In a campaign ad that tugs at the heartstrings, Meischa Zimmerman, a former patient of Sen. Roger Marshall, R-Kansas, recounts being arrested when she was eight months pregnant for missing a $50 medical payment to Marshall, an obstetrician-gynecologist. Zimmerman is one of 700 patients Marshall sued for medical debt, according to The New York Times.
"I said, 'Please do not handcuff me in front of my two-year-old daughter,'" Zimmerman said in the commercial for Democratic Senate nominee Adam Hamilton's campaign. "Roger Marshall preyed on the low-income families of Kansas."
Marshall's pursuit of patients for unpaid bills, which resulted in 81 arrests, has become a major issue in the unexpectedly close Senate race in the Sunflower State. The 30-second
commercial has already been seen more than 1 million times on the social media platform X.
Kansas last elected a Democrat in 1932, the longest active Senate losing streak in U.S. history, but Hamilton holds a two percentage-point lead over Marshall in the latest Emerson College-Nextstar Media Kansas poll. Trump carried Kansas by 16 points in 2024. But with Trump's approval ratings sagging, even some bright-red states such as Ohio and Texas have become competitive − a situation exacerbated in Kansas by Hamilton's strengths and Marshall's liabilities.
Marshall's lawyers dispute Zimmerman's account, alleging defamation and have requested a cease-and-desist to block the ad's distribution.
Marshall's legal team said the unpaid bill was much larger than $50. "The amount sought in the collection action was $3,595. The '$50' figure appears nowhere in the case as the basis for any arrest," they wrote in a Sept. 28 letter.
"Those are common, common business practices we would go a year before we would send someone over," Marshall said in response to the Times report during a debate last month with Hamilton at the Kansas State Fair, drawing chants of "Shame on you" from the crowd. The Times reporter, Sarah Kliff, said on X that she spoke with patients who said they were sued sooner than that.
Marshall holds a "complete and total endorsement" from President Donald Trump, who has won the state three times. But concerns over the struggling economy, high gas and grocery prices, and Hamilton's name ID as senior pastor at the country's largest Methodist parish have also boosted his campaign.
Kansas has shown a willingness to vote Democratic in certain statewide races before. Although Trump has always won the state by at least 14 percentage points, Democratic Gov. Laura Kelly was elected governor in the 2018 midterms and reelected in 2022. Over the last century, several Democratic governors have served, including Kathleen Sebelius, the Obama-era Health and Human Services secretary.
Kansas was shifted from "likely Republican" to merely "leans Republican," by the nonpartisan Cook Political Report on Sept. 23.
'These are national issues'
Hamilton leads Resurrection, a United Methodist Church, in the Kansas City area. The church, the largest Methodist congregation in the country, boasts around 25,000 members and includes satellite locations in neighboring Missouri.
Hamilton and Texas state Rep. James Talarico, the Democratic Senate nominee in the Lone Star State and a Presbyterian seminary student, are a part of a group of leftist faith leaders seeking higher office across the country.
Like Talarico, Hamilton has presented himself as a moderate and infused faith into his push to unseat Marshall. Kansas Democrats hope Hamilton, a 62-year-old minister, can upset nearly a century of losses.
Bob Beatty, the political science chair at Washburn University in Topeka, said it's harder for Kansas Democrats to win Senate races than governor races because the way federal races are nationalized.
Kelly, a moderate Democrat, first won election to the governor's mansion in 2018, when she succeeded Sam Brownback, who was known nationally for his staunchly socially conservative stances such as saying he believes homosexuality is immoral due to the doctrine of his Catholic faith. Brownback previously served in the Senate, where he replaced former Senate Majority Leader Bob Dole, a stalwart Republican who was the only former GOP presidential nominee to endorse Trump in 2016 and 2020.
The billionaire Koch family, nationally known for their conservative activism, is deeply rooted in Kansas.
Former Republican Gov. Bill Graves is breaking ranks to support Hamilton and recently applauded the candidate's message of "Kansas can do better" to PBS. Graves said Marshall has been pretty much "a yes-vote" for anything the Trump administration wants but Republicans, who have also enjoyed full control in Congress, are nearing a wake-up call.
"It's like the morning after the frat party, and they're going to wake up and understand that, gee, we are having all that fun, and we might have overplayed our hand a little bit," Graves told PBS.
Kyle Kondik, the managing editor of Sabato's Crystal Ball, a nonpartisan election-forecasting newsletter run by the University of Virginia Center for Politics, said Kansas will be a close race.
"Seems like there's some weakness in farm country now. But are those folks actually willing to vote Democrat? That’s the great guess," Kondik told USA TODAY. "Hamilton could run a perfect race, and Marshall could run a horrible race, and Marshall could still win."
'Pretty weak and pretty woke:' Republicans outline Hamilton attacks
Hamilton has been a respectable fundraiser in his challenge against Marshall. He raised $1 million within four days of launching his campaign and $4 million in total, according to his most recent Federal Election Commission filings. Marshall has raised $6.2 million, according to his recent FEC filings.
But Kansas Democrats have previously raised millions of dollars and still lost. For example, Marshall beat former state Sen. Barbara Bollier by 11 points in 2020, even though Bollier, a fellow physician, raised more than $25 million.
Hamilton's website outlines policy proposals on affordability, agriculture, healthcare, corruption, housing, and labor, but steers clear of social issues such as LGBTQ rights, which have proved challenging for Democrats in red states. Among his go-to talking points, Hamilton speaks passionately about healthcare access and food security. This includes, he said, an estimated 63,000 Kansas residents who have lost their health insurance since early 2025. He attributes this drop to the expiration of enhanced Affordable Care Act (ACA) premium tax credits and Medicaid cuts.
Hamilton has also said there are an estimated 18,000 children in the state whose families no longer have Supplemental Nutrition Assistance Program (SNAP) benefits.
"That's enough to provide macaroni and cheese, and a hot dog for a kid for dinner, but we took those away from 18,000 people," Hamilton told MS NOW on Sept. 27. "I mean, folks are just looking at this and saying, 'This is not okay. This is not who we are.'"
Supporting abortion rights, which Hamilton does, is not a problem in Kansas; however, the state's voters decisively upheld the right to an abortion in the country's first state-level vote on abortion access after the Supreme Court overturned Roe v. Wade in 2022.
"I am an independent-minded, independent-thinking Democrat, and I'm a centrist," Hamilton told USA TODAY in a Sept. 29 phone interview.
Republicans take issue with that self-description. When asked for comment about the race by USA TODAY, Marshall's chief of staff Brent Robertson sent a Fox News article with the headline, "Woke megachurch pastor, Dem nominee called on congregation to repent for driving, eating beef."
Robertson wrote, "This was the news of the day yesterday — hope you cover it."
The Marshall campaign did not respond directly to an interview request, but John Whitmer, a former Republican state representative, who now hosts a conservative talk radio show, said he's still betting on Marshall.
"We're a Republican state. It's been, what, going on 100 years since Kansas elected a Democrat to the Senate," Whitmer told USA TODAY. "I don't foresee us doing it this year, so I think Doc (Marshall) will be fine. But it's going to be closer than what we'd like, I'm sure." Whitmer also called Hamilton "pretty weak and pretty woke."
Hamilton dismissed the criticism in his interview with USA TODAY. "I think if Jesus were here today, Roger Marshall would say he was woke," he said.
"The idea that having compassion for people, that trying to care for people, that you're standing up for people that have been bullied and marginalized is somehow bad," Hamilton added. "If that's what he thinks, I just, it's sad. It's a reflection on his own character."
One Kansas voter weighs her option with Senate candidates' views on data centers
In El Dorado, Kansas, Danica Dickson’s recently co-founded "Protect the Heartland – NO DATA CENTERS" group is pushing back against high-impact data centersand battery energy storage systems (BESS) from overtaking rural towns without their input. Opposition to data centers has given Democrats running in red states a potent weapon in some races.
"We're seeking a state moratorium on data centers, and we're praying we can get good leadership, especially on the federal and state levels, that would actually fight with us on this," Dickson said. "We're looking to see who supports our views."
Hamilton and Marshall both told KSHB-TV last month that they support Kansas towns saying no to data centers, but Dickson is "very disappointed" with Trump's enthusiastic commitment to data center expansion. She thought the president's "America First and making America healthy again mentality" included preserving the nation's farmland.
"I voted for him. I didn't even know what a data center was when I cast my vote two years ago," Dickson said about Trump. "I totally did not expect to hear all of the things he's said and why he's pushing so hard for data centers. I'm not bashing the president, but I’m strongly questioning his motives when it comes to this issue."
Will Kansas follow Hamilton's lead?
This cycle is an anti-establishment election season with incumbent Democrats being knocked out by progressive primary challengers, according to Don Haider-Markel, a political science professor at the University of Kansas. In states like Kansas, a rare opening for Hamilton could exceed the Bollier hype from six years ago.
Hamilton is the perfect anti-establishment candidate for this moment, Markel said.
Kansas native Robert Wuthnow is a sociologist whose latest bookexplores religious liberalism, "The Religious Left: What It Does and How It Can Do Better." He told USA TODAY that "Kansas is a little bit more split on some issues than its reputation as one of the main red states in the country would suggest."
While Kansas has strong ties to the conservative right, Wuthnow pointed to Hamilton's Resurrection and Village Presbyterian Church, one of the nation's largest Presbyterian congregations with 4,600 members, that supported Black Lives Matter in 2020.
"The religious left is stronger than the legacy media has usually acknowledged," Wuthnow said.
Hamilton told USA TODAY that he met one such voter recently in Halstead, a town of just over 2,000 people.
"He said, 'I will not vote for anybody who doesn't believe we should love our neighbors as we love ourselves,'" Hamilton recalled.
Contributing, Jason Alatidd, USA TODAY Network
This article originally appeared on USA TODAY: Can Democrats flip a GOP Senate seat in Kansas? They actually might
