Trump’s Biggest Test on the Economy and Health Care: Confronting the Affordability Crisis

President Donald Trump faces mounting pressure this week to confront an issue voters consistently cite as a top concern: rising costs for health care, groceries and housing. The White House has scheduled an event in Pennsylvania focused on affordability, but congressional action and a coherent administration strategy remain uncertain.

Immediate Stakes: ACA Subsidies and Millions at Risk

The Senate could vote as soon as this week on whether to extend enhanced Affordable Care Act (ACA) subsidies as part of the deal that ended last month’s government shutdown. If Congress does not act, millions of enrollees could see premiums spike — a KFF analysis found average monthly premiums could jump from about $888 to $1,904 next year — forcing many to choose between unaffordable coverage and going without insurance.

Republican Split

GOP lawmakers are divided. Some favor a temporary extension to buy time for a replacement plan; others demand reforms before they will back more subsidies. Speaker Mike Johnson’s narrow House majority has little appetite for rescuing a law many Republicans oppose, complicating prospects for a bipartisan solution.

“Every bill we bring to the floor should be focused on lowering the cost of living for people who need it most,” said Rep. Brian Fitzpatrick, a vulnerable Republican in the 2026 midterms.

White House Messaging Vs. Voters’ Reality

President Trump continues to describe the economy as a “golden age,” declaring at the National Christmas Tree lighting that “our economy is thriving, inflation has stopped, our nation is strong.” Yet polling tells a different story: a recent CNN/SSRS poll found 61% of Americans say Trump’s policies have worsened economic conditions, and a CBS survey put approval of his handling of the economy at just 36%.

The administration has taken targeted steps — notably cutting import duties on staples such as coffee and bananas — but critics say such measures are limited and that broader policies may be exacerbating price pressures. Inflation, which Trump says he has halted, recently ticked up to 2.8%, undercutting the claim that price increases have ended.

Health Care: The Political and Practical Conundrum

Health care is the most immediate front of the affordability crisis. Democrats highlighted the subsidy issue during the shutdown fight because its repeal would have direct political consequences for Republicans: millions of voters rely on ACA help. Utah Sen. John Curtis encapsulated the dilemma: extending temporary fixes without structural reform is politically risky, but leaving subsidies to expire will cause immediate harm.

Critics also say the White House has failed to present a serious, actionable blueprint for the insurance market. Suggestions such as expanding health savings accounts have received limited political investment, and a White House proposal to extend subsidies was recently pulled back amid GOP opposition.

Political Stakes Heading into 2026

The split between the president’s upbeat messaging and many Americans’ lived experience creates political exposure for both the administration and vulnerable Republican lawmakers ahead of the 2026 midterms. Democrats are preparing to use rising costs — especially health care premiums — in targeted campaign messaging to swing-seat voters.

Whether Congress moves this week, and whether the White House softens its rhetoric to acknowledge the problem, will affect both immediate household budgets and broader political calculations. Affordability has become a defining issue that incumbents must address with credible, timely policies — not just branding.