The 2026 campaign has already kicked off, with ads focused on Medicaid, Trump tax cuts

By Helen Coster and James Oliphant

NEW YORK (Reuters) -Residents of Columbus, Indiana awoke last week to a yellow billboard purchased by the Democratic National Committee blaring: “Under Trump’s Watch, Columbus Regional Health is Cutting Medical Services."

Meanwhile, the National Republican Congressional Committee, which oversees races for the U.S. House of Representatives, this month launched a digital ad campaign touting President Donald Trump's tax cuts and blaming Democrats for spiking inflation.

As members of Congress return to their home districts for the August recess, the Democratic and Republican parties are launching ad blitzes centered around the tax-cut and spending bill Trump signed into law on July 4, in an unofficial start to the 2026 midterm election campaign.

Democrats are focusing their message around access to healthcare, three party operatives and three officials from allied groups told Reuters. Republicans are countering that the tax provisions will put more money in voters’ pockets – particularly wage workers and seniors, four party operatives said.

The bill makes permanent Trump's 2017 tax cuts and funds his immigration enforcement crackdown, while reducing health care and food aid.

It devotes $170 billion to immigration enforcement while cutting $1.1 trillion from Medicaid and other public health programs and $186 billion in food assistance.

The nonpartisan Congressional Budget Office estimated that 10 million people would lose their health insurance by 2034 as a result of the bill, and that the tax provisions and increased immigration and military spending would increase the federal deficit by $3.4 trillion over the next decade.

"How voters feel about Trump and the economy may be the most important factor next fall - but so is how voters feel about the Republican response to their concern," said Jacob Rubashkin, a nonpartisan analyst with Inside Elections.

Republican strategists concede that Democrats, who campaigned against the bill while it was working its way through the Republican-controlled House and Senate, are starting with an upper hand in messaging around the legislation. But they say they have plenty of time to sell the bill’s benefits.

"We will use every tool to show voters that the provisions in this bill are widely popular,” said Mike Marinella, a spokesman for the NRCC.

And the party has a cash advantage. The RNC had $81 million in cash at the end of June, according to Federal Election Commission data, compared to the DNC’s $15 million during the same period. The DNC has trailed the RNC in fundraising in the first half of the year at the same time as it has deepened its financial commitments, spending in every state, FEC disclosures show.

The RNC also enjoys a huge asset in a sitting president who is still holding fundraisers for big-ticket donors.

“At the end of the day, Democrats got a jump start on messaging,” said a Republican Senate operative who asked to remain anonymous to discuss party strategy. “They have won the battle. Now we have to focus on winning the war.”

Republicans can only afford a net loss of two of the 220 seats they hold in the House to maintain control. In the Senate, they have a 53-47 advantage.

"CRITICAL OPPORTUNITY"

The messaging battle, largely focused on battleground states and districts, is key to defining the bill in the minds of voters.

“The bill is currently unpopular, and there's been a lot of conversation among Republicans about how to refocus on the more popular aspects and use the upcoming recess to sell the bill to skeptical voters,” Rubashkin said.

According to a Reuters/Ipsos poll, conducted last month as the bill was moving through Congress, some 64% of registered voters oppose cuts to Medicaid and food stamps in return for lower taxes for everyone.

Democrats are seizing on that sentiment, pushing the idea that Republicans have taken away healthcare to pay for tax giveaways for billionaires. The DNC has purchased billboards in a handful of Republican districts facing reduced services and shutdown of rural hospitals and health facilities.

“Republicans threw working families under the bus to fund tax cuts for the wealthy, and we’ll never let them — or voters — forget that,” said DNC Deputy Communications Director Abhi Rahman in a statement to Reuters. “This will define the midterms.”

Republicans say the bill's provisions on tips, overtime and Social Security show the party is focused on issues affecting working families. They also point to a $50 billion fund the bill establishes to help rural hospitals.

In a memo earlier this month, the National Republican Senatorial Committee encouraged candidates to talk about the bill in personalized terms, highlighting “service industry workers who will keep more of their hard-earned tips,” “first responders and critical workers who will keep more of their overtime pay” and “working parents and caretakers who benefit from increased tax credits for child and dependent care.”

Another Republican strategy memo prepared by Tony Fabrizio and David Lee, Trump's pollsters, urges candidates to "lead on kitchen-table issues."

The memo was commissioned by One Nation, a super PAC that last week launched a $10-million-plus TV and digital ad blitz playing up the tax features of the bill. The ads will air in states like Georgia and Texas where Republicans are defending seats.

Another Republican PAC, Americans for Prosperity, the conservative advocacy group founded by Charles Koch and the late David Koch, will launch a TV and digital ad campaign in key districts next month, said Bill Riggs, a spokesperson for AFP.

And the American Action Network is running TV and digital ads in 29 battleground congressional districts in Arizona, California, New York and Pennsylvania, emphasizing tax cuts and border security.

"It's a new America, full of hope, thanks to President Trump and House Republicans," the ad intones.

'TRUMP TAX'

Democrats, meanwhile, are trying to tie Medicaid cuts to reduced healthcare access and higher costs.

The DNC’s Trumptax.com website claims that the bill will "cost the poorest 10% of households $1,600 a year while raising the income of the richest 10% of Americans by $12,000 a year."

Unrig Our Economy, a left-leaning outside group focused on populist economic messaging, is running ads in Iowa, Arizona and Pennsylvania depicting voters voicing frustration at their Republican lawmakers for voting for Trump's bill.

“I’m so angry that Congresswoman Mariannette Miller-Meeks just voted for the largest cut to Medicaid in history to give tax breaks to billionaires,” said one ad running in Iowa, featuring a Davenport resident identified as Maria.

The group plans to spend $7 million by the end of the year, according to spokesperson Kobie Christian.

On Monday the group launched a “multi-million dollar” ad campaign focused on the Medicaid cuts in four Texas congressional districts.

Protect Our Care, a left-leaning healthcare advocacy organization, said it plans to spend up to $10 million on ads in the first half of next year, largely focused on urging Republican lawmakers to restore funding to Medicaid.

“Republicans won’t be able to spin their way out of their parents being kicked out of a nursing home,” said Brad Woodhouse, the group's executive director.

Environmental groups are also targeting the bill's rollback of clean energy incentives.

Climate Power and the League of Conservation Voters spent $500,000 on an ad pressuring lawmakers in six congressional districts to vote against the bill, claiming that it will increase electricity rates, according to League of Conservation Voters President Pete Maysmith.

“The bill just happened, so let’s start communicating with people when it’s fresh and happening,” said Maysmith. “We don’t want to show up later and try to pick up that conversation.”

(Reporting by Helen Coster in New York and James Oliphant in Washington. Additional reporting by Jason Lange in Washington. Editing by Paul Thomasch and Suzanne Goldenberg.)