Just minutes into their final TV debate on Wednesday, the candidates jockeying for U.S. Senate in Kansas immediately faced questions about the two issues that have dominated TV ads in recent weeks.

The first question posed to U.S. Sen. Roger Marshall, a Republican, centered on his history of suing patients as a rural physician. The Rev. Adam Hamilton, a Democrat, was asked about his church’s handling of abuse allegations from the early 2000s.

Wednesday’s hourlong debate, moderated by FOX4’s John Holt, offered both candidates a chance to set the record straight on the attack ads that have sought to define the two men ahead of Election Day. The candidates have traded dueling claims against each other in a race that’s grown increasingly negative ahead of the Nov. 3 election.

Marshall has faced scrutiny over his medical debt collection practices as an OB-GYN after revelations that he took more than 700 patients to court over unpaid bills. Hamilton, meanwhile, has been hit with attacks over his church’s handling of a sex abuse scandal more than two decades ago.

The debate stage provided Marshall and Hamilton the clearest opportunity to address the criticisms looming over their campaigns.

Perhaps more noteworthy, it also gave each candidate a chance to emphasize their opponent’s vulnerabilities less than two weeks before Election Day.

Marshall’s medical debt practices

After the two candidates took the stage, Holt asked Marshall to respond to criticism of his medical debt collection practices. The incumbent senator accused his critics of lying about the controversy before acknowledging that his office sent patients with unpaid bills to collections.

While he didn’t name her, Marshall appeared to reference a viral ad featuring Meischa Zimmerman, one of his former patients, who has said she was arrested in front of her daughter while eight months pregnant after missing a $50 payment to Marshall’s practice.

He emphasized that Zimmerman was arrested after missing court appearances, although he inflated the number of hearings that she missed. Zimmerman was one of 81 of Marshall’s former patients arrested after missing court dates, The New York Times found.

“We did everything possible to keep them from going to collections — it was a very, very rare situation,” he said. “Once we turned them into collections, it was out of our hands.”

In a follow-up question Holt asked Marshall if he ever put limits on how his attorneys handled collections involving his patients, a reference to the high interest rates his patients were required to pay.

Marshall responded by characterizing the practice as commonplace among area hospitals. He said he thought there were times when patients would reach out about their bills, but reiterated that once a bill was sent to collections, it was out of his hands.

“Generally speaking, once it was turned over to collections, it was done,” he said, adding that his also provided free care at his clinic in Great Bend.

A Star analysis of court records tied to 150 active and defunct medical practices across Kansas found 35 that sued patients over unpaid bills. Many sought wage garnishments, but none charged as high as 18% annual interest on bills, the rate Marshall tacked on.

Hamilton’s church abuse controversy

In the first question posed to Hamilton, Holt asked the pastor to respond to criticism about his handling of a sex abuse scandal at Church of the Resurrection, the church he founded.

Marshall’s campaign and supporters, including President Donald Trump, have elevated the controversy in recent weeks and accused Hamilton’s church of attempting to cover up the scandal.

Hamilton, in response, said that his church changed its policies in response to the scandal and eventually turned the matter over to police. The police declined to pursue charges after a separate investigation, he said.

“I will tell you that, ultimately, we helped get this man put behind bars,” Hamilton said. “And the policies that we developed were used by 10,000 churches across America.”

A series of court records undercut the claim that Hamilton attempted to protect the child abuser, Scott Preston Moore, a former church retreat volunteer who faced allegations of abuse before his conviction in an unrelated case in 2013. But Hamilton has also acknowledged that he would have handled the case differently today.

Hamilton said he was not involved in his church’s investigation of Moore and the church’s decision to let Moore return to the camp in 2006, a year after the initial allegations. Court records show that the investigation into the initial allegations was inconclusive.

“I did not sign off on him going back. I should have checked to make sure that he wasn’t going back,” he said. “That was a mistake on my part. But I will tell you, when he was investigated the next year, we forbade him from working with youth or children anymore.”

Court records reviewed by The Star show that the church revoked Moore’s ability to work with kids. Another man decided to report to police additional abuse by Moore, who was the man’s babysitter, after speaking with Hamilton in 2010, according to court records and Hamilton’s campaign.

After responding to their most visible attacks, the two candidates traded barbs over a slew of policy issues, including health care, prescription drug prices, tariffs and the ongoing war with Iran.

Election Day nears

The stakes are high as the race Marshall was supposed to win handily is now neck-and-neck, according to recent polling. National reporters, big GOP donors and the president himself have descended on Kansas as Republicans seek to stave off Hamilton’s challenge.

A Democrat has not won a Senate seat in Kansas since 1932, when Amelia Earhart flew solo across the Atlantic Ocean, Babe Ruth hit 41 home runs and the country was caught in the Great Depression.

Hamilton is attempting to become just the fourth Democratic senator in the state’s history.

Meanwhile, national Republicans are attempting to mobilize the state’s conservative voters around Marshall in a state Trump won with 57% of the vote in 2024.

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