Iowa — 1st District

Republican U.S. Rep. Mariannette Miller-Meeks and Democrat Christina Bohannan staved off primary challenges from their right and left flanks, respectively, setting the stage for another rematch this November.

The two will gear up for their third faceoff since 2022 in the race considered potentially pivotal to deciding which party controls Congress.

Miller-Meeks blocked a second primary challenge Tuesday, June 2, from Davenport marketing consultant David Pautsch by a far more comfortable margin than their 2024 matchup. Bohannan handily fended off a challenge from Tiffin health care specialist Travis Terrell.

With more than 90% of the vote counted, Bohannan triumphed over Terrell with 82% to 18%, according to unofficial results, while Miller-Meeks led Pautsch by 44 percentage points. The Associated Press called both races by 9:10 p.m.

Miller-Meeks, 70, a former state senator from Ottumwa, was first elected to Congress in 2020 and represents southeastern Iowa's 1st Congressional District, which spans 20 counties, including the cities of Iowa City, Davenport and Keokuk.

Celebrating her primary election victory, Miller-Meeks said in a statement she has defeated Bohannan twice "because I fight for Iowa values, while she fights for a woke agenda Iowa families can't afford."

"I spent 24 years in the Army, became a nurse and then a doctor caring for Iowa families," Miller-Meeks said. "I watched Washington and big corporations make life harder for the people I treated, and I knew Iowans deserved someone willing to fight back. Our state faces serious challenges, and Iowans deserve someone serious about solving them, not a radical progressive like Christina Bohannan."

Bohannan said she was "honored to be the Democratic nominee for Iowa's 1st Congressional District" in a statement and expressed gratitude for voters' support across the political spectrum. She vowed to unveil plans to "restore trust in Congress" through November.

"Rep. Miller-Meeks has gone Washington," Bohannan said. "Her outright corruption is fueling the cost of living crisis. She sides with insurance companies and Big Pharma over affordable, accessible health care for her constituents. Her subordination to her party bosses has led us into another war without an end in sight. Miller-Meeks is too beholden to billionaires and special interests to ever address the needs of everyday working people."

An ophthalmologist, Miller-Meeks touts her medical background as shaping her focus in Congress on pharmacy benefit manager changes, rural health funding and work to limit patients' costs by challenging insurance companies.

She also is running heavily on President Donald Trump's signature tax cuts that were made permanent in Republicans' budget reconciliation law dubbed the One Big, Beautiful Bill.

That same law has put her medical resume under fire as critics hammer its Medicaid changes that will usher in steep cuts to the public insurance program for low-income Americans over a decade.

Bohannan, 54, a former state representative from Iowa City and University of Iowa law professor, has centered her message on cutting living costs, with a particular focus on health care.

She has called for reversing Medicaid cuts and expanding Medicare to include dental, hearing and vision coverage. And she wants to allow Americans of any age to opt into Medicare to create competition with private insurance and drive down costs while guaranteeing a basic level of care.

Primaries fail to stop the three-peat

Pautsch challenged Miller-Meeks from the right, taking more hardline positions on immigration, abortion and LGBTQ rights and accusing her of not being a true "red meat Republican."

He raised little money and had low name identification but came within 12 percentage points of ousting Miller-Meeks in 2024.

But the self-proclaimed MAGA Republican suffered a blow when Trump waded into the race to endorse Miller-Meeks for the first time since 2020, giving her a boost that helped shore up the GOP base she needed.

In an interview, Pautsch lambasted Miller-Meeks and continued to accuse her of being a RINO, or "Republican In Name Only," but acknowledged Trump's endorsement helped widen her margin of victory.

Pautsch said he doesn’t see "any big groundswell for me to run again" after his showing Tuesday.

This marked Bohannan's first cycle facing primary challengers as frustrations grew over her first two failed bids to unseat Miller-Meeks. She has broadened her message beyond a focus on reproductive rights this cycle and ramped up door-knocking efforts across the district.

Terrell — a first-time candidate with a progressive pitch to uplift the working class — ultimately couldn’t compete with her quasi-incumbent status. He raised little money and struggled to pick up much support beyond the most progressive voters and local officials in Johnson County, the district's blue bubble.

In the coming days, Terrell told the Register he would reflect on whether he could help most by working on campaigns or by seeking office again.

Still, he said his campaign "sent the message that we think people are ready for something different" and signaled that Democrats need to address people's struggles to win.

"Every Democrat I met while campaigning believes in universal health care," Terrell said. "Every Democrat I’ve met believes in the need for immigration reform. If Democrats want to win in Iowa and not just hope Donald Trump is so unpopular that they can just sneak in wins, they have to actually speak to the people and not just be slightly better than a Republican.”

Bohannan, Miller-Meeks teeing up for 'toss-up' third rematch

In a bruising 2024 election year for Democrats, Bohannan lost to Miller-Meeks by nearly 800 votes, about 0.2 percentage points — one of the closest congressional races in the nation. But Bohannan closed the gap compared with 2022, when she lost by about seven percentage points.

Nonpartisan elections observers with the Cook Political Report consider the race a "toss-up," meaning either party has a fair shot of nabbing the seat.

The battleground contest is bound to draw significant spending from both parties. Bohannan has a slight edge in overall cash on hand, tallying $4.3 million to Miller-Meeks' $4.2 million in the most recent federal filings.

Emily Tuttle, spokesperson for the National Republican Congressional Committee, said in a statement Iowans "will reject Bohannan for a third time this November."

"Two-time loser Christina Bohannan is a radical liberal who pushes for men in girls' sports, defunding the police, and raising costs for Iowa families while resting comfortably in her million-dollar mansion," Tuttle said. "Meanwhile, Army veteran and doctor Mariannette Miller-Meeks is delivering results for working families."

Suzan DelBene, chair of the Democratic Congressional Campaign Committee, accused Miller-Meeks of representing Washington special interests in a statement.

"At every opportunity, she sides with them over Iowans: falling in line to rubber stamp policies that are raising costs on Iowans while enriching the drug and insurance companies with billions in special tax breaks at Iowans’ expense," DelBene said. "While Miller-Meeks hurts the people she represents, Christina Bohannan understands their struggles because she has lived them."