The United States is heading into a closely watched election day, with inflation, immigration and healthcare dominating the final contest between Republicans and Democrats.
The November 3 midterm elections will decide control of the House of Representatives and Senate, making the results particularly important for President Donald Trump and his administration. Republicans are working to hold on to their congressional majorities, while Democrats are focusing their campaigns on the rising cost of living, access to healthcare and opposition to the administration's immigration policies.
Economic concerns have become a major challenge for the White House. While employment and overall economic growth have remained relatively strong, many Americans continue to struggle with expensive groceries, fuel, housing and higher borrowing costs.
A Gallup survey published on October 29 found that 50% of registered voters considered the economy extremely important when deciding how to vote. Healthcare received the same rating, while 40% said immigration was extremely important.
The election has therefore become more than a battle for congressional seats. It is also a test of public confidence in Trump's second-term leadership and his administration's approach to domestic policy.
INFLATION AND RISING LIVING COSTS TOP VOTER CONCERNS
Affordability has become one of the strongest themes of the final campaign.
Democratic candidates have made household expenses a central part of their message, arguing that families are still struggling with high grocery bills, fuel prices, rent, utility costs and other everyday expenses.
Republicans have defended their economic record, pointing to employment figures and economic growth. They argue that their tax and investment policies will deliver longer-term benefits to American households.
However, strong economic indicators have not necessarily translated into greater public confidence. Many voters are judging the economy based on what they pay at supermarkets, petrol stations and when managing their monthly bills.
A Reuters report published on November 2 highlighted continuing dissatisfaction with the economy despite relatively resilient employment and growth figures. Tariffs and the prolonged conflict involving Iran have also contributed to concerns about rising costs, particularly through their impact on energy markets.
Higher borrowing costs have added to the pressure. Mortgage rates above 7% have made buying a home increasingly difficult for many Americans.
For voters, the key question is straightforward: are their incomes keeping pace with the cost of living?
IMMIGRATION EMERGES AS A MAJOR POLITICAL DIVIDE
Immigration remains one of the most divisive issues in the election, with Republicans defending Trump's tougher border policies and Democrats questioning the administration's deportation approach.
Republican candidates have argued that stronger border controls, tougher enforcement and action against illegal immigration are necessary to protect national security and restore order to the country's immigration system.
Democrats, meanwhile, have raised concerns about large-scale deportations, family separations, detention conditions and the treatment of migrants. Several candidates have called for stronger legal protections and clearer pathways for eligible immigrants.
Gallup's October survey found that 40% of registered voters considered immigration extremely important to their congressional vote. The issue was particularly significant among Republican voters, 44% of whom gave it the highest importance rating. The figure stood at 41% among Democrats.
The numbers show that immigration is an important concern for voters across party lines, even though Republicans and Democrats have sharply different views on how the government should address it.
HEALTHCARE COSTS PUT BOTH PARTIES UNDER PRESSURE
Healthcare has also become a major campaign issue, particularly as Americans face rising insurance premiums, prescription drug prices and medical expenses.
Democrats have placed affordable healthcare access at the centre of their campaign, arguing that families need stronger protections against rising costs. They have also criticised Republican proposals that they believe could reduce coverage or place additional financial pressure on vulnerable households.
Republicans have focused on market competition, reducing government spending and giving consumers more choices. They argue that meaningful healthcare reform requires addressing the underlying costs of the system rather than relying primarily on increased federal funding.
Gallup found that 50% of registered voters considered healthcare extremely important to their midterm decision, putting it level with the economy.
The issue is especially important among Democratic voters. Around 68% rated healthcare extremely important, compared with 34% of Republicans and 48% of independents.
These figures suggest healthcare could help mobilise Democratic voters, while independent voters may prove particularly important in closely contested congressional races.
TRUMP DEFENDS HIS RECORD AS DEMOCRATS CHALLENGE HIS POLICIES
Trump has spent the final days of the campaign defending his administration's performance and urging Americans to support Republican candidates.
The President has highlighted border enforcement, economic growth, tax policies and his broader domestic agenda. Republican candidates have also warned that Democratic proposals could lead to higher government spending and increased regulation.
Democrats have taken a different approach, concentrating on household expenses and the economic consequences of the administration's trade and foreign policies.
The ongoing conflict involving Iran has added another complication. Higher energy costs have intensified concerns about inflation, giving Democratic candidates an opportunity to question the administration's handling of international affairs and its impact on American households.
An Associated Press report published during the final campaign period noted that Democrats were focusing heavily on high prices and the Iran conflict, while Republicans were attempting to portray their opponents as too extreme.
Both parties are now trying to convince voters that their policies offer a more convincing response to the economic and security challenges facing the country.
GALLUP POLL HIGHLIGHTS THE ISSUES THAT MATTER MOST
A Gallup survey conducted between October 1 and 19 offers a snapshot of the concerns shaping the final election debate.
Issues rated extremely important to voters in the 2026 midterms:
Economy: 50%
Healthcare: 50%
Iran: 47%
Income inequality: 44%
Gas prices: 42%
Immigration: 40%
Abortion: 38%
Source: Gallup survey of registered voters, October 1–19, 2026.
The findings suggest that voters are weighing several connected concerns rather than focusing on just one issue.
Economic pressure remains a major priority, but healthcare and international developments are also attracting considerable attention. Immigration continues to divide voters, while gas prices and income inequality add to wider concerns about affordability.
The survey also points to changing priorities among Democratic voters. Compared with 2022, more Democratic voters now consider the economy and immigration extremely important, reflecting the shift in political priorities that often follows a move into opposition.
For Republicans, immigration remains a leading concern alongside crime and the economy.
CONTROL OF CONGRESS HANGS IN THE BALANCE
The campaign is reaching its conclusion amid a closely contested battle for control of Congress.
All 435 seats in the House of Representatives and 35 Senate seats are being contested. Republicans are defending narrow majorities in both chambers, while Democrats are hoping to win enough seats to change the balance of power in Washington.
Reuters reported on November 3 that Democrats were favoured to regain the House, although the Senate contest remained uncertain.
A Democratic victory in either chamber would give the opposition greater influence over congressional investigations, federal spending and legislative negotiations. It could also make it more difficult for Trump to secure approval for key policy proposals and appointments.
If Republicans retain control of both chambers, the administration would have a stronger congressional position from which to pursue its legislative agenda.
Although Trump's presidency is not directly on the ballot, the election represents an important test of his political standing and the public's response to his second-term policies.
RISKS AND KEY ISSUES TO WATCH
Persistent inflation: Continued pressure from food, housing, fuel and other household expenses could weaken confidence in the administration's economic record.
Immigration enforcement: Deportation policies and border security measures could influence voters differently across Republican, Democratic and independent constituencies.
Healthcare affordability: Insurance premiums, prescription drug prices and federal healthcare funding could become decisive issues in closely contested races.
Energy-market uncertainty: The conflict involving Iran and wider international tensions could keep fuel prices elevated and add to inflation concerns.
Political polarisation: Differences over immigration, abortion and healthcare could deepen divisions between the two parties.
Congressional gridlock: A divided Congress could complicate budget negotiations, healthcare legislation and other major policy decisions.
WHAT TO WATCH NEXT
Election turnout: Participation among independent, younger and suburban voters could influence the outcome of competitive races.
House results: Democratic gains could change control of the chamber and increase congressional scrutiny of the Trump administration.
Senate battlegrounds: Closely contested statewide races will determine whether Republicans retain their majority.
Healthcare policy: The next Congress will face continued pressure to address insurance affordability and federal healthcare spending.
Immigration legislation: The election outcome could shape future debates over border security, deportations and immigration reform.
Economic response: The administration's next steps on inflation, fuel prices and household affordability will remain under close scrutiny.
FACT CHECK METER
Editorial confidence: 98%
Strongly supported by the cited Gallup, Reuters and Associated Press reporting.
Confirmed details
The 2026 US midterm elections are scheduled for November 3.
The economy and healthcare were each rated extremely important by 50% of registered voters in Gallup's October survey.
Immigration received an extremely important rating from 40% of respondents.
Control of Congress is at stake in the elections.
Economic dissatisfaction and the Iran conflict have featured prominently in final campaign messaging.
Important distinctions
Polling reflects voter priorities, not the final election outcome.
Economic concerns do not mean every US economic indicator is deteriorating.
Immigration and healthcare proposals vary between candidates and political parties.
The midterm elections determine congressional control, not the presidency.
AWX VERDICT
Inflation, immigration and healthcare have emerged as defining issues in the final days of the 2026 midterm campaign. Rising living costs are creating an opening for Democrats, while Republicans continue to emphasise border security, economic performance and their wider policy agenda.
The results will show which party has done a better job of connecting with voters on the issues that matter most to them.
THE AWX BOTTOM LINE
The 2026 US midterm elections have become a major test of public opinion on the economic and social challenges facing American households.
Rising living costs are putting pressure on family budgets, immigration remains a sharp political dividing line, and healthcare affordability continues to influence voters across the country.
For Republicans, the challenge is to defend Trump's record and hold on to congressional control. For Democrats, the opportunity lies in turning public frustration into meaningful electoral gains.
The outcome will determine more than the balance of power in Washington. It will also offer an indication of what Americans expect from their political leaders during the next two years.
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