Westerville, Ohio The shouting began the moment Vivek Ramaswamy walked onto the stage Tuesday. “The child, she was 12 years old!” yelled a young man in the crowd. He was talking about a video that circulated on social media the previous night, released by Mr. Ramaswamy’s campaign for Ohio governor. It featured Democratic opponent Amy Acton’s mother calling her daughter a “liar.”Ms. Acton’s brother, Philip Stearns, responded in a statement that they were removed from their mother’s custody in 1978 after their stepfather was indicted on charges of sexually abusing Ms. Acton, who is now 60.

As security escorted the heckler out of the town hall in this Columbus suburb, applause erupted. “Bye!” a woman to my right cheered. The 250 attendees nodded along as Mr. Ramaswamy, the son of Indian immigrants, outlined his policy proposals and credited his home state “for giving me opportunities that would not have been available to a kid like me in any other country on planet Earth.”Mr. Ramaswamy, 41, energizes MAGA loyalists, yet he faces an uphill battle among independents, moderate Republicans and the far-right fringe. If he loses, Democrats will reclaim an office Republicans have held for 32 of the past 36 years.

Neither candidate has an extensive record in elected office to critique, so the race has turned into a bitter war of personal attacks. Mr. Ramaswamy is a biotech entrepreneur who served a stint in Donald Trump’s DOGE effort during the transition between the 2024 election and Inauguration Day. Ms. Acton served under Republican Gov. Mike DeWine as Ohio’s public-health director during the early days of the Covid-19 pandemic. She has declined to debate Mr. Ramaswamy. “I won’t normalize somebody who has said that my childhood is something I’m just complaining about,” Ms. Acton told Spectrum News. “The words our leaders use matter.”

Ms. Acton casts Mr. Ramaswamy as an “out-of-touch billionaire” who conned his way to a pharmaceutical fortune. He says his financial independence frees him from special interests and that Ohio’s chief executive needs a business background: “I’ve signed in front of a paycheck, not just the back of one.”

The Ramaswamy campaign has spent nearly four times as much as the Acton campaign, largely on ads, some of which accuse Ms. Acton of substance abuse and claim her medical knowledge was “insufficient” for the Ohio medical board. When I asked if he approved of the ad featuring her estranged mother, Mr. Ramaswamy said, “I have no idea what happened between Amy Acton and her mother. What I do know is she has viciously lied during the course of this campaign.”

He is sticking with the ad despite bipartisan backlash. Mr. DeWine urged Mr. Ramaswamy to take it down but didn’t rescind his endorsement of the Republican nominee. It’s unclear how it will play with the electorate, but none of the supporters I met in the suburbs of Columbus after the ad was posted brought it up.

Mr. Trump carried Ohio three times, yet the state has borne the costs of his second-term policies. Farmers have struggled with rising diesel and fertilizer costs. The tariff war with Canada hits manufacturers and small businesses. Ohioans across party lines favor a pause in building new data centers. The president’s approval rating stands at 39%, near the national average, in a state he won by more than 11 points in 2024.

Both gubernatorial candidates have distanced themselves from their parties’ more divisive positions that could scare off independents and moderates. Ms. Acton emphasizes healthcare costs, school funding, rising electric bills and labor unions. Mr. Ramaswamy hardly mentions Mr. Trump’s name or Iran at his rallies. He sticks to questions of affordability, taxes, crime and education.

Mr. Ramaswamy promises to expand school choice, require civics tests and raise academic standards. He often takes aim at Ms. Acton’s decision to close public schools before any other state during the pandemic. She resigned as health director in June 2020 after the Legislature pressured her to open county fairs. The Ohio Republican Party has mocked Ms. Acton at fairs with life-size cutouts of her wearing a mask.

The pandemic isn’t a distant memory for voters in Westerville. Andrea Moore, 57, a high-school intervention specialist who helps students with behavioral, developmental or academic needs, said “you can just tell who had to wear a mask when they were young” because of lingering speech impediments today. “Now we’re picking up the slack.”

Mr. Ramaswamy wants to deliver the largest property-tax cut in state history, resetting the baseline tax to 2020 levels. He also wants to phase out the state income tax. He says the budget shortfall would be offset by economic growth from having “fewer people sitting and camping out in Texas and Florida and Tennessee for six months and a day.”Ms. Acton wants to expand property-tax breaks for elderly and disabled homeowners. Her affordability plan also involves directing the state to forgive medical debt for many Ohioans, which Mr. Ramaswamy claims would require more than doubling the state income tax.

“What she would represent would be an equivalent of a Great Depression for Ohio,” Mr. Ramaswamy said. The Acton campaign says she hasn’t proposed an income-tax increase and that the debt-relief plan will be similar to one in Illinois, which costs the state less than 1% of the value of the forgiven debt.

“Voting for Acton is a referendum on state Republican leadership,” said Brian Rothenberg, a political consultant representing Ohio’s Democratic candidates for the state supreme court and attorney general. He compared the enthusiasm he’s seen among independents and moderates for the Democratic Party to 2006, the last time his party won the governorship.

Many Ohio voters are anxious about the proliferation of data centers. Mr. Rothenberg points to tax breaks for data-center development signed by former Gov. John Kasich. Ms. Acton proposes a conditional moratorium to ensure that developers cover utility costs, along with other standards. Mr. Ramaswamy supports building data centers on abandoned industrial sites and giving their surplus generated energy as “free electricity” to neighbors.

Mr. Ramaswamy hasn’t entirely abandoned hot-button themes that energize the MAGA base. He says he will cooperate with federal immigration enforcement and doesn’t support sanctuary jurisdictions. Mr. Trump has come to Ohio twice this month to campaign with Mr. Ramaswamy and Sen. Jon Husted, whom Mr. DeWine appointed to succeed JD Vance and who faces a tough race against former Sen. Sherrod Brown. Mr. Trump has one more scheduled visit before Election Day.

Some on the right have pilloried Mr. Ramaswamy’s past support of high-skilled immigration. He has also faced anti-Indian and anti-Hindu attacks from self-styled “heritage Americans” on the Republican fringe. During the Ohio primary, opponent Casey Putsch called him “questionably American” and invited him to play “cowboys versus Indians.”Mr. Putsch won about 18% of the primary vote.

“I don’t even call it the right, because there’s nothing conservative about it,” Mr. Ramaswamy said of these attacks. “It’s disappointing and it’s un-American.”He blames such behavior on economic anxiety, which is downstream of educational failures. “Those are legitimate frustrations that I need to address, but it’s not by indulging the ugliness of identity politics.”

Ms. Acton has led most polls by single digits, but Ohio gubernatorial polls have been unreliable in the past. October 2018 polls had Democrat Richard Cordray ahead by as much as 6 points. Mr. DeWine won by 3.7. Matt Dole, GOP chairman for Licking County, said that although he expects parts of the MAGA coalition to peel away after the midterms, Mr. Ramaswamy is holding the coalition together in Ohio. “If the notion is that Republicans lack energy and enthusiasm this cycle, his events suggest otherwise.”

Ms. Koch is an associate editor of WSJ Opinion’s Free Expression newsletter and a 2026-27 Robert Novak Journalism Fellow.