San Francisco, California – Three words stretch across the front page of Richard Pan’s campaign website: “Public Health Hero”.

The California paediatrician is part of a wave of public health professionals angling for a seat in the United States Congress in Tuesday’s midterm elections.

The American College of Gastroenterology has estimated that as many as 25 physicians could win congressional office this election cycle, a record number that would usher in “a new generation of physician-lawmakers”.

But while many of the incumbents are Republicans, experts say there has been a notable rise in the number of Democratic doctors and healthcare workers on the ballot.

Some are competing in the highest-profile races of the year. Abdul El-Sayed, a physician and former public health official, is locked in a close race for Michigan’s open Senate seat.

In South Carolina, meanwhile, paediatrician Annie Andrews has turned what would normally be a safe Senate seat for Republicans into a battleground.

Experts and advocacy groups credit the growing number of Democratic doctors-turned-politicians, in part, to frustration with Republican President Donald Trump.

Democrats, they say, are tapping into public rage not only over rising healthcare costs but also Trump-era policies they see as anti-scientific.

“Scientists themselves have woken up. We cannot just abandon the public forum to all of this misinformation, disinformation,” said Eric Feigl-Ding, an epidemiologist who founded Vax PAC, a political advocacy group that backs candidates who support responsible vaccine policies.

Feigl-Ding sees the surge in political participation not as an act of partisanship but rather as a chance to advocate for responsible healthcare policies.

“It’s not like public health is rolling up our sleeves and getting dirty in the pigsty,” Feigl-Ding said. “What public health is doing is immunising ourselves against politics.”

An increasingly divisive issue

While the pocketbook issues consistently rank as the top priority for American voters, healthcare remains a prevailing concern.

A Pew Research Center poll on October 8 identified healthcare as the third most important election issue for Americans, behind the economy and the future of US democracy.

Democrats, in particular, were more likely to rank healthcare high among the factors swaying their votes. Eighty-two percent said it was a very important issue, compared with 53 percent for Republicans.

The politicisation of healthcare isn’t new, but it has evolved, according to Matt Motta, a policy expert at Boston University’s School of Public Health. He describes the issue as more divisive than it has been in the past.

“Health has always been political, but health hasn’t always been partisan,” Motta told Al Jazeera. “Our health has become increasingly polarised along partisan lines.”

One of the early instances of that fracture came in the 1994 midterm election cycle. In the year leading up to the race, the administration of Democratic President Bill Clinton had pushed Congress for healthcare reform.

But Republicans like Representative Newt Gingrich framed that effort as “socialism”. The right-wing party ultimately flipped both chambers of Congress that year, in a midterm race dubbed the “Republican Revolution”.

Another major milestone was the passage of the Affordable Care Act (ACA) in 2010, under Democratic leader Barack Obama.

Ever since, healthcare has played a defining role in nearly every midterm following the election of a new president, according to Motta.

During the 2010 midterms, for instance, Republicans ran in opposition to the newly passed Affordable Care Act. Then, in the 2018 midterms, after Trump’s first election, Democrats campaigned against his efforts to roll the Affordable Care Act back.

Later, in the 2022 race, restrictions related to the COVID-19 pandemic gave Republicans fuel to attack a new Democratic leader, then-President Joe Biden.

A backlash to MAHA?

This time around, however, Trump is back in the midterm crosshairs. The news agency Reuters and the research firm Ipsos found in late October that his approval rating has slumped to a record low of 31 percent.

As a candidate for the presidency in 2024, Trump had courted voters sceptical of the American healthcare system.

Confidence in doctors and public health researchers had been on the decline since the COVID-19 pandemic. Trump tapped into that trend by recruiting vaccine sceptic Robert F Kennedy Jr to join his campaign.

Kennedy rallied supporters under the banner “Make America Healthy Again” or “MAHA” — a variation on Trump’s “Make America Great Again” slogan.

In turn, Trump promised to let Kennedy “go wild on health” if he were returned to office. Shortly after his re-election, Trump announced Kennedy as his pick for health and human services secretary.

Since the start of Trump’s second term, Kennedy has pushed to minimise federal vaccine guidelines, bucking scientific consensus.

He has also championed cuts to agencies such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).

Trump, meanwhile, rallied Republicans to pass the One Big Beautiful Bill Act last year, which resulted in more than $1 trillion in cuts to healthcare spending.

As part of that bill, Republicans allowed health insurance subsidies to expire, resulting in higher premiums for millions of Americans.

The new crop of Democratic doctors-turned-candidates is “trying to capitalise on how frustrated most people are with these decisions”, Motta said.

In South Carolina, for instance, Andrews — the paediatrician turned Democratic Senate contender — has pointed to her state’s measles outbreak as evidence of the failure of Trump’s health policies.

An estimated 997 cases were reported in the state between 2025 and 2026.

“We are flirting with the return of an old killer, not because the science changed, not because the virus itself changed, but because our politics did,” Andrews wrote in a February column about the outbreak.

“At the highest levels of our federal government, we have watched medical expertise get shoved aside while conspiracy theories get promoted.”

In Michigan, meanwhile, El-Sayed touted his health credentials by pointing to a recent uptick in cyclospora, a diarrhoea-inducing parasite that can be spread through fresh produce, such as lettuce.

“If I were elected, I would be the first Democratic doctor elected to the US Senate in nearly 50 years,” El-Sayed said at a campaign stop in September.

“If you’re kind of tired of dodging lettuce in the United States of America, I think we all could agree we probably need a public health senator right about now.”

He and other Democrats have blamed the parasite’s spread on the federal government’s reduced capacity to inspect food, as a result of Trump’s budget cuts.

‘How many times in history?’

Currently, the majority of the doctors serving in Congress are Republicans, including all four physicians previously elected to the Senate.

But those party dynamics may shift. One high-profile Republican doctor, Senator Bill Cassidy, is stepping down. Others, such as Senator Roger Marshall of Kansas, are facing uncertain odds for re-election.

Meanwhile, at least five Democratic newcomers with medical degrees are aiming to join the 120th Congress after November’s midterm election.

At least 10 Democratic nurses are making a bid for Congress this year too, compared to four Republicans, according to the publication Nurse.org.

Not every healthcare professional on November’s ballot shares the same view on healthcare policy, though.

In South Carolina, Andrews told NewsNation that “Medicare for All” — a proposal for universal public healthcare — is an “outdated, non-pragmatic policy”.

El-Sayed, by contrast, is a strong proponent of the policy, having co-written a book called Medicare for All: A Citizen’s Guide.

The US has one of the costliest healthcare systems of any high-income country in the world, and affordability has been a common feature in many of the Democratic doctors’ campaigns.

Andrews, for instance, has dubbed her political agenda the “Patients and Prices Platform”, and she travelled around her state on a similarly named tour.

US Representative Ami Bera, a California Democrat who is also a doctor, told Al Jazeera that the country is at a key juncture to decide the future of its healthcare system.

Bera is running for re-election in the midterms, in part based on the belief that doctors and patients should be at the centre of that discussion, as opposed to mere costs.

“Let’s not talk about reimbursement. Let’s talk about why we went to medical school — we want to care for our patient,” Bera said.

“Doctors who have practised, have been in the exam room, in the OR (operating room) have a unique perspective on patient care. They bring that unique perspective to Congress.”

Bera helped form the Democratic Doctors PAC this year to help boost healthcare as an election-season cause.

Other health-inspired groups have likewise poured money and resources into the race. The pro-science advocacy group 314 Action reported in October that it had spent nearly $30m on this year’s midterms.

But Bera expressed optimism that healthcare would ultimately not be seen as a single-party issue or a source of partisan divide.

“Up until this moment in time, that is what the conversation’s been, right? Democrats defending the Affordable Care Act, Republicans attacking the ACA,” Bera said. “I think it’s such a crisis moment that it’s opened up the opportunity to think about the ‘what next’?”

Feigl-Ding, the founder of Vax PAC, also believes this midterm election cycle is a moment of opportunity.

He pointed to the recent Democratic primary victory for Amy Acton, the former director of the Ohio Department of Health, now running to be the state’s governor.

Acton is leading her Republican opponent going into Tuesday’s vote by 7 percentage points, according to a recent Marist University poll. Feigl-Ding described that result as historic.

“If you think about it, how many times in history does a health director run for governor and win the primary, and is now slated to potentially win the governor’s race?” Feigl-Ding asked.