Democrat Adam Hamilton has defeated Republican Roger Marshall in the race for the U.S. Senate in Kansas, ending nearly a century without a Democratic senator from the state. Hamilton, a Methodist minister and founding pastor of a large United Methodist church, assembled a broad coalition in a state that Donald Trump won by more than 16 percentage points two years ago.

Marshall sought to portray Hamilton as too liberal and weak to represent Kansas. Hamilton’s campaign instead presented him as a centrist whose political views draw on his faith. Over his lifetime, he has been registered as a Republican, a Democrat and an Independent.

The result marks a sharp reversal for Marshall, who won re-election in 2020 by more than 11 points. His campaign faced a difficult political environment and scrutiny over lawsuits he had filed to collect medical debts from patients while working as an OB-GYN.

A September report by The New York Times said at least 81 of Marshall’s patients had been arrested after missing court dates related to their debts. Among them was Meischa Zimmerman, who was uninsured when Marshall delivered her child by C-section in 2009 and was arrested three times as he pursued payment.

Marshall later addressed the issue in a campaign advertisement, acknowledging that he had asked collection agencies to pursue patients’ debts. He said that Kansas law does not allow people to be imprisoned for debt and that he would not want that outcome for any patient he had treated. He told The Wall Street Journal that he regretted not responding sooner.

Economic concerns also featured prominently in the race. Voters consistently identified the economy as their top issue, while rising diesel prices and the president’s decision to permit beef imports at lower tariff rates affected a state where nearly 90 percent of land is used for farming and ranching.

Visits to Kansas by President Donald Trump and Vice President JD Vance did not secure Marshall’s re-election. During a visit days before the vote, Trump called Hamilton a “perverted pastor.” Hamilton said he would work with the president on measures that benefited Kansas residents.

Sources: Rolling Stone.