Headlines this week captured consumer confidence reaching a 12-year low this month, and while our preferred consumer sentiment index was slightly more optimistic, there is no debating that Americans hold a dismal view of the US economy these days. The persistent mix of inflation, tariffs, slow job growth, and political instability has given consumers a lot to chew on over recent months, but one issue has risen, or perhaps returned, to become Americans’ largest cost-of-living concern: healthcare. According to KFF polling, more Americans are worried about affording healthcare than any other household expense, including food, utilities, rent or mortgage, and transportation. The expiration of the Affordable Care Act enhanced subsidies may have raised the salience of this issue, but healthcare’s unaffordability extends far beyond that relatively small slice of the population. Over half of respondents say their healthcare costs increased last year, and slightly more expect them to increase again this year. In a midterm election year, affordability is going to be a powerful political current, and healthcare affordability may be the singular issue where voters are most disappointed with their representation.