To: Partner Organizations, Campaigns, Allies
From: RuralOrganizing
Re: 2026 Elections on Our Radar — State-by-State Overview
Date: 2026 Cycle
Overview
RuralOrganizing is tracking a wide, strategically connected set of 2026 House, Senate, and Gubernatorial races in which rural and exurban voters are decisive to the outcome. Across these contests, the dominant throughline is material accountability, including health care cuts, rising insurance premiums, rural hospital closures, water and land use conflicts, ag consolidation, USPS service, and federally funded infrastructure. The memo organizes races by state to highlight where multiple competitive contests stack on the same ballot, creating the greatest leverage for organizing investments. States like Michigan, Pennsylvania, California, New York, Texas, and Arizona stand out because statewide and House races overlap directly with visible service delivery failures, especially around hospital access and affordability of care.
At the district level, a core set of GOP-held House battlegrounds, many of them majority rural or heavily exurban, present clear accountability opportunities even in seats rated Lean or Likely Republican. These districts consistently share three characteristics: high rurality, documented rural hospital vulnerability or recent service loss, and media markets where local consequences can be tied directly to federal votes. Health care access serves as the most reliable entry point for persuasion, reinforced by water scarcity, land-use conflicts, school funding pressures, and postal reliability. States with stacked races offer the chance for compounding impact across offices, while single-race states remain critical for margin control and long-term rural infrastructure building.
As we look to 2026, it’s worth reflecting on how the 2025 elections played out. Democrats overperformed by 14% in the presidential margin in special elections last year. (Based on data compiled by The Downballot, there are currently 47 House GOP districts where the 2024 presidential margin was under 14%.)
One of the premier overperformances, the one that really caused consternation for GOP House leaders, was in TN-07 (a very gerrymandered district that Trump won by 22%.) On December 2, Aftyn Behn lost the race by 9% - overperforming by 13% in a race where turnout essentially matched 2022.
Turnout in Virginia and New Jersey gubernatorial races, where Abigail Spanberger and Mikie Sherill won by 15%, exceeded the 2018 blue wave turnout in midterms when they last had statewide races. In California, turnout for Proposition 50, the redistricting ballot measure to counter Texas’ redistricting, matched that of 2022 - and won in a blowout: 64%-36%.
This memo organizes every race on our radar by state, starting with those that present the highest leverage due to multiple competitive contests on the same ballot.
Priority House Battleground Districts
Listed in alphabetical order. All are GOP-held seats with high rural or exurban composition and clear accountability pathways around health care, services, land use, and federal investment.
AZ-02 — Eli Crane
Media Markets: Phoenix; Flagstaff–Prescott; Yuma–El Centro
Arizona’s 2nd District is 93% rural/exurban, making it one of the most rural seats in the country. The district includes multiple rural hospitals identified as financially at risk, reinforcing long-standing concerns about emergency access, staffing shortages, and travel distance for care. Combined with water scarcity, federal land management disputes, and veterans’ health needs, hospital vulnerability makes health care cuts and insurance cost increases especially visible and politically salient even in a Likely Republican seat.
AZ-06 — Juan Ciscomani
Media Markets: Tucson; Phoenix (spill)
Arizona’s 6th District is 54% rural/exurban and rated Even, Toss Up. While the district is not home to many standalone rural hospitals, it depends heavily on regional rural health systems under financial strain, particularly in outlying communities. Water scarcity, rapid development, and access to care heighten sensitivity to federal budget decisions that could further destabilize nearby hospitals.
CA-22 — David Valadao
Media Markets: Bakersfield; Fresno–Visalia
California’s 22nd District is 50% rural/exurban and centered in the Central Valley, where hospital access is already limited and safety-net facilities operate on thin margins. Agricultural labor patterns, Medi-Cal dependence, and provider shortages make the region acutely vulnerable to rural hospital closures, tying federal health policy directly to local outcomes.
CA-40 — Young Kim/Ken Calvert
Media Markets: Los Angeles; San Diego (spil
California’s 40th District is 34% rural/exurban and rated R+1, Lean Republican. Rural and exurban pockets rely on a small number of regional hospitals and clinics, facing staffing and reimbursement challenges. Hospital vulnerability compounds wildfire recovery needs and insurance cost pressures in outlying communities, often decisive in close-margin elections.
IA-01 — Mariannette Miller-Meeks
Media Markets: Cedar Rapids–Waterloo–Iowa City–Dubuque; Quad Cities
Iowa’s 1st District is 73% rural/exurban and rated R+4 but a Toss Up. The district includes communities that have already experienced rural hospital closures or service reductions, resulting in longer travel times and limited emergency care. Combined with heavy reliance on ACA and water quality concerns, hospital instability creates a direct accountability line from congressional votes to lived consequences.
IA-02 — Open (Ashley Hinson running for Senate)
Media Markets: Cedar Rapids–Waterloo–Iowa City–Dubuque; Sioux City (spill)
Iowa’s 2nd District is 74% rural/exurban and faces accelerating rural hospital closures and financial distress across its health system. Communities have seen maternity wards close and emergency services consolidated, making health care affordability and Medicaid-related policy decisions highly salient despite the district’s Safe Republican rating.
IA-03 — Zach Nunn
Media Markets: Des Moines–Ames; Omaha (spill)
Iowa’s 3rd District is 50% rural/exurban and rated R+2, Lean Republican. Rural areas rely on regional hospitals serving multiple counties with narrow margins, amplifying concerns about federal policies that raise premiums or reduce reimbursement. Hospital vulnerability intersects with farm economy stress and insurance affordability.
MI-04 — Bill Huizenga
Media Markets: Grand Rapids–Kalamazoo–Battle Creek; Traverse City–Cadillac
Michigan’s 4th District is 71% rural/exurban and includes rural hospitals identified as financially vulnerable or operating with sustained negative margins. Agricultural consolidation, water quality issues, and long travel distances for care heighten the political impact of hospital instability, even in a Likely Republican seat.
MI-07 — Tom Barrett
Media Markets: Lansing; Detroit (spill); Grand Rapids (spill)
Michigan’s 7th District is 68% rural/exurban and rated Even, Toss Up. Rural hospitals and clinics face persistent staffing shortages and financial pressure, making any federal action that raises insurance costs or accelerates closures immediately tangible. Hospital access, water contamination, and land-use conflicts converge in a true swing environment.
NY-17 — Mike Lawler
Media Markets: New York City; Albany–Schenectady–Tro
New York’s 17th District is 49% rural/exurban, where upstate hospital closures and service consolidations have reshaped care access. Rural communities closely track how state and federal policy choices affect whether local hospitals survive, giving health care accountability cross-party traction.
PA-07 — Ryan Mackenzie
Media Markets: Philadelphia; Allentown–Bethlehem–Easton
Pennsylvania’s 7th District is 38% rural/exurban and rated R+1, Toss Up. While less rural overall, its rural communities depend on a shrinking number of regional hospitals, making access to emergency and specialty care a persistent concern that amplifies accountability messaging.
PA-08 — Rob Bresnahan
Media Markets: Scranton–Wilkes-Barre–Hazleton
Pennsylvania’s 8th District is 70% rural/exurban and shaped by hospital access challenges and limited addiction treatment capacity. Financial stress on rural hospitals increases travel distances and delays care, reinforcing health care as a dominant issue even in a Lean Republican district.
PA-10 — Scott Perry
Media Markets: Harrisburg–Lancaster–Lebanon–York
Pennsylvania’s 10th District is 68% rural/exurban and rated R+3, Toss Up. Rural hospitals and clinics operate under pressure from staffing shortages and reimbursement constraints, while USPS reliability and land-use conflicts add to service delivery anxiety. Health care instability sharpens voter scrutiny of federal budget decisions.
NOTE: Virginia’s Congressional districts are likely to change. The Virginia House and Senate are working on new maps that will be subject to a statewide vote.
VA-01 — Rob Wittman
Media Markets: Richmond–Petersburg; Norfolk–Portsmouth–Newport News
Virginia’s 1st District is 58% rural/exurban and includes communities that rely on a limited number of rural hospitals and outpatient facilities. Aging populations, military families, and long travel distances for care make hospital stability a central political concern despite the district’s Republican lean.
VA-02 — Jen Kiggans
Media Markets: Norfolk–Portsmouth–Newport News; Richmond (spill)
Virginia’s 2nd District is 35% rural/exurban and includes at least one rural hospital identified as financially at risk, underscoring access challenges in coastal and inland rural communities. Hospital vulnerability, insurance costs, and infrastructure needs sharpen accountability dynamics in this Lean Republican seat.
State-wide and Federal Races On Our Rural Radar
Across these states, health care accountability—premium hikes, hospital closures, insurance access—serves as the most consistent entry point into rural persuasion, reinforced by land, water, education, USPS, and federal investment fights. States with stacked races offer the greatest opportunity for compounding organizing impact, while single-race states remain essential for margin control and long-term rural infrastructure. (There will also be state legislative races in these states (except Virginia), and we will monitor developments in those contests.)
Michigan (6 Races)
Michigan is one of the highest-leverage rural states in the country. Senate, Governor, and multiple House races intersect with rural hospital closures, insurance affordability, water contamination, land-use fights, and ag consolidation, putting every level of the ballot in play.
U.S. Senate — OPEN
Governor — OPEN
U.S. House
MI-03 — Likely D
MI-08 — Lean D
MI-07 — R Toss Up
MI-10 — OPEN | Lean R
MI-04 — Likely R
New York (6 Races)
New York has no statewide races, but it represents a massive rural and exurban House battlefield. Upstate hospital closures, education funding pressures, renewable siting conflicts, and USPS reliability shape voter attitudes across these districts.
U.S. House
NY-18 — Likely D
NY-22 — Likely D
NY-03 — Lean D
NY-19 — Lean D
NY-04 — D Toss Up
NY-17 — Lean R
California (6 Races)
California’s Central Valley and inland districts are places where rural issues are decisive. Health care access, water scarcity, ag consolidation, and land-use conflicts involving solar, warehouses, and data centers drive trust and turnout.
U.S. House
CA-21 — Likely D
CA-25 — Likely D
CA-47 — Likely D
CA-45 — Lean D
CA-13 — D Toss Up
CA-22 — R Toss Up
CA-48 — R Toss Up
Pennsylvania (5 Races)
Pennsylvania remains a classic rural–metro balance state with multiple persuasion zones. Hospital access, addiction treatment, legacy environmental damage, and warehouse and data-center sprawl all intersect with competitive House races.
U.S. House
PA-17 — Likely D
PA-07 — R Toss Up
PA-10 — R Toss Up
PA-08 — Lean R
PA-01 — Likely R
Texas (5 Races)
Texas is a scale state where rural margins matter even when statewide wins are difficult. Non-expansion Medicaid, rural hospital closures, water stress, data-center growth, and eminent-domain land fights create ongoing accountability pressure.
U.S. Senate
TX — John Cornyn (R incumbent)
U.S. House
TX-28 — Lean D
TX-34 — Lean R
TX-15 — Likely R
TX-35 — OPEN | Likely R
Arizona (4 Races)
Arizona is defined by water scarcity and rapid growth pressures that make land use and health care existential issues. Data centers, groundwater depletion, and rural and tribal health access are central to voter decision-making.
Governor
AZ — Katie Hobbs (D incumbent)
U.S. House
AZ-01 — OPEN | R Toss Up
AZ-06 — R Toss Up
AZ-02 — Likely R
Ohio (4 Races)
Ohio combines high-profile statewide races with competitive House districts where rural service delivery matters. Hospital closures, Medicaid politics, school funding fights, and data-center expansion shape persuasion opportunities.
U.S. Senate
OH — Jon Husted (expected GOP nominee)
Governor
OH — OPEN
U.S. House
OH-13 — Lean D
OH-01 — D Toss Up
OH-09 — Lean R
Wisconsin (3 Races)
Wisconsin is a margin state where rural turnout and persuasion routinely decide statewide outcomes. Hospital staffing shortages, water contamination, and education funding gaps anchor rural accountability narratives.
Governor
WI — OPEN
U.S. House
WI-03 — R Toss Up
WI-01 — Likely R
Georgia (2 Races)
Georgia’s rural politics are shaped by hospital closures, non-expansion Medicaid, and land-use change tied to warehouses and data centers. These issues cut across race and geography and influence both statewide races.
U.S. Senate
GA — Jon Ossoff (D incumbent)
Governor
GA — OPEN
North Carolina (3 Races)
North Carolina features a competitive Senate race alongside rural House districts where health care access and school funding are top concerns. Eastern and western rural regions remain decisive for statewide outcomes.
U.S. Senate
NC — OPEN
U.S. House
NC-01 — Lean R
NC-11 — Likely R
Nevada (4 Races)
Nevada’s rural politics are driven by water allocation, federal land management, and limited health care access. Small rural margins can swing statewide races, making service delivery central.
Governor
NV — Joe Lombardo (R incumbent)
U.S. House
NV-01 — Likely D
NV-04 — Likely D
NV-03 — Lean D
Iowa (3 Races)
Iowa is defined by accelerating hospital closures, water pollution, and school consolidation. Even in a challenging partisan environment, accountability around health care and clean water remains potent.
U.S. Senate — OPEN
Governor — OPEN
U.S. House
IA-01 — R Toss Up
IA-03 — Lean R
IA-02 — OPEN | Likely R
Maine (3 Races)
Maine is a heavily rural state where health care access, aging infrastructure, and USPS reliability carry outsized weight. Split-ticket voting remains possible in the right conditions.
Governor
OPEN
U.S. Senate
ME — Susan Collins (R incumbent)
U.S. House
ME-02 — OPEN | Likely R
New Hampshire (3 Races)
New Hampshire’s small size and rural composition make local service delivery highly visible. Health care access, education funding, and property tax pressures shape statewide dynamics.
Governor
NH — Kelly Ayotte (likely GOP nominee)
U.S. Senate
NH-01 — OPEN | Likely D
NH-02 — Likely D
Colorado (2 Races)
Colorado’s competitive House districts include large rural and exurban areas affected by water scarcity, energy development, and health care access. These races offer targeted persuasion opportunities.
U.S. House
CO-08 — R Toss Up
CO-03 — Likely R
Virginia (3 Races)
Virginia’s rural and military-connected communities face health care access challenges, school funding gaps, and USPS reliability issues that shape competitive House races.
U.S. House
VA-07 — Lean D
VA-02 — R Toss Up
VA-01 — Lean R
Washington (2 Races)
Washington’s rural districts are shaped by land-use conflicts, water management, and access to services across large geographies. These issues cut across partisan lines in competitive seats.
U.S. House
WA-08 — Likely D
WA-03 — D Toss Up
Kansas (1 Race)
Kansas’s open governor’s race occurs amid ongoing rural health care access challenges, school funding debates, and water depletion concerns that drive statewide accountability.
Governor
KS — OPEN
Minnesota (1 Race)
Minnesota’s targeted House race includes rural and exurban communities where hospital access, broadband, and education funding remain salient.
U.S. House
MN-02 — OPEN | Likely D
Montana (1 Race)
Montana’s at-large House race is shaped by land access, water scarcity, and health care availability across vast rural areas.
U.S. House
MT-01 — Likely R
Alaska (1 Race)
Alaska’s at-large race reflects extreme rural service delivery challenges, including health care access, infrastructure, and mail service across remote communities.
U.S. House
AK-AL — Likely R
Florida (2 Races)
Florida’s targeted House districts include rural and exurban areas where insurance costs, hospital access, and disaster resilience influence voter behavior.
U.S. House
FL-23 — Lean D
FL-13 — Likely R
Illinois (1 Race)
Illinois’s targeted House race includes rural regions facing hospital closures, aging infrastructure, and school funding pressures.
U.S. House
IL-17 — Likely D
Indiana (1 Race)
Indiana’s targeted House race reflects rural concerns around hospital closures, Medicaid policy, and education funding.
U.S. House
IN-01 — Likely D
Nebraska (1 Race)
Nebraska’s competitive House race includes rural communities affected by hospital access challenges, ag consolidation, and broadband gaps.
U.S. House
NE-02 — OPEN | Lean D
New Mexico (1 Race)
New Mexico’s targeted House race is shaped by water scarcity, rural and tribal health care access, and federal land management.
U.S. House
NM-02 — D Toss Up
Oregon (1 Race)
Oregon’s competitive House race includes rural regions where health care access, wildfire recovery, and land-use conflicts shape voter trust.
U.S. House
OR-05 — Likely D