Iowa’s U.S. Senate candidates faced off Monday over health care, the future of the U.S. Supreme Court, and COVID-19 relief in the first televised debate between the two candidates with a little over a month until the 2020 election. 

Sen. Joni Ernst, the Republican incumbent, and Democratic challenger Theresa Greenfield, sparred over the Affordable Care Act and how to bring down health-care prices. The Supreme Court is expected to hear oral arguments on a case aiming to invalidate the law in its entirety in November. 

Ernst, who joined Senate Republicans in multiple votes to either repeal parts of or replace the ACA, said the program limits choice and hasn’t brought health-care prices down. She highlighted bills she has sponsored to lower prescription drug price costs and protect pre-existing conditions.

“Making sure that the federal government is caring for [pre-existing conditions] and providing equal access to health-care products, making sure that they’re affordable — that should be the government’s role,” Ernst said.

An ad from Iowa Voices, a Democratic group, targets Ernst’s vote in 2017 to hold a floor debate on the American Health Care Act, which would have replaced the ACA and allowed insurers to charge more for pre-existing conditions. Ultimately, Ernst joined most Senate Republicans to support a “skinny” repeal of the ACA which did protect pre-existing conditions, but the bill couldn’t garner enough support in the Senate. 

Greenfield said health care has been a top issue with voters in events she’s held across the state. She said Congress should build on the ACA and called for adding a public option for health insurance plans, which she said would encourage competition from private companies and bring down prices. 

“I believe health care is a right, and we need to make sure that everyone has access to high-quality and affordable health care,” she said.

The death of former Supreme Court Justice Ruth Bader Ginsburg has become a political issue as Republicans try to fast-track a nomination process before Election Day.

Ernst has faced sharp criticism over her reversal on supporting the nomination of a Supreme Court Justice during an election year. In 2016, Ernst opposed holding hearings on President Obama’s nominee to replace Justice Antonin Scalia, Merrick Garland. In 2018, she reiterated that statement, saying President Trump shouldn’t take up an appointment during the 2020 election year. 

Now, with an opening on the court and a little over a month to the election, Ernst, who is on the judiciary committee, said the circumstances have changed and now supports holding hearings for Trump’s conservative nominee, Amy Coney Barrett. 

“Right now we do not have a divided government situation, so I feel that I have been consistent, we are following the Biden Rule,” she said.

Ernst was referring to a 1992 speech from then-Senator Joe Biden, in which he said that if an opening on the court were to occur that year during the presidential-election process, the Republican president, George H.W. Bush, should not name a nominee and the Democratic Senate should not hold hearings.

Ernst criticized Biden for not publishing a list of potential Supreme Court nominees in the event of a vacancy, and said Democrats plan to pack the court by adding more justices to the bench. 

Greenfield said she wouldn’t support adding justices to the Supreme Court, but she said the Supreme Court vacancy should be filled by the winner of the November election.

“Iowans, they’re going to the polls in just a few days,” she said. “And I believe they’re independent voters, they’re independent thinkers, and we should let them vote, and let the next U.S. Senate and president get seated and then process this nomination.”

On COVID-19 relief, Ernst pointed to the $2 trillion CARES Act the Senate passed in the spring, along with other provisions passed early in the pandemic. Lawmakers have not been able to reach an agreement on a new stimulus package as Republicans and Democrats are at odds over the cost of another round of relief.

“That’s why I do travel to all 99 counties to make sure that I’m hearing directly from constituents about these issues,” Ernst said. “So gathering that information, going back to Congress, and working in a bipartisan manner, we have been able to get four packages over the finish line.”

Greenfield said Congress should come up with a bipartisan bill to provide unemployment benefits and more aid for small businesses and local governments. Greenfield criticized Ernst’s support of a $300 billion relief bill — which was voted down by Senate Democrats — in early September, saying the bill didn’t go far enough.

“The bottom line is, Senator Ernst supported a skinny package, and we don’t have a skinny problem, people,” Greenfield said. “We have a big, fat problem.”

Both state parties quickly claimed victory for their candidates after the debate ended. 

“Given the chance, [Greenfield] and her radical liberal allies would work to abolish the 2nd amendment, raise taxes & regulate our farms into oblivion,” the Iowa GOP tweeted. “Meanwhile [Ernst,] the clear winner of tonight’s debate, has never wavered in her commitment to standing up for Iowa.”

Given the chance, @GreenfieldIowa & her radical liberal allies would work to abolish the 2nd amendment, raise taxes & regulate our farms into oblivion.

Meanwhile @joniernst, the clear winner of tonight's debate, has never wavered in her commitment to standing up for Iowa. #IASen pic.twitter.com/N0aYuwi5W3

— Iowa GOP (@IowaGOP) September 29, 2020

Iowa Democratic Party chair Mark Smith decried Ernst’s debate performance in a statement and said voters are tired of Ernst’s partisan politics.

“Theresa Greenfield’s winning performance tonight showed precisely why her vision has caught fire with voters across Iowa,” Smith said. “From biofuels, to health care, to our retirements, Theresa will deliver results on issues important to Iowans where Senator Joni Ernst has failed us.”