Iowa state Sen. Joni Ernst (R), who is running for U.S. Senate against Rep. Bruce Braley (D-Iowa), suggested in an April newsletter that Medicaid recipients do not have personal responsibility for their health.
"Iowa has nearly 500,000 Medicaid enrollees. If the program is expanded, it is estimated the Medicaid population will grow by an additional 110,000 to 181,000 recipients who have no personal responsibility for their health and no accountability for the care provided," she wrote in the letter to constituents, first publicized by The Washington Post.
Her campaign has since argued she was referring to bureaucrats who oversee Medicaid.
The Senate race in Iowa remains very close. Just over 1 percentage point separates the candidates, according to HuffPost Pollster, which aggregates polling data from multiple sources.
This is not the first time Ernst has attracted national attention.
Ernst's primary campaign was in the news for an ad that referred to to her experience in castrating hogs while it made the argument that she could cut spending in Washington.