Republican U.S. Rep. Zach Nunn and Democrat Sarah Trone Garriott spent Tuesday evening clashing over the trajectory of the war in Iran, the sustainability of Medicaid, and the rising cost of living in their only televised debate before next week’s midterm elections. The matchup, hosted by KCCI in Des Moines, serves as a final flashpoint in one of the nation’s most competitive House races, where national Democrats are aggressively targeting the 3rd District to regain control of the chamber.
The stakes for the district—which spans 21 counties including the Des Moines metro—are deeply personal. With 19% of the district’s population relying on Medicaid, according to Iowa Public Radio, the candidates’ divergent views on the One Big Beautiful Bill Act aren’t just policy debates; they are arguments over who keeps their doctor and who loses coverage.
The Medicaid Divide and Rural Health
Trone Garriott, a state senator and Lutheran minister, focused her attack on the human cost of Medicaid cuts embedded in the One Big Beautiful Bill Act. She linked those cuts directly to clinic closures and the loss of coverage for Iowans, calling the impact “devastating to our neighbors.” Trone Garriott argued for a public healthcare option to fill existing gaps, noting that the fear of losing insurance often prevents people from leaving stable jobs to become entrepreneurs.
Nunn, seeking a third term, countered by highlighting the $50 billion allocated for rural health within the same law. He pointed to the Rural Health Transformation Program, which sent $209 million to Iowa in its first year. Nunn also reminded voters that he broke party lines in January to extend expiring Affordable Care Act (ACA) subsidies, asserting that he didn’t “pull the rug out from people when they needed it most.”
However, Nunn stopped short of endorsing the ACA as a permanent solution. He argued the system is “broken” and sapped by “deadbeat dads” and undocumented immigrants, claiming that without reform, taxpayer dollars are being flushed away while insurance premiums rise. The divide is stark: Trone Garriott wants to protect and expand the ACA, while Nunn views it as a flawed vehicle that requires significant overhaul.
KFF estimates roughly 80,000 Iowans could be uninsured by 2034 because of the One Big Beautiful Bill Act, with 68,000 of those losses tied specifically to the Medicaid changes, according to an Iowa Public Radio analysis.
War Powers and the Iran Conflict
As the conflict in Iran passes the eight-month mark, the debate shifted to the role of Congress in limiting executive war powers. Trone Garriott pressed Nunn on his record, specifically his five previous votes against limiting President Donald Trump’s war powers in Iran. While Nunn did flip his vote in September to support such limits, he explained the shift as a response to the collapse of open peace negotiations.
Despite their disagreements on leadership and war powers, the candidates found narrow common ground: both agree Iran must never possess a nuclear weapon, and both support the use of sanctions to pressure the regime.
Tariffs, Tips, and the Cost of Living
The economic debate centered on whether the current administration’s trade and tax policies are helping or hurting the average Iowan. Trone Garriott pinned high prices—particularly for diesel—on Trump’s tariffs and the ongoing war in Iran. She argued that ending “chaotic tariffs” is the most direct path to lowering costs for families and farmers.
Nunn pointed toward long-term growth and rural infrastructure. He touted the 21st Century ROAD to Housing Act, passed in July, as a tool for lowering future housing costs. On the fuel front, Nunn advocated for the growth of the biofuels industry and the $8 billion Harvest Fuel Relief Program. He also pushed for the year-round sale of E15, a measure that passed the House but remains stalled in the Senate.
The candidates also sparred over tax benefits. While Trone Garriott expressed support for the “no tax on tips” and “no tax on overtime” provisions—which allow eligible workers to deduct up to $25,000 in tips and $12,500 in overtime—she criticized the broader tax law for favoring wealthy Americans. She argued that those making under $180,000 a year should be the primary beneficiaries of tax cuts, rather than the highest earners.
Nunn and Trone Garriott Disagree on Water Pollution
On the issue of water pollution, both candidates agreed that farmers need more resources to improve water quality. Nunn advocated for a locally-driven approach, suggesting that the government should partner with public universities to make monitoring more transparent rather than imposing federal mandates. He credited recent EPA changes that narrowed federally regulated waters as a way to cut “red tape” for the state.
Trone Garriott pushed for stricter federal safeguards, specifically calling for a lower federally allowed nitrate limit for drinking water to protect public health.
The race remains a focal point for national political analysts. While the Cook Political Report recently shifted the contest from a “toss-up” to “lean Democrat,” the high volume of outside spending—exceeding $10.6 million according to Hoodline—suggests neither campaign is treating the seat as settled. Early voting is currently underway, with Election Day set for Nov. 3.
