Democrats are banking on backlash to Republicans’ Medicaid cuts to boost them in next year’s midterms. There’s just one problem: The cuts haven’t happened yet.

Republicans delayed work requirements until 2027 and financing changes until 2028. They also frontloaded their One Big Beautiful Bill Act with tax breaks that voters are likely to see sooner.

“If we say ‘they took it from you,’ but it hasn’t happened yet, it just complicates it,” said California-based Democratic strategist Doug Herman.

That’s leaving some Democrats concerned that their Medicaid-focused messaging might not hit home before November 2026 — and blunt their efforts to use the backlash to President Donald Trump’s signature legislative achievement to fuel a Democratic wave next year.

“I do [worry about it],” said Cherlynn Stevenson, a former Kentucky state representative running for the congressional seat being vacated by GOP Rep. Andy Barr. “I think that there are some people who are like, ‘Well, I’m not on Medicaid, so it’s not going to affect me.’”

But Democrats are still forging ahead with making Republicans’ Medicaid reductions a central theme of their midterms messaging. Many have already dusted off the playbook they deployed in the 2018 midterms, when Democrats picked up dozens of House seats after running against Republicans’ near-repeal of the Affordable Care Act and massive tax cuts. This cycle, Democrats have eyed redder seats in Kentucky, Florida and Virginia as they try to push into GOP-held territory.

That’s in part because, though most of the pain was put off as long as possible, some of the effects — like on rural hospitals that have to budget on longer timelines — could be felt sooner.

The seat Stevenson is aiming to win in rural Kentucky has a half-dozen hospitals that could potentially face funding disruptions that serve nearly 200,000 Medicaid enrollees. Democrats are embarking on a series of roundtables in the state to discuss the ramifications of Republicans’ health care cuts. But they know the effects will be more tangible if the cuts were already here.

“We will need to remind voters that the impact is going to kind of come in waves, and that a lot of the brunt of the damage won’t be felt until next year, or even after the midterms,” Stevenson said. “We just will have to remind them that provisions of the bill are still coming, that deadlines are looming.”

But the bulk of the health care cuts Republicans built into their megabill — including reductions to the so-called provider tax many states use to help fund their Medicaid programs and new work requirements that could cost millions of people their coverage — won’t kick in until after the midterms.

Republicans have signaled they’ll use the popular parts of the legislation like a tax deduction on tips to go on offense against Democrats.

NRCC spokesperson Mike Marinella said Democrats were using “desperate and disgusting fear-mongering tactics” and added the GOP would “use every tool to show voters that the provisions in this bill are widely popular.”

Polling shows voters are receiving mixed messages on Medicaid. A tracking survey from nonprofit health policy group KFF shows 63 percent of independents said they believe the bill will strip health care coverage from people who need it, but they also broadly support adding work requirements to the program.

“If Republicans are able to characterize these changes as simply fraud and waste, there may not be as drastic political implications,” said Ashley Kirzinger, associate director of KFF’s Public Opinion and Survey Research Program.

Another potential pitfall for Democrats: States use different names for the Medicaid programs — Medi-Cal in California, SoonerCare in Oklahoma, Health First Colorado — that could leave some voters unaware that the cuts are from national Republicans.

Democrats will get a trial run for their Medicaid messaging in this year’s gubernatorial races in New Jersey and Virginia.

Rep. Mikie Sherrill, New Jersey Democrats’ nominee to succeed term-limited Democratic Gov. Phil Murphy, has attacked her opponent for being “fully on board” with Republican cuts, and argued that New Jersey is “the first chance to hold them accountable at the ballot box.” Laura Matos, a Democratic strategist in New Jersey, noted that Republicans are “counting on people not paying attention” to the impact of the bill, but also warned Democrats not to get too bogged down in national issues.

“For Mikie, it’s this nebulous thing,” she said. “You can talk about national issues, but what she really needs to do is pivot to the things she’s going to do here to improve affordability and quality of life.”

But other Democrats are brushing aside concerns that voters won’t register the impacts of the bill, pointing to substantial news coverage of its cuts to Medicaid and the more immediate changes to Affordable Care Act tax credits that could dramatically increase some Americans’ health insurance costs.

“It’s the same cynical backdoor bullshit that we always see in Washington,” said Rebecca Cooke, who’s running in a purple district in Wisconsin. “The message, honestly, is going to be coming from voters themselves as these cuts hit.”

Republicans may also tweak their Medicaid language before it’s fully implemented. Some GOP lawmakers who voted for the megabill are already pushing to stop some of the harsher provisions — like changes to the provider tax that could have an adverse effect on rural hospitals — from taking effect.

“If Republicans don’t want to be accused of cutting Medicaid, it’s probably a good idea not to cut Medicaid,” Sen. Josh Hawley (R-Mo.) said Wednesday at the Capitol.

But Democrats are committed to hammering Republicans over the vote no matter what.

“People are not stupid,” said former Iowa State Rep. Christina Bohannan, who’s mounting a rematch. “People are aware of what’s going on, and so we just have to make sure that people understand what’s going to happen here, and to hold people accountable for these votes.”