Rob Sand is now the Democratic nominee for Iowa governor and will face Republican Zach Lahn in the general election after Lahn won the GOP primary. Sand has been campaigning on health and public policy issues, including a plan to reduce cancer rates, improve water quality, and roll back Medicaid privatization. He also recently said an Iowa Medicaid pharmacy benefit manager audit suggests taxpayers may have been overcharged, though his office said missing records limited how much it could prove. Overall, the race is being described as highly competitive.