Voters were highly concerned about health care, according to preliminary exit polls on Tuesday, with more citing it as their top concern than the economy or any other issue — the first time in at least a decade that has happened.

A plurality of 41 percent identified health care as the issue most important to their vote, which Democrats made the centerpiece of their campaign in races throughout the country.

Asked which party would better address Americans with pre-existing conditions, 58 percent said Democrats versus 34 percent who said Republicans.

The White House, Republican state officials, Republicans in Congress had repeatedly sought to eliminate or roll back protections for pre-existing conditions via lawsuits and legislation, but many candidates tried to take a softer tone on the issue in the final days of the midterms.

Economy takes back seat

The set of issues voters prioritized this year looked very different than exit polls of past elections, where the economy was typically a larger focus.

Another 23 percent named immigration, which the president aggressively pushed into the national conversation over the last week, at one point producing an ad that networks refused to run for its inflammatory depiction of Hispanic immigrants as violent criminals.

The president’s handling of the issue divided voters relatively closely, with 48 percent calling them too tough, 16 percent saying they weren’t tough enough, and 32 percent saying they were just right.

In an unusual break from recent history, only 21 percent naming it as their leading concern. It was the first time in more than a decade that a plurality of voters had not named it their number one issue in exit polling and comes after weeks of positive headlines on job and wage growth.

Another 11 percent named gun policy, which became a focus of activism after mass shootings at a music festival in Las Vegas last year, a high school in Parkland, Florida in March, and a synagogue in Pittsburgh just last month.

Majority disapproves of Trump

Voters signaled their discontent with President Donald Trump's performance as well as the overall direction of the country.

President Trump’s approval rating stood at 44 percent versus 54 percent disapproval among respondents, roughly in line with public polling in the lead-up to the midterm.

There was an intensity gap between his critics and supporters as well, with a full 47 percent reporting they strongly disapproved of his performance versus only 31 percent who said they strongly approved.

Voters reported that Trump played a significant role in their midterm choices as well. About two-thirds said he was a factor in their vote, with 38 percent saying they cast a ballot to oppose his policies, 26 percent saying they did so to support him, and only 33 percent reporting that he played no role in their decision.

Country on wrong track

Voters appeared to be in a bleak mood about the state of the nation. Fifty-six percent said the country was on the wrong track, versus 41 percent who said things were headed in the right direction. That number was down from the last presidential election, however, when 62 percent said things were on the wrong track, as well as the last midterm election, when 65 percent said the same.

Across party lines, voters perceived the country’s political culture as harsh and getting harsher. 77 percent said the nation was becoming more divided, versus just 8 percent who thought it was becoming more united and 13 percent who thought it was staying the same.

Gender gap, but not a chasm

In a year that's featured a huge spike in women running for office among Democrats, the gender gap looks to be on par with prior elections. 39 percent of women said they support Republican candidates in exit polls while 50 percent of men reported supporting Republicans. That's a drop in support for Republicans among both groups since 2016, but a similar 11-point distance between them.

There was a significant gender gap in opinions of Justice Brett Kavanaugh, who was confirmed after Christine Blasey Ford testified he sexually assaulted her when they were teenagers, a charge he denied. Voters opposed his confirmation by a 48 to 43 margin in the exit poll overall, but 50 percent of men supported confirmation versus 37 percent of women.