Spend enough time around Kansas coffee shops, grain elevators or school board meetings and you’ll hear a familiar complaint: politicians spend a lot of time talking about issues that make headlines, but not enough time talking about the problems people actually face.

A new KFF/AP Rural Voters Survey suggests that rural voters across the country feel much the same way. While national political debates often focus on immigration, abortion, guns or the latest partisan controversy, rural voters say their biggest concerns are far more practical: the cost of living, health care expenses and the availability of medical care in their communities.

That should sound familiar to Kansans.

The survey found that the cost of living is the top issue rural voters want candidates to address. 75% of rural voters rate the cost of living in their community as either “fair” or “poor,” representing a dramatic increase (50%) from a similar survey conducted in 2017. Among household expenses, rural voters identify health care costs and gas prices as some of their greatest concerns.

Health care deserves particular attention because it sits at the intersection of two major concerns: cost and access.

The survey found that rural voters view health care as a major election issue and express significant frustration with current conditions. 54% disapprove of the president’s handling of health care, and by more than a two-to-one margin (37% vs. 15%), rural voters say recent federal health care changes under the Trump administration have worsened health care costs and access to medical care in their communities–though most are unaware that future cuts to Medicaid were approved under the “One Big Beautiful Bill.” At the same time, many rural voters say they trust neither political party to address the cost of health care effectively.

For Kansas, these concerns are hardly abstract.

Many rural communities face physician shortages, hospital staffing challenges and long travel distances to specialists. Even where local hospitals remain open, recruiting doctors and nurses remains difficult. For many rural families, the issue is not simply insurance coverage but whether affordable care is available nearby.

The political implications are significant.

The survey shows that rural voters continue to lean Republican, and Republicans maintain an advantage over Democrats on many issues. Yet the data also reveal something more nuanced. Rural voters are not necessarily enthusiastic about current conditions, and many express dissatisfaction with the economy. The survey found that economic frustration may even be dampening turnout enthusiasm among some Republican voters heading into the midterm elections. While 74% of rural Republican voters say they are “absolutely certain” to vote, that figure drops to just 59% among Republicans who disapprove of President Trump’s handling of the economy.

In other words, rural voters are not abandoning their values or switching parties en masse. They are asking whether elected officials are delivering results.

Political scientists call this retrospective voting: citizens judge elected officials based on whether conditions in their lives are improving. When voters perceive improvement, incumbents benefit. When they do not, incumbents often pay a political price regardless of party.

The new survey suggests many rural Americans are asking exactly that question. Despite receiving enormous political attention every election cycle, many continue to feel squeezed by rising costs and uncertain economic conditions.

Kansas politicians should pay attention.

Rural communities do not need another round of symbolic battles designed to generate social media engagement. They need policies that make health care more affordable, strengthen rural hospitals, improve access to doctors and help families manage the everyday costs of living.

The lesson from this survey is straightforward. Rural voters are not asking politicians to become less conservative or more liberal. They are asking them to focus on practical problems that affect daily life.

In 2026, the candidates who understand that distinction may be the ones who earn rural voters’ trust. The ones who ignore it may discover that political loyalty has limits when the bills keep rising.

— Alexandra Middlewood is an associate professor and chair of the Political Science Department at Wichita State University.