¶ Overview
In 2009, Lahn gained national attention after challenging President Obama during a town hall, questioning whether the Affordable Care Act would increase prices and arguing that a government-run health plan would have an unfair advantage over private insurers. In 2015, Lahn dismissed Medicaid expansion as "just more of the ObamaCare mess." As of 2025, more than 603,000 Iowans relied on Medicaid, including approximately 183,000 adults covered through Medicaid expansion. In 2026, more than 123,300 Iowans received coverage through Affordable Care Act marketplace plans, and Medicaid expansion helped drive significant reductions in uninsured rates among low-income workers.
From 2014-2015, while Lahn was the Director of Americans for Prosperity-Montana, Lahn helped lead efforts to block Medicaid expansion, using town halls, mailers, phone campaigns, and anti-expansion pledges to pressure Republican lawmakers to oppose the policy. Lahn argued Medicaid expansion would “shackle” Montanans to a "system that already fails to provide adequate access to healthcare" and incorrectly claimed “millions of Montanans” opposed expansion, despite Montana's population being only about one million at the time. Ultimately, Montana expanded Medicaid despite those efforts.
¶ Lahn Opposed The Affordable Care Act And Medicaid Expansion Despite More Than 123,300 Iowans Receiving Coverage Through ACA Marketplace Plans And More Than 603,000 Iowa Adults Relying On Medicaid
¶ 2009: Lahn Gained National Attention After Challenging Obama’s Affordable Care Act And Defending Private Health Insurance Competition
HEADLINE: "Iowa GOP Governor Nominee Recounts Viral Clash That Put Obama On The Spot At 2009 Town Hall" [Fox News, 6/4/26]
Fox News Highlighted Lahn’s 2009 Exchange With Obama Over The Affordable Care Act At A Town Hall. According to Fox News, “The Republican nominee for governor in Iowa pulled back the curtain for Fox News Digital on the time he went viral for stumping Barack Obama at a 2009 town hall centered on the then-president's namesake legislation. [...] But 17 years ago, when he was a student at the University of Colorado Boulder, Lahn confronted Obama at a town hall where the 44th president was promoting the Affordable Care Act, known as Obamacare. The old clip went viral after his Tuesday win. At the time of the exchange, the video was circulated by late conservative radio titan Rush Limbaugh, who praised Lahn as 'amazing,' and said that with 'one simple question that Obama can't answer, [he] nukes the entire foundation of Obamacare." [Fox News, 6/4/26]
2009: Lahn Questioned Obama On The Public Option And Whether The Affordable Care Act Would Increase Prices And Argued A Government-Run Health Plan Would Have An Unfair Advantage Over Private Insurers. According to Fox News, "Speaking to Obama in 2009, Lahn said: 'We all know the best way to reduce prices in this economy is to increase competition.' 'How in the world can a private corporation providing insurance compete with an entity that does not have to worry about making a profit, does not have to pay local property taxes, they're not subject to local regulations? How can a company compete with that?' he questioned. I don't want generalities — I'm not looking for philosophical arguments. I'm just asking a question,' he asserted. Obama thanked him for the question, and then for the first time during the Obamacare debate, said he might not be in favor of the public option, which would have allowed Americans to buy government-run health insurance alongside private insurance." [Fox News, 6/4/26]
¶ 2015: Lahn Argued Medicaid Expansion Was “Just More Of The ObamaCare Mess”
2015: Lahn Argued Medicaid Expansion Was “Just More Of The ObamaCare Mess.” According to an op-ed from Zach Lahn in Townhall, "Montanans need real free-market solutions that create good-paying jobs; policies that give the most vulnerable the ability to lift themselves up and live out their own version of the American dream. But the Governor’s plan is not that answer. All it does is shackle 77,000 new Montanans to a system that already fails to provide adequate access to healthcare for its current beneficiaries. Bullock has a clear choice: press Montana to cast its lot in with hyper-liberal states like Maryland and California, or join other centrist states who’ve had a healthy debate over this and seen it for what it is: just more of the ObamaCare mess." [Zach Lahn Op-Ed – Townhall, 4/7/15]
¶ 2026: More Than 123,300 Iowans Were Enrolled In An Affordable Care Act Marketplace Plan
2026: There Were 123,304 Individuals Enrolled In An Affordable Care Act Marketplace Plan In Iowa. According to KFF, in 2026, there were 123,304 individuals enrolled in the Affordable Care Act marketplace plan in Iowa.
[KFF, Accessed 6/8/26]
¶ Kaiser Family Foundation: 2025: 603,000 Iowans Relied On Medicaid, Including Approximately 183,000 Covered Through Medicaid Expansion
¶ 603,000 Iowans Relied On Medicaid In 2025 After Iowa Expanded Medicaid In 2013
2025: 603,000 Iowans Were Enrolled In Medicaid. According to KFF,
[KFF, Medicaid In Iowa, 5/25]
2025: Iowa's Medicaid Expansion Program Provided Health Coverage To At Least 183,000 Adults. According to KFF,
[KFF, Medicaid In Iowa, 5/25]
2013: Iowa Expanded Medicaid To Include Iowans Up To 133 Percent Of The Federal Poverty Level. According to the Gazette, “Many of the roughly 181,000 Iowans in the state’s version of Medicaid expansion would be subject to work requirements, and the entire program could be eliminated if the federal government ever disallows work requirements, under legislation approved this week by Republican state lawmakers. Medicaid is the government’s health care program for people with low income or disabilities. Iowa in 2013 expanded its Medicaid coverage to include individuals up to 133 percent of the federal poverty level, up from the previous threshold of 100 percent.” [Gazette, 3/26/25]
¶ The Affordable Care Act Allowed States To Expand Medicaid, Which Dramatically Lowered The Uninsured Rate Among Low-Income Workers
The Affordable Care Act Allowed States To Expand Medicaid, And States That Expanded Medicaid Dramatically Lowered The Number Of People Without Health Insurance. According to the Center on Budget and Policy Priorities, "The Affordable Care Act (ACA) permits states to expand Medicaid coverage to adults with incomes up to 138 percent of the poverty level (about $20,780 annually for an individual or $35,630 for a family of three). States that have adopted the expansion have dramatically lowered their uninsured rates. Extensive research finds that the people who gained coverage have grown healthier and more financially secure, while long-standing racial inequities in health outcomes, coverage, and access to care have shrunk." [Center On Budget And Policy Priorities, 6/14/24]
- The Uninsured Rate Among Low-Income Workers Fell From 38 Percent In 2013 To 17 Percent In 2022, Which Coincided With Implementation Of Medicaid Expansion. According to the Center on Budget and Policy Priorities, "Millions of workers have gained coverage through Medicaid expansion, including people working in industries that provide critical goods and services such as health care, transportation, grocery stores, food manufacturers, and child care. Many have no access to health coverage through their jobs. In expansion states, the uninsured rate among low-income workers fell from 38 percent in 2013 to 17 percent in 2022; this sharp decline coincided with a large increase in the share of low-income workers enrolled in Medicaid.[16] In non-expansion states, the uninsured rate among low-income workers fell much less, from 46 percent to 31 percent. (See Figure 3.)" [Center On Budget And Policy Priorities, 6/14/24]
¶ While Working At Americans For Prosperity-Montana, Lahn Led Efforts To Block Medicaid Expansion In Montana, Claiming It Would “Shackle” Montanans To A "System That Already Fails To Provide Adequate Access To Healthcare"
¶ Lahn Led Americans For Prosperity Montana’s Effort To Stop Medicaid Expansion Through Pressure Campaigns And Public Events
¶ 2014: Lahn Joined Koch-Backed Americans For Prosperity
2014: Lahn Defended His Decision To Join The Koch-Backed Americans For Prosperity (AFP) Organization And Praised Their Investments In Talent And Technology. According to the Bozeman Daily Chronicle, "Being associated with the billionaire Koch brothers Charles and David, who provide much of the funding for AFP and have been much vilified by Democrats like Sen. Harry Reid for spending hundreds of millions of dollars influencing candidates, campaigns, and policy, didn’t concern Lahn when he took the new job. ‘My apprehension with AFP when I was first approached about this was more that I didn’t really fully understand what AFP was doing,’ Lahn said. ‘I had a friend working with them in another state. All that they are doing in states around the country – the technology they’re using, the investment in their talent – it’s second to none in the nation.’" [Bozeman Daily Chronicle, 8/3/14]
¶ Under Lahn’s Leadership, AFP Montana Pressured Republicans To Oppose Medicaid Expansion
2014: Lahn Led AFP Montana’s Push To Pressure Republicans To Oppose Medicaid Expansion Through Mailers, Telephone Call Campaigns, And Local Events. According to the Iowa Starting Line, "The political-arm organized local chapters that have worked to block renewable energy standards, clean car rules, and carbon pricing at the state level. But when Lahn came on in 2014 as state director, he helped lead AFP Montana’s push to block Medicaid expansion in the 2015 legislative session. In mailers, telephone call campaigns, and local events, AFP pressured Republican legislators to dig their heels in and for those who faulted: one Republican state legislator had his face superimposed over a picture of President Barack Obama on a poster, the Montana Standard reported. Lahn’s effort ultimately failed. The Montana House passed legislation to expand Medicaid to 75,000 people." [Iowa Starting Line, 6/3/26]
2015: Under Lahn’s Leadership, AFP Montana Held Town Halls And Ran Attacks Against Republicans Who Did Not Oppose Medicaid Expansion. According to Flathead Beacon, "A conservative advocacy group targeting Republican state legislators it deems too liberal braved out a hostile reception in Kalispell Thursday night when the group took aim at local state Rep. Frank Garner, who has refused to sign a blanket pledge opposing Medicaid expansion in Montana. The group, Americans for Prosperity-Montana, has been holding ‘Healthcare Town Hall’ meetings across the state, singling out districts in which Republican lawmakers have declined to support AFP’s pledges of opposition to Medicaid expansion under the Affordable Care Act, or Obamacare. So far, the group has targeted Garner, who represents House District 7, as well as Reps. Jeff Welborn, of Dillon, and Tom Berry, of Roundup, sending out a flurry of mailers to districts portraying the respective lawmaker’s face superimposed over a photograph of President Barack Obama." [Flathead Beacon, 2/6/15]
2015: Under Lahn’s Leadership, AFP Montana Pressured Republican Lawmakers To Sign Anti-Medicaid Expansion Pledges. According to Flathead Beacon, "Lahn, the AFP-Montana director, said the group has been focusing its resources on legislators who did not answer a survey that the group distributed asking lawmakers about their stances on major issues. The group has circled back and asked those dozen-or-so lawmakers to sign pledge cards opposing Medicaid expansion. Those who don’t sign have been targeted in their districts by telephone calls, mailers and local events, including the recent series of ‘Health Care Town Hall’ meetings, which feature speakers from groups like the Foundation for Government Accountability who inform locals about why Medicaid expansion is ‘bad policy,’ encouraging them to tell their legislators to oppose it. Lahn insisted the meetings were not an attack on specific legislators, but ‘a crusade against bad policy.’ ‘This is not a dig at Frank Garner. This is not and will not be a crusade against any legislator,’ Lahn said. ‘This is a crusade against bad policy.’ Lahn said the group used an image of Obama on the postcards and flyers because the Affordable Care Act is the president’s signature health care policy; its purpose was to let lawmakers know that their constituents oppose Obamacare, he said." [Flathead Beacon, 2/6/15]
¶ Lahn Had Incorrectly Stated “Millions Of Montanans” Opposed Medicaid Expansion Despite Montana Having About Only One Million Residents In 2014
2014: After The Montana House Voted To Expand Medicaid, Lahn Incorrectly Claimed “Millions Of Montanans” Opposed Medicaid Expansion, Despite Montana’s Population Being About One Million. According to the Iowa Starting Line, “‘We are deeply disappointed in the legislature’s decision tonight to expand Medicaid. This decision stands directly against the voices of millions of Montanans who have made it clear that they do not want more Obamacare,’ Lahn wrote in a statement. Only, Montana’s estimated population in 2014 was 1.02 million; not millions.” [Iowa Starting Line, 6/3/26]
- 2014: Montana’s Population Was 1.02 Million. According to the Iowa Starting Line, "Only, Montana’s estimated population in 2014 was 1.02 million; not millions." [Iowa Starting Line, 6/3/26]
¶ 2015: Lahn Claimed Medicaid Expansion Would “Shackle" Montanans To A "System That Already Fails To Provide Adequate Access To Healthcare"
HEADLINE: "Why Gov. Bullock's Plan To Expand Medicaid Is Wrong For Montanans" [Zach Lahn Op-Ed – Townhall, 4/7/15]
2015: Lahn Claimed Medicaid Expansion Would “Shackle New 77,000 Montanans To A System That Already Fails To Provide Adequate Access To Healthcare." According to an op-ed from Zach Lahn in Townhall, "Montanans need real free-market solutions that create good-paying jobs; policies that give the most vulnerable the ability to lift themselves up and live out their own version of the American dream. But the Governor’s plan is not that answer. All it does is shackle 77,000 new Montanans to a system that already fails to provide adequate access to healthcare for its current beneficiaries. Bullock has a clear choice: press Montana to cast its lot in with hyper-liberal states like Maryland and California, or join other centrist states who’ve had a healthy debate over this and seen it for what it is: just more of the ObamaCare mess." [Zach Lahn Op-Ed – Townhall, 4/7/15]