Voters in Idaho’s 1st Congressional District are preparing to weigh starkly different approaches to healthcare affordability and agricultural labor policy this November. With the general election set for Nov. 3, incumbent Republican Russ Fulcher faces a three-way challenge from Democrat Kaylee Peterson, independent Sarah Zabel, and Constitution Party candidate Brendan Gomez.
The district, which spans Idaho’s panhandle and extends down the western side of the state, has long grappled with high medical expenses. While all candidates acknowledge healthcare costs as a primary concern for constituents, their proposed solutions range from market-based reforms to significant government intervention.
What Happened
Russ Fulcher, the Republican incumbent, argues that the Affordable Care Act, enacted in 2010, contains structural flaws that cannot be ignored. However, he maintains that repealing the law without a viable replacement would harm Idahoans who rely on its provisions.
Fulcher is championing a “voluntary parallel path” for private marketplace insurance. Developed in collaboration with Alabama Rep. Gary Palmer, the proposal aims to deliver benefits directly to beneficiaries. This approach would allow individuals to select their preferred providers and services, rather than relying solely on traditional insurance structures.
Independent candidate Sarah Zabel has outlined a four-pronged strategy to tackle medical expenses: hospital services, physician services, prescription drugs, and the insurance marketplace. She advocates for breaking up large hospital systems to increase competition and expanding the roles of nurse practitioners and physician assistants to broaden access to care.
Zabel also supports requiring greater cost transparency from providers. Her plan includes reinstating enhanced premium tax credits, which expired at the end of 2025, to help lower monthly premiums for those purchasing coverage through exchanges.
“We’ve seen where the biggest holes were,” Zabel told the Idaho Capital Sun regarding her targeted approach to insurance reform. “So look at where are the people most affected, and let’s see if we can patch those parts at least where the people are most affected, and where it’s driving the worst part of the insurance spiral.”
Democratic candidate Kaylee Peterson advocates for a more dramatic shift in policy. She supports moving toward a single-payer health insurance system while retaining options for private insurance. Peterson argues that the current structure forces Idahoans to pay for healthcare twice: once through taxes and again through high out-of-pocket costs.
“For me, the government needs to step in, and we have to reimagine a system in which we’re not also paying the taxes for healthcare and paying thousands of dollars a month,” Peterson told the Idaho Capital Sun. “I think single-payer options right now would seem like the most affordable.”
By The Numbers
- Nov. 3: Date of the general election for Idaho’s 1st Congressional District.
- 2010: Year the Affordable Care Act was enacted, a law Fulcher says needs reform but not elimination.
- End of 2025: When enhanced premium tax credits expired, a policy Zabel seeks to restore.
- 2019: Year the Farm Workforce Modernization Act was first proposed, becoming a key debate issue in this race.
Immigration and Agricultural Labor
Beyond healthcare, the candidates are divided on immigration policy, particularly regarding the agricultural workforce. Idaho’s farming industry relies heavily on seasonal labor, leading to different legislative preferences among the contenders.
Peterson supports the Farm Workforce Modernization Act, which was first proposed in 2019 and passed the House in 2021 before stalling in the Senate. The legislation would create temporary legal status for undocumented farm workers, streamline the H-2A visa program, and offer a path to green cards for long-term agricultural employees. It also requires employers to use the E-Verify system.
Fulcher voted against the Farm Workforce Modernization Act, citing concerns about amnesty provisions. He has stated he opposes immigration reform that includes amnesty but remains open to negotiating measures that right-size visa slots and adjust validity windows. Fulcher favors state-by-state and industry-specific adjustments to address labor needs without broad federal overreach.
The current H-2A program is limited to temporary, seasonal work and cannot be used for year-round farm labor or dairy operations. Zabel supports the Securing Agriculture’s Workforce Act, introduced this year, which would expand the H-2A program to allow for year-round employment. She also backs similar visa expansions for the construction and hospitality industries.
In a notable partisan split, Idaho Republican U.S. Rep. Mike Simpson voted for the Farm Workforce Modernization Act, while Fulcher opposed it. Peterson additionally supports funding more immigration judges to streamline legal immigration processes.
Zoom Out
The debate in Idaho’s 1st District mirrors national tensions over how to balance market freedom with government oversight in healthcare. As federal Medicaid rules continue to evolve, including recent restrictions on certain procedures as seen in Federal Medicaid Rule Blocks Coverage of Gender-Affirming Procedures for Children, Idaho voters are increasingly focused on who controls their medical decisions and costs.
Additionally, work requirements and eligibility changes for Idaho Medicaid Enrollees Must Document Medical Frailty to Escape Work Requirements highlight the state’s ongoing efforts to manage taxpayer spending while maintaining safety nets. These local policy shifts provide context for the broader federal debate unfolding in this congressional race.
What’s Next
Campaigns will intensify in the coming weeks as candidates make their final appeals to voters across the panhandle and western Idaho. Brendan Gomez, the Constitution Party candidate, did not respond to interview requests for this profile, leaving his specific policy positions less defined in public reporting.
Fulcher has also identified public lands management as a top priority, an issue that resonates strongly with constituents in Idaho’s rural counties. As election day approaches, voters will be asked to choose between maintaining the current legislative trajectory or adopting alternative frameworks for healthcare and immigration policy.
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