Iowa’s US Senate race stopped being a foregone conclusion this month. The Cook Political Report moved the open seat from “Lean Republican” to “Toss-up” on Aug. 20, citing a brutal farm economy and a uniquely tough environment for Republicans in a state Donald Trump carried twice. A recent poll had GOP Rep. Ashley Hinson up just three points on her Democratic opponent, 48-45—inside a race that could help decide whether Republicans keep control of the Senate.
The seat is open because US Sen. Joni Ernst is retiring. Hinson, a four-term congresswoman from Marion, is the Republican nominee. She’ll face Democratic state Rep. Josh Turek of Council Bluffs, a two-time Paralympic gold medalist in wheelchair basketball who beat state Sen. Zach Wahls in the June 2 primary.
Both campaigns will spend the next 10 weeks arguing about who’s really fighting for Iowans. At Iowa Starting Line, we pulled together three key points of disagreement that should help an unsure voter decide who best represents them.
Healthcare and Medicaid
Hinson voted for the 2025 budget law Republicans dubbed the “One Big Beautiful Bill,” which cut federal Medicaid spending nationwide. Turek says the law puts coverage for 110,000 Iowans at risk and has tied it to five rural health facilities announcing closures or service cuts. Hinson’s campaign points to $209 million in federal money headed to Iowa health facilities through a separate rural health fund as an offset.
Turek wants to restore that Medicaid funding and protect the Affordable Care Act subsidies he says 118,000 Iowans rely on. Hinson has not proposed reversing the Medicaid changes.
Tariffs and the farm economy
Hinson has backed President Trump’s tariffs, saying they “level the playing field” for Iowa producers, and says she’ll “stand with Iowa agriculture.” Turek calls the tariffs a direct cause of falling commodity prices and warns Iowa is heading toward “a 1980s-style farm crisis”—a reference to the debt-driven wave of farm foreclosures that gutted rural Iowa four decades ago.
Abortion and reproductive rights
As a state legislator, Hinson voted for Iowa’s six-week abortion ban and to defund Planned Parenthood; in Congress, she co-sponsored the Life at Conception Act, which would ban abortion nationwide with no exceptions. On the trail, she’s also talked instead about expanding over-the-counter birth control access.
In contrast, Turek wants to restore Roe-era protections for reproductive rights nationally and has sponsored legislation to repeal Iowa’s near-total ban.
The bottom line
None of this gets settled by a poll or a Cook Political Report label. It gets settled by who shows up in November, and by whether Iowans have real information about what each candidate would actually do with the seat Ernst is leaving behind.
