How women’s stories are reshaping a high-stakes Kansas Senate race

When President Donald Trump waded into Kansas’ fiery Senate race this week on behalf of Republican incumbent Roger Marshall, he was responding to the stories of women.

“Roger is one of my favorite Senators — He is absolutely GREAT, a wonderful person, given a ‘bum rap’ because he was mandated by Law to request money owed from patients,” Trump posted on social media on Monday about Marshall, a former OBGYN whose reputation has come under scrutiny after reports that he sued hundreds of patients over outstanding medical bills. 

Marshall’s Democratic opponent, pastor Adam Hamilton, has been highlighting stories of Marshall’s former patients in an effort to cast the senator as an unfit representative. With early voting underway and polls suggesting an unusually tight race in the ruby red state that could help determine Senate control, the stories of women and mothers are front and center. 

The New York Times reported last month that Marshall’s lawyers repeatedly pursued punitive measures to collect payments from patients who received services such as Cesarean sections, miscarriage care and hysterectomies. The lawsuits against patients were instigated before Marshall’s election to the Senate in 2020. Marshall regularly charged an 18 percent annual interest rate for unpaid bills, a highly unusual sum for doctors in the state. In some cases, women were arrested over missed court dates.

“I think it’s fair to think there’s more empathy, or empathy for women, particularly when they’re talking about being mothers — especially among a more conservative electorate,” said Kelly Dittmar, a professor of political science at Rutgers University. “This is particularly bad because you’re not only attacking women but attacking mothers, or hurting mothers.”

Marshall has made his physician background central to his political identity, arguing that his work as a doctor has informed his ability to legislate on issues such as rural health, Medicare policy and abortion. His campaign website refers to him as “Doc Marshall” and highlights his background delivering babies in a rural part of the state where he was often “the only OB-GYN in the area.” In one picture, a scrubs-clad Marshall drapes a stethoscope around his neck, holding one newborn in each arm.

The Marshall campaign did not respond to a request for comment. A spokesperson defended his and his hospital’s billing practices in the initial report by The New York Times.

Polling released by the Hamilton campaign suggests these stories may be influencing Kansas voters, with Marshall’s favorability ratings declining this fall after reports of his lawsuits became public. Open-ended survey responses published by GBAO Strategies, a liberal research firm hired by Hamilton’s campaign, included statements from voters such as: “He arrests people for $50,” “Collecting bills from a poor woman who apparently gave birth and then had her arrested for nonpayment” and “Bro is literally robbing poor women.”

In one advertisement from the Hamilton campaign, a woman named Meischa Zimmerman describes being eight months pregnant and jailed after missing a payment for care she received from Marshall. State court records show that Zimmerman was paying roughly $50 per month for a bill of over $3,500 before interest.

“The healthcare system is broken, but not for Roger Marshall. He’s absolutely profiting from it,” Zimmerman said in the ad.

In a digital video the campaign posted online this month, a woman named Destiny holds a toddler while describing a medical bill she received more than 10 years ago after getting an emergency appendectomy at a hospital co-owned by Marshall. 

“I think if you don’t have a heart for the small people of this country, then you shouldn’t be representing anybody,” she said at the end of the clip.

And in yet another ad, a lineup of physicians describe Marshall’s reported billing practices as “predatory,” “egregious” and “obscene.” 

“Doctors see firsthand the healthcare system is broken,” one doctor says to the camera. “Roger Marshall is making it worse,” says another.

Marshall has challenged his opponent’s campaign messaging. A lawyer for the senator issued a cease-and-desist warning to the Hamilton campaign after it ran the ad; Marshall has argued that Zimmerman was not jailed for missing a single $50 payment. A lawyer for the Hamilton campaign has defended the ad and said it will continue to air, according to the Kansas Reflector.

And on Tuesday, Marshall’s campaign released its own ad featuring a woman named Deb who said the incumbent senator delivered her baby and “has shown me nothing but compassion.” The ad did not include more details about when or what kind of pregnancy care she sought from Marshall. 

Healthcare costs are a top concern for Americans. Recent polling from The 19th and YouGov found that 61 percent of Americans worry about healthcare expenses. Women, who typically have higher medical expenses, were more worried than men, with 65 percent expressing concern compared with 56 percent of men.

“Most people know somebody who is struggling,” said Ashley All, a Kansas-based political strategist. “And they know somebody who is a parent or a mom who is trying to do all of the things and take care of their kid — which is almost completely conveyed through that image of her bouncing her kid on the porch. I think that triggers people.”

One reason these stories may be resonating, Dittmar said, is because they challenge a core component of Marshall’s political persona: that of a trusted doctor. The reported lawsuits may stay with voters who don’t trust politicians whom they perceive as out of touch with the concerns of working people. That most of the people affected were women simply adds another layer.

“The perception that women are more vulnerable yields more sympathy when the attack is made,” she said. “I would add to that exactly what you’re seeing in there: even more so when they’re mothers.”