MAHA and the Politics of Cancer

While news-grabbing Democratic primaries in Maine, Michigan, Wisconsin, and elsewhere have featured populist progressive insurgents against establishment incumbents, Iowa’s landscape is different because it’s more red. The electorate is 2:1 Independents and Republicans to Democrats. Donald Trump has won the state in the past three presidential election cycles. Iowa has had an all-Republican federal delegation since 2023, while the GOP has enjoyed a trifecta in the statehouse since 2016.

However, Iowa voters seem far less concerned about the culture wars that define the national Republican agenda. Polling has found overwhelming support for candidates who prioritize clean water and stricter regulations on pesticide use and nitrate runoff from industrial farms.

Democratic campaigns claim they are gaining a foothold by speaking to these issues. But they are moving in diverging directions, leaving voters to decide between anti-partisan reforms to the political system on the one hand, and structural critique of the agricultural economy on the other.  

Sands puts a curse on both houses

Rob Sand, the Democratic state auditor since 2018 and assistant attorney general since 2011, has received national media attention during his campaign for governor. While he generally occupies the centrist-Democrat position on most issues, he emphasizes reform to state institutions in service of ethics, transparency, and democracy.

“He is running as a change agent against the political system, not necessarily the corporate structure of things,” wrote Pulitzer Prize-winning columnist Art Cullen from his outpost in Storm Lake, Iowa.

“Sand is playing a different theme in this campaign that seems to be working,” says longtime Iowa Democratic leader John Norris. “He’s trying not to get caught up in these partisan issues.”

This strategy allows Sand to touch every important issue in the campaign—education, health care, cancer, clean water and agriculture—without taking a campaign-defining position on any. His proposed solutions—ethics reform, mandatory town halls for lawmakers and open primaries to disrupt the two-party system—are not necessarily attention-grabbing ideas.

“He’s shown incredible discipline in his campaign, which I think has cost him some energy,” says Norris. “But I also think that he’s calculated [that] there’s more to be gained” from this strategy than “championing progressive causes and issues that some progressives would like to see him do.”

Then there is Sand’s Republican challenger Zach Lahn (pronounced “Lane”).

In June, Lahn ousted the anticipated winner, Trump-endorsed former 4th District Congressman Randy Feenstra. (Trump has since endorsed Lahn.) Lahn’s rebuke of agricultural monopolies and opposition to liability shields for pesticide companies earned him endorsements from MAHA (Make America Healthy Again) PAC and Turning Point Action. U.S. Health Secretary Robert F. Kennedy Jr., a central figure of the MAHA movement, even rallied for Lahn’s campaign in August.

In his campaign speeches, Lahn leans further into his critique of the “uniparty,” a term describing both Democratic and Republican politicians bought out by lobbyists, corporations and special interests, while positioning himself as outside of that influence.

“Many people in the primary said you can’t win a Republican primary talking about the big agricultural conglomerates that are extorting our farmers, talking about clean water and how we need to lower our cancer rates,” said Lahn in a recent “soapbox” speech at the Iowa State Fair. “We did talk about it, and we won.”

An analysis by The Des Moines Register found that Lahn’s support in the primary was broad and deep. In fact, his performance was strongest in Iowa’s most liberal precincts in Des Moines and Iowa City, which sounds odd for a candidate who’s aiming for a populist reputation. It could also spell trouble for Sand, who’s looking to win voters on exactly this terrain.

The state’s cancer crisis, which is in part attributable to its deplorable water quality, has become a critical weathervane in Iowa politics. For the first time, candidates and the electorate acknowledge that farm-driven pollution is causing cancer and needs to be addressed.

Iowa has the second-highest cancer rate in the country and is one of only three states where cancer rates are rising. A University of Iowa analysis found some of the most common diagnoses are colon cancer and non-Hodgkin lymphoma—cancers that have been linked respectively to high levels of nitrates as well as glyphosate, the main ingredient in pesticides like Roundup.

In his primary campaign, Lahn not only praised organic farming and called for antitrust enforcement but raged against pesticide companies and “Big Ag conglomerates,” calling them “cartels” that “have pillaged our state.” This is rhetoric you won’t hear from the Republican establishment, which caters to the status quo of corporate farming exemplified by the Iowa Farm Bureau, one of the most powerful political players in the state.

Unlike past campaigns, the Iowa Farm Bureau PAC has not endorsed a candidate for governor. On September 2, it endorsed all Republican candidates for U.S. Senate and House, as well as Republican Mike Naig for secretary of agriculture. (The Iowa Farm Bureau did not respond to requests for comment why they did not endorse a gubernatorial candidate.)

The omission points to a dilemma facing corporate agribusiness in the state. 

In a recent interview with Politico, Kirk Leeds, CEO of the Iowa Soybean Association, said some farmers “are probably still in denial” about the election’s groundswell of opposition to industrial agriculture. His organization lists Bayer, Corteva and Syngenta among its top-tier partners, who each manufacture and sell pesticides and other crop-related chemicals.

“And then you get others like me who’d say, ‘You know, in agriculture, we have no credibility if we don’t share in our responsibility to improve water quality in this state.’ ”

Critics point out that Lahn’s biography does not shore up his populist credentials. He grew up in Iowa but has lived his adult life out of state. Having worked as a Republican operator in D.C. and all over the West—most recently running a private school in Kansas—he only registered to vote in Iowa in 2024.

When it comes to crusading against Big Ag monopolies, Lahn carries additional baggage. For years he’s worked for initiatives funded by the Koch family, a fertilizer powerhouse and right-wing funder. In 2024, Koch Ag & Energy Solutions, an affiliate of Koch Industries, acquired OCI Global’s Iowa Fertilizer Company, which produces about 18% of the national output of nitrogen fertilizer. In 2014, Lahn was hired as the executive director of the Koch-funded Americans for Prosperity in Montana until his sudden departure. He’s now married to Charles Koch’s former daughter-in-law.

“It’s pretty hard to trust Lahn on water quality when he built his career working for corporate agriculture special interest groups, has opposed limiting nitrogen fertilizer, and chose a running mate [Derek Wulf] who oversaw the elimination of Iowa’s water quality monitoring,” Mazie Stilwell, Executive Director of Progress Iowa, a progressive communications hub in the state, tells Barn Raiser in an email. 

While water and cancer are hot-button issues, affordability, health care, and education are other dominant themes.

Lahn talks about supporting public schools by continuing controversial Education Savings Accounts for families to spend taxpayer money on private education. He argues for innovation, competition and choice—which liberals understand as raiding public coffers to funnel money to private schools. Lahn also promises to curb what he describes in vague terms as an ideological influence among public school teachers.

Lahn’s association with a private school in Wichita provides convenient contradictions for Sand to highlight. In a recent TV ad campaign, Sand focused on his own role as a “Iowa Public School Dad.” On health care, Lahn is also vulnerable, having lobbied against Medicaid expansion in Montana during the Obama years.

A recent podcast appearance and attendance at a cancer forum suggests that Lahn may be backing away from the populist rhetoric on farm policy that won him the primary. His campaign may be pivoting to an emphasis on agriculture technology and incentive-driven measures that both parties have historically leaned on for support. He also took the party line supporting the Save Our Bacon Act, a signature policy of the pork industry and the Republican Congressional delegation. The law would prevent states from enacting laws like California’s Proposition 12, which sets production standards—in this case relating to animal welfare—for the agricultural products that they import.

Family farm advocates argue that invalidating laws like Prop. 12 would cut off a higher-value market that smaller pork producers have already invested in. With only four multinational corporations controlling 70% of the pork market, a federal bill eliminating state production standards would allow these corporate conglomerations to undercut family-scale farmers in the market.  

“Because of Prop 12, Iowa’s farmers can’t sell their quality products to an expanded market and are missing out on millions of dollars per year in revenue,” a Lahn campaign spokesperson tells Barn Raiser. The campaign did not respond to a question about the apparent contradiction between Lahn’s opposition to Prop 12 and his advocacy against agriculture conglomerates. Sand’s campaign likewise did not respond for comment about the policy.

If Lahn’s policies cater to corporate agriculture, progressives say it would help both candidates seem more similar. A blurring between the two could benefit Sand, given that Lahn represents the Republican status quo by fiat unless he can change that reputation with his own messaging.

“I don’t believe either [Sand or Lahn’s] position [on clean water] goes far enough in distinguishing themselves from others and distinguishing themselves from the past failed, voluntary efforts,” says longtime progressive and former Democratic state legislator Ralph Rosenberg. Iowa’s Nutrient Reduction Strategy, the state’s ag-focused water quality improvement program, depends on opt-in and incentive-driven funding to compensate farmers for implementing practices like cover crops and no-till that can cut down on pollution.

On water and agriculture, Sand is sticking to the middle. (His campaign, and previous campaigns, have been funded with millions of dollars from his wife and in-laws. His wife is the CEO of Lauridsen Group, a family-owned conglomerate that sells agricultural products including animal feed, food ingredients, pharmaceuticals and pet food). Though he’ll mention it on the campaign trail, Sand’s recent rural plan omits the antitrust lawsuits and enforcement that Lahn promotes. Instead, Sand promises to raise the state minimum wage from $7.25 to $12 an hour, reverse Medicare privatization and help small farms diversify—positions Tom Vilsack, former Iowa governor and U.S. Department of Agriculture secretary under Obama and Biden, has endorsed.

Addressing the water question, Sand advocates for expanded research and conservation, which is exactly what Lahn proposes. In a recent town hall, Sand was asked to differentiate himself from his opponent on the state’s cancer crisis. He emphasized Lahn’s MAHA-inflected views, namely his opposition to mRNA vaccines, and shepherded the question away from clean water.

For now, on cancer and farm pollution, some members of the Democratic party worry that Sand sounds more like the status quo. Not everyone on his side of the aisle is comfortable with the strategy.

“Some party insiders are concerned that more centrist Democrats could cede agricultural pollution as a wedge issue to the GOP,” reported Mother Jones and Food & Environment Reporting Network.

Chris Jones running on Iowa’s third rail

Chris Jones is the lone exception to the mainstream’s reluctance to campaign on substantial change for Iowa agriculture. His willingness to challenge the status quo, which led to his departure from the University of Iowa as the director of a stream pollution monitoring network who ran a blog exposing the water crisis, may now gain him a seat in state leadership.

“Consolidation in the livestock industry has brought us 25 million hogs along with the untreated fecal waste equivalent to 168 million people,” he told attendees at the Iowa Democratic Party state convention in June. “Farmers lose money, we get sick, and corporate agribusiness skates off with money after fouling our air, water and soil.”

“The writing is on the wall that ethanol is going to die,” says Jones.

Jones campaigns for a transition away from ethanol, an industry that eats up half of the state’s corn production and has benefitted from decades of bipartisan political support. He also calls for stricter regulation of confined (or concentrated) animal feeding operations, or CAFOs, in the name of curbing water pollution, which no Iowa politician will do.

Jones’s critique of industrial agriculture may be radical—especially for Iowa—but voters are paying attention.

Sand’s emphasis on incentives, pragmatism, and consensus on the water question can easily be read as a strategic attempt to distance himself from Jones. In June 2025, the two traded barbs after Sand walked into Art Cullen’s office and said he was irritated with Jones, viewing his positions as “anti-agriculture.”

Recently, those prickly feelings seemed confirmed.

“When asked by reporters about Jones’s policy, Sand said he hasn’t read Jones’s proposals and that he has not been ‘weighing in’ on other races and doesn’t plan to do so,” reported Iowa Starting Line from a Sand campaign stop with Vilsack on August 19.

Turek takes lessons from running in the red

Josh Turek, the Democratic candidate for Senate, is a two-term state legislator from Council Bluffs in western Iowa. The para-Olympic gold medalist won his first election in 2022 for an open seat by 6 votes. He was re-elected in 2024 by 6 points in what had become a very red district.

Turek describes himself as a “common-sense prairie populist” but he doesn’t define this term or elaborate. His platform promises in five different places to “crack down” on some form of monopoly across the economy with no further specifics.

Turek recently weighed in on a recent farm bill vote by hitting Democrats from the right, telling the press he would have voted to pass the latest version of the omnibus bill despite the fact that it would have continued the Republican dismantling of the Supplemental Nutrition Assistance Program (SNAP) that Democratic leaders like Amy Klobuchar and other Midwestern liberals united to block. He’s recently begun running ads that tout his bipartisan voting record in the state legislature, voting with Republicans 700 times. On the farm bill and Prop 12, Turek has been a populist in name only, and progressives consider this obeisance to the Republican party line on farm policy a political mistake.

Turek is trailing but in range of his opponent Ashley Hinson, a young Congresswoman from more densely-populated Eastern Iowa. The race remains close, but the Democrat hasn’t gained statistical ground in recent months. Hinson has name recognition but is vulnerable to charges that her net worth has increased substantially under Trump’s administration. As a member of the House Agriculture Committee, she’s also a perfect foil for the agricultural status quo, according to Norris.

“He’s got ample things to distinguish himself from Hinson on, and he just gave that one away,” says Norris, adding that Turek’s opposition to Prop 12 “definitely clouds that populist image [he’s trying to build].”

The lack of stark differences between the two candidates is a risk, said one long-time political operative.

“I will vote for Turek, and I will vote for Sand,” says former state legislator Ralph Rosenberg. “But I am critical of their strategies and positions.” Rosenberg particularly applauded Sand’s appeal to voters who are dissatisfied with politics, but he doesn’t think that should preclude stronger policy stances.

“Are they moving too much to the center at a risk of losing their base in Iowa? There is a substantial progressive base in Iowa,” Rosenberg says. “I worry about that.”

While on policy they differ substantially, Iowa’s highest profile Democratic candidates are united in tapping roots of discontent. By turns, they are working to harness disapproval of Republicans in power, the political system as a whole; and in Jones, the foundational orthodoxy of the farm economy.

“It’s good to see more bipartisan values and anti-establishment priorities rising to the top,” says Stilwell of Progress Iowa.

The November results will tell if Iowa voters agree.

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Charlie Hope D’Anieri is a freelance copywriter, journalist, and researcher. His work has appeared in The Guardian, Los Angeles Review of Books, The New Republic, The Baffler, and many other magazines and websites. To follow his work, subscribe to his newsletter, The Charlie Review of Books.