Republicans are running health care ads in the districts where they voted to cut Medicaid

Health care is back in the middle of a midterm campaign, and the notable part is who is putting it there.

An NPR review of YouTube video ads running this cycle found Republicans in competitive races making health care a central message, months after voting for the One Big Beautiful Bill Act, which tightened insurance requirements and reduced funding for state health programs. The ads cluster around three themes, aimed largely at voters over 35: fraud in Medicaid, the survival of rural hospitals, and the price of care.

Who is running them

Rep. David Valadao, whose Central Valley district NPR describes as a toss-up, has run ads promising to lower costs and protect Medicare and Medicaid, NPR reported. He voted for the law.

Rep. Mike Lawler of New York, also in a toss-up seat, has run ads on Medicaid changes, saying the law reduced the number of able-bodied people in the program. NPR's review found that Lawler also made a false claim in his advertising, that people in the country illegally can no longer receive benefits.

Sen. Susan Collins of Maine has advertised the $190 million she directed to rural hospitals in her state. Rep. Ashley Hinson of Iowa, now running for the Senate, and Rep. Mariannette Miller-Meeks, a physician in a toss-up Iowa district, have both built affordability messages that place the blame on insurers and drug companies rather than on Washington.

What the law did

NPR's account of the legislation is specific: stiffer insurance requirements, reduced funding for state programs, and $137 billion in Medicaid cuts falling directly on rural areas. About 10 million fewer people are expected to have health insurance in 2034. Roughly 3 million fewer people were enrolled through the insurance exchanges in early 2026 than before. Premiums on the Affordable Care Act marketplaces rose 21.7 percent nationwide between 2025 and 2026.

Those are the numbers the ads are running alongside, not against.

The case each side is making

Republicans are not, in these ads, arguing that the cuts were good. They are arguing about a different set of facts: that the program contained fraud and waste worth removing, that work requirements for able-bodied adults are a reasonable condition, that money was directed to rural hospitals, and that the real driver of household health costs is the insurance and pharmaceutical industries. NPR quoted no Republican official responding directly to the criticism; the ads themselves are the party's public answer.

Democrats' argument is the juxtaposition: that a member who voted to reduce a program cannot credibly campaign on protecting it.

The polling explains the strategy on both sides. Kaiser Family Foundation surveying in April found only about a third of voters approve of the Trump administration's handling of health care costs, NPR reported. But KFF also finds Republicans outperforming Democrats specifically on addressing fraud and waste in government health programs, and about a third of independents saying they trust neither party on health care.

That is a map, not an accident. It shows the one piece of the health care argument Republicans are winning, which is the piece their ads are built on, and a large bloc of unattached voters that neither party has convinced.

The timing

The deepest effects land after November. NPR reported that the most significant changes take effect later, which means most voters will cast ballots before feeling them. Whether that is a reprieve or a delay is the wager both parties are making.