HARRISBURG, Pennsylvania: Americans head to the polls next Tuesday (Nov 3) in closely watched midterm elections that could shift the balance of power in Washington, as rising living costs and concerns over US foreign policy weigh on voters. They will decide which party controls the House of Representatives and Senate for the next two years, in polls widely regarded as a referendum on President Donald Trump's second term.

For Republicans, who currently control both chambers of Congress, the stakes are particularly high. Losing either chamber could significantly constrain Trump's ability to advance his legislative agenda during his final two years in office.

But for many voters, the election is less about the political battles in Washington than the financial pressures affecting their everyday lives. In Pennsylvania, a key swing state that has backed the winner of the last five presidential elections, concerns over affordability, healthcare and America's involvement in overseas conflicts are shaping voter sentiment.

The state is also home to some of the country's most fiercely contested congressional races, making it an important battleground in the fight for control of Capitol Hill.

VOTERS WANT WASHINGTON TO LISTEN In Harrisburg, the state capital, residents told CNA they wanted elected officials to pay greater attention to the struggles facing ordinary Americans. "A lot of people are struggling, elders, childcare, all types of things like that.

So just listen to the people, what they really need," said one voter.

Others questioned America's involvement in conflicts abroad, arguing that Washington should focus more on problems at home.

"I care about our country.

Like, there's no other countries that are going to war for other countries.

Just sick of being world police," another voter said.

Their concerns reflect the challenges facing the Trump administration as it seeks to defend its record on the economy and foreign policy.

Trump returned to the White House in January 2025 promising to put American interests first, revive domestic industries and ease the financial burden on households.

But the war in Iran, disruptions to global energy supplies and the impact of tariffs have added to economic uncertainty, with businesses and consumers facing mounting costs.

FUEL PRICES ADD TO HOUSEHOLD PRESSURES Among those feeling the squeeze are America's truck drivers, who form the backbone of the country's freight transportation industry. Rising diesel prices, driven in part by the war in Iran and disruptions to global oil supplies, have pushed up operating expenses for drivers already grappling with tight margins.

One trucker told CNA his fuel costs had doubled, leaving him with few options to offset the increase.

"There's only so much you can do right now with what's going on overseas and stuff," he lamented. For the trucking industry, higher fuel prices can erode profits and increase the cost of moving goods across the country.

Those additional expenses can eventually be passed on to businesses and consumers, adding to the financial strain on households. In Scranton, a city in northeastern Pennsylvania with a long industrial history, businesses and non-profit organisations are also feeling the strain.

Joseph Hollander, CEO of Scranton Primary Health Center, which provides healthcare regardless of patients' ability to pay, said rising costs have put pressure on his operations.

"The cost of doing business just keeps increasing – utility costs, supply costs, with the expense of transportation increasing, since so much of what we purchase is from outside the US," he told CNA. HEALTHCARE BACK IN THE SPOTLIGHT Healthcare, an issue that has long divided American politics, is once again taking centre stage.

The Affordable Care Act, commonly known as Obamacare, expanded health insurance coverage to millions of Americans after it was enacted in 2010.

But Trump's sweeping tax and spending legislation, dubbed the "One Big Beautiful Bill", included substantial reductions in projected federal Medicaid spending, while the expiration of enhanced health insurance subsidies has renewed concerns about access to affordable medical care. Medicaid provides healthcare coverage to low-income Americans and other eligible groups, including people with disabilities.

Care worker Wanda Caroll-Russell said the potential consequences extend beyond the vulnerable people who depend on her services, to her own medical bills.

"Some of the medications I take, I won’t be able to handle it if I don’t have healthcare, because that medication is US$800," she said. "As for my client, it's going to hurt him because he will lose access to me and his home.

I really think they want us all to die."

Demonstrators protest against data centres, at the Pennsylvania state Capitol in Harrisburg, US, Oct 6, 2026.

Beyond healthcare and fuel prices, the rapid expansion of data centres has also become a source of concern in some communities, where residents have raised questions about their impact on electricity demand, health, infrastructure and local costs. A POLITICAL PRICE TO PAY?

Political analysts say mounting voter grievances could pose a significant challenge to Republicans come Nov 3. "You put all these things together and it really does develop into this really potent voter animosity to what is currently in place," said Chris Borick, professor of political science at Lehigh University.

"What's currently in place is Republican control in Washington.

And there's a price to pay for that.

And with everything I see on the ground and through metrics and data, that price might be pretty significant." Midterm elections have historically offered Americans an opportunity to express their approval or dissatisfaction with the sitting president, even though the president himself is not on the ballot.

Next week, the outcome will determine whether Republicans retain control of Congress or Democrats gain the power to challenge Trump's legislative priorities and intensify scrutiny of his administration.

In Pennsylvania, where competitive congressional races could help determine control of Washington, the political consequences of voter frustration could be particularly significant. The stakes also extend beyond the remaining two years of Trump's presidency.

The results could influence the direction of both parties as Republicans and Democrats begin positioning themselves for the 2028 presidential election.