Vice President JD Vance began the final stretch of his midterm campaigning with a trip to red America on Monday.
On the heels of his party’s unusual midterm convention, Mr. Vance, one of Republicans’ most valuable surrogates, deployed to the Kansas City area to campaign alongside Senator Roger Marshall of Kansas, a Republican. He also held an event in Missouri on the administration’s effort to combat fraud.
Mr. Vance’s visit could suggest that Republicans are worried about yet another state that President Trump won in 2024, as the party steels itself for tougher-than-expected Senate races in places like Texas, Iowa and Ohio. A combination of high prices, the unpopular war with Iran and Mr. Trump’s low approval ratings have created stiff political headwinds for the party.
Later this week, Mr. Trump himself will visit North Carolina, where his party’s Republican nominee, Michael Whatley, a former chair of the Republican National Committee, is trailing former Gov. Roy Cooper in polls of the state’s Senate race. Democrats see the seat, which is held by the retiring Republican, Senator Thom Tillis, as crucial to their chances of retaking the chamber.
Quality polls of the Senate race in Kansas are limited, but the available surveys suggest that the race between Mr. Marshall, an obstetrician-gynecologist who was elected to the Senate in 2020, and Adam Hamilton, a Democrat and the pastor of a liberal megachurch in the Kansas City area, is closer than Republicans would like it to be.
In recent weeks, Mr. Marshall — a staunch ally of the president — has sought to differentiate himself from Mr. Trump in a few small but telling ways. He has asked the Trump administration for “targeted relief” for ranchers and farmers facing high diesel prices — an implicit acknowledgment that costs are too high.
He has also defended a Canadian airplane company with more than 1,000 employees in Wichita that found itself in Trump’s cross hairs. And he has expressed frustration about the administration’s decision to widen beef imports in an effort to lower prices.
None of those divisions were on display when Mr. Vance took the stage.
“In Doc Marshall, you have a man who devoted his life to delivering babies and making sure that moms and children from every walk of life were safe and had the health care that they need,” Mr. Vance said. “So I ask you this November to stand for a man who stood for moms and babies.”
In recent days, Mr. Marshall has faced new scrutiny over his efforts to collect debts from some of those moms. An investigation by The New York Times found that he sued more than 700 patients for debts, with records showing that 81 of those patients were arrested over missing court dates. Patients also had their bank accounts and wages garnished, and were routinely charged an 18 percent annual interest rate.
The story has been picked up by local news outlets. Mr. Marshall has also drawn criticism from the conservative radio host Todd Starnes, who said he needed to address the report directly.
“Certainly this is going to be a big campaign issue for Senator Marshall,” Mr. Starnes said on his show last Wednesday, adding, “If I’m doing opposition research, if I’m the Democrat, this is like Christmas Day.”
Mr. Vance did not mention the report during his remarks, but at one point, a protester interrupted him, shouting that Mr. Marshall had sued his patients.
“He decided to come in and lie about my dear friend Doc Marshall,” Mr. Vance said, referring to the protester, “because Doc Marshall has stood up for everyday Americans every single day he’s been in the U.S. Senate.”
Democrats have seized on the findings and sought to connect them to one of their major arguments of the midterms: that Republicans have raised the cost of health care by voting last year to end subsidies for the Affordable Care Act.
“Most people are not arrested for not getting their payments made. There’s a payment plan that’s worked out,” Mr. Hamilton said during a debate on Saturday in front of a rowdy crowd at the Kansas State Fair. He called the matter Mr. Marshall’s “issue to deal with.”
Mr. Marshall said that he had relied on “common business practices” and that “one in five” patients at his hospital had received free care.
On Monday, as he spoke over some people in the crowd shouting, “Shame on you,” Mr. Marshall also indicated that his hospital “would go a year before we’d ever send somebody over” to litigation.
The Times spoke with multiple obstetric patients whom Mr. Marshall sued sooner.
One patient faced a lawsuit when her baby was nine months old over $129 in outstanding debt from a postpartum medical visit. Another, who miscarried twins in December, was sued by Dr. Marshall in October for $1,289 that she owed.
Kansas, where Mr. Trump beat former Vice President Kamala Harris by 16 percentage points in 2024, has not elected a Democrat to the Senate since 1932.
But voters there have more recently elected Democrats to statewide office. Gov. Laura Kelly, a Democrat, was elected in 2018 and re-elected in 2022.
Before his campaign event with Mr. Marshall, which took place at a manufacturing facility in Olathe, Kan., Mr. Vance held an event in Kansas City, Mo., showcasing the Trump administration’s efforts to crack down on fraud. There, he announced that about 870,000 people suspected of defrauding the government’s pandemic aid programs for small businesses would be barred from receiving future federal loans.
Enacted during the first Trump administration, the aid programs disbursed $1.2 trillion in loans — most of them made by banks and other lenders, and intended to be forgiven — to small and midsize companies to help them weather the pandemic’s economic shocks. But the hastily created programs skipped many of the Small Business Administration’s usual fraud detection checks and were rife with errors and deliberate thievery.
Sarah Kliff and Stacy Cowley contributed reporting.
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