACA subsidies, which could raise premiums for millions and is deepening divisions within the party. He said Republicans are anxious because voters have not yet felt the effects of recent tax and spending legislation.

GOP strategist Karl Rove warned Saturday that Republicans must offer a credible health-care agenda and a clear, forward-looking economic plan to avoid setbacks in the 2026 midterm elections.

In an interview, Rove urged the party to return to fundamentals, invoking James Carville’s 1992 admonition — 'It’s the economy, stupid' — to stress the need for tangible economic policies. He encouraged GOP candidates to prioritize 'progrowth policies' that deliver direct benefits to American families and improve household finances.

Rove also emphasized health care as a central issue. 'Don’t forget health care,' he said, arguing that without a concrete health-care proposal Republicans will be 'in deep trouble' with voters. His warning comes as enhanced Affordable Care Act (ACA) subsidies are set to expire at the end of the year, a change widely expected to raise premiums for millions of Americans.

Health care played a key role in a recent, record-long government shutdown when Democrats sought extended subsidies as a condition to reopen the government. The impending lapse of those subsidies has intensified divisions within the Republican Party, since many GOP voters could be directly affected.

Rove added that internal cracks are widening because many Republicans are 'scared to death of the midterm,' noting that voters have not yet felt the effects of the administration’s recent tax and spending legislation. '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,' he said.

Rove concluded that to maximize success in 2026, Republicans need a coherent, forward-looking agenda that addresses both health care and the economy — not just rhetoric about past achievements.

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