DES MOINES, Iowa — If not for the sea of forest-green Make America Healthy Again caps, handed out free to the several hundred people who showed up, it would be hard at first to tell that Wednesday’s rally for Zach Lahn, the Republican candidate for governor of Iowa, had anything to do with health.

A line snaked around the Horizon Events Center in Clive, a Des Moines suburb, where rallygoers waited on the free Steak ‘n Shake burgers and fries they’d been promised, and ate them, sometimes two at a time. The couple dozen people I spoke to said they had come to support Lahn, a former Koch-network operative and Republican campaign strategist who’d recently moved to Iowa with his large blended family to try his hand at farming and politics.

They were deep-red Republicans, they told me, determined for Lahn to win in a race where he is currently down in the polls, in a state Trump carried three times (by 13 points in the last election), and which forecasters now predict could flip to centrist Democrat and state auditor Rob Sand.

Two years ago, the activists and operatives behind MAHA claimed they had captured a once-in-a-generation political coalition of health-focused moms and dads, anti-vaxxers, gym rats, conspiracy theorists and wellness warriors. They were mostly Republicans, sure, but citing a single poll, they claimed that a meaningful tide of independents and Democrats had voted for Trump in 2024 because the president had promised Robert F. Kennedy Jr. the power to upend the systems they’d lost faith in.

“Unwrap the gift of MAHA that President Trump has handed you and win big in the midterms,” MAHA PAC President Tony Lyons wrote in a February memo to Republican leaders.

But on the eve of the midterm elections, whatever is left of that coalition is in danger. Kennedy has dismantled public health agencies and stumbled through deadly outbreaks of vaccine-preventable disease and foodborne illness. Along the way, he’s also managed to alienate some of his most enthusiastic supporters, while the Trump administration gives a pass to the industries Kennedy once blamed for America’s poor health, and in some cases expands their power. Many of the people who worked on Kennedy’s presidential campaign and celebrated his partnership with Trump now say both men sold them out and have made the country sicker.

MAHA organizers call Lahn “the dream MAHA candidate.”The Iowa race is the clearest test of whether their political power is real or just a project by a fringe movement to conscript troops for an unpopular battle against childhood vaccines.

“If there’s any candidate who would be a MAHA candidate, it has to be Zach Lahn,” Lyons said at the rally’s opening address.

Kennedy, who headlined Lahn’s rally but tip-toed around an explicit endorsement because of federal rules prohibiting it, told the room it was the “most important election in the country.”Lahn’s platform, he said, was simple: water, children, cancer, and farming. “I think you know what to do,” Kennedy told the crowd.

A political message aimed at health makes sense in Iowa; where adult obesity, heart disease, and diabetes rates are among the highest in the nation and continue to climb, where children’s health and well-being have declined along with education in recent years, and where young adults have the second-highest rates of new cancers in the country. Plenty of people here wonder whether there’s something in the water supply, or if pesticides on the state’s vast farmland are to blame. (The University of Iowa has been investigating the state’s cancer crisis, and so far has found that the causes are hard to separate from factors like lifestyle and screening.)

But there were no booths at Lahn’s MAHA rally dedicated to tackling those problems. Instead, volunteers for anti-vaccine organizations Stand for Health Freedom, Informed Choice Iowa, and the far-right group Moms for Liberty, manned tables and handed out literature.

The crowd didn’t light up when speakers touched on those subjects, either. Self-described “Christian libertarian environmentalist capitalist lunatic farmer” Joel Salatin’s remarks on farming elicited more coughs than applause, and one man appeared to fall asleep during Kennedy’s riff on humans’ connection to the land.

What got the crowd on its feet — besides the fries — was the Republican red meat: Joe Mitchell, the 29-year-old MAHA-endorsed congressional candidate whose stump speech approximates a Trump impression and who recently said real Iowans don’t ride bicycles, brought the house down when he called for Anthony Fauci to be jailed. And Lahn’s biggest line of the night was his vow to get rid of the Covid-19 vaccine.

“The fight to pull the Covid vaccine off the market is a pro-life issue,” Lahn said. “I don’t believe that the ideas in this movement are radical.”

The room erupted: “Zach Zach Zach Zach!”Lahn’s rally was supposed to be the third star-studded MAHA PAC event organized for Republican candidates. The first two, announced by Lyons on the PAC’s weekly broadcast to be held in Fort Worth and Lansing, were abruptly canceled without explanation.

It wasn’t the first time a MAHA political operation fell short of its projections. In March, MAHA PAC announced a $100 million campaign to elect MAHA-aligned Republicans in the midterms. The most recent federal filings show a far smaller contribution to the cause: MAHA PAC spent a little over $1 million on midterm races – most of it on ads to unseat Louisiana Sen. Bill Cassidy, who had become Kennedy’s loudest Republican critic. Cassidy lost his primary in May.

When Lyons faced criticism from within the movement for MAHA’s meager receipts, he said on Steve Bannon’s show that the negative press attention attracted donors and millions more in cash — a claim not yet verifiable in FEC documents. Then Lyons announced a $1.65 million donation to Lahn’s campaign and told me via text that MAHA volunteers would also be sweeping the state to chase votes. To do that, Lyons partnered with Turning Point Action, the advocacy arm of the conservative youth organization, which already had a door-knocking operation.

It’s unclear how successful the mobilization effort has been. Outside of a few online posts from Turning Point representatives, there is little evidence of a major MAHA mobilization in Iowa.

It’s difficult to identify what exactly MAHA is. The various projects tied to the MAHA effort can be dizzying. There is the hybrid PAC led by Lyons. There is MAHA Worldwide LLC, which handles trademark rights, and was transferred from anti-vaccine activist, Del Bigtree, to anti-vaccine speaker and security consultant, Gavin de Becker. There is MAHA Holdings, a shadowy company that collects membership dues and organizes the MAHA summit, and whose board includes Kennedy’s son Finn. There’s also the MAHA Institute, the MAHA Center, and several MAHA media companies.

Together they make up what some former allies have taken to calling “Big MAHA.”This newly skeptical group included some of the most prominent influencers, alternative doctors and activists from the original movement. They are turning on Big MAHA – specifically against Kennedy and Lyons.

In October, Tiffany Cianci, an anti-private equity influencer who once campaigned for Kennedy, published the MAHA Scorecard website, which lists what she claims are promises made (42) and kept (0) by Kennedy and Trump on pesticides, clean air and water, school food, and family farms. For Cianci, one of Kennedy’s most egregious betrayals was his support of an executive order increasing the production of glyphosate, a pesticide that Kennedy had claimed for years caused cancer. The order also provided limited legal immunity to the manufacturers.

Dr. Robert Malone, a Covid conspiracy theorist hand-picked for Kennedy’s vaccine advisory panel, publicly excoriated his former boss and friend last month over the MAHA Summit.

“MAHA rose to prominence by condemning precisely this convergence of money, access, industry influence, and government power … Who exactly is MAHA for now?”Malone wrote on Substack.

The loudest voice of the new opposition has been Mary Talley Bowden, a Texas doctor who treated Covid patients with ivermectin and has compared Covid vaccines to thalidomide, a drug developed in the 1950s for morning sickness in pregnant women that caused severe birth defects in thousands of children. Seven weeks before the midterms, Bowden wrote an open letter to Kennedy, since signed by thousands, warning that the administration’s refusal to pull the Covid vaccine from the market would cost Republicans who had benefited from MAHA’s loyalty.

The letter ended, “If you continue to ignore our central issue of removing the mRNA platform, the MAHA and health freedom movements will withdraw their support of you, and you will face the political consequences.”Bowden has since been sparring online and on podcasts with loyalists who have closer personal ties to Kennedy. The most notable of Kennedy’s remaining defenders is Children’s Health Defense, the world’s largest anti-vaccine organization, which paid Kennedy millions as its chairman until he left to join the Trump administration.

Its leaders have urged supporters to give Kennedy more time. Lyons sits on its board. The organization points to Kennedy’s wins — inverting the food pyramid to prioritize protein, barring junk food from Supplemental Nutrition Assistance Program benefits, and commissioning a study from anti-vaccine researchers into the cause of autism — as evidence that he will, at some point, fulfill his promises. But it’s unclear whether the movement can survive on allegiance to Kennedy alone.

“From the beginning, the coalition, it was like herding cats,” said Jeff Hutt, a Texas political consultant who ran field operations for Kennedy’s presidential campaign, and still believes in the MAHA cause.

Hutt said MAHA leaders, including Lyons, have been hampered by inexperience. They knew how to amass a large staff, organize fundraisers and throw parties, he said, but not how to turn a coalition into votes.

“It was going to be hard to begin with to turn out the MAHA vote in 2026,” Hutt told me. “But that base that Kennedy brought into the Republican coalition, he was going to have to deliver on all the promises.”

The morning before Lahn’s rally, I drove three hours northeast to Dubuque to interview Rob Sand, Lahn’s opponent — a trip punctuated by relentless political ads on the radio, alleging that Republicans were corrupt rubber stamps for Donald Trump or that Democrats would swarm Iowa with immigrants and turn all the children trans.

Outside Jitterz coffee shop on Main Street, where his “Solvin’ Iowa’s Problems” event was about to start, I asked Sand about MAHA.

Sand, who has doggedly campaigned to show himself as a centrist in the face of attack ads that label him “extreme,” said there was a lot of common ground to be found with those who considered themselves part of the MAHA movement. Clean water and healthy kids — surely everyone could agree on those goals. The issue was how to reach them.

“When it comes to questions about cancer and health in Iowa, we want to know that we’re basing what we’re doing on evidence and facts, because we want to make sure that we’re getting it right and actually improving people’s health in Iowa,” Sand said. About vaccines, Sand was more direct.

“There are no perfect instruments or tools in the world,” he said, describing vaccines generally, “but these are instruments that have saved countless lives.”Inside the coffee shop with a few dozen potential voters, Sand asked for any Republicans to raise their hands. A few shot up, followed by several more when Sand asked for independents. When it came time for questions, the subject of health came up again and again. An organic farmer told Sand she had cancer, and that a grant for her farm had been canceled due to Republican cuts. Another questioner wanted to know how he planned to feed hungry kids at school.

Emily Brannon, a mom with a milky pink manicure, soft honey-brown curls, and a 2-year-old at home, told me her child’s health and education were most on her mind. She used chlorine-free diapers, restricted sugar and food dyes, and chose to vaccinate her child, but respected other parents’ decisions on vaccines, even if she disagreed. MAHA had further polarized the issue of parenting, Brannon said.

“By tying health to one party and MAHA/MAGA, I think that lost the plot a little bit,” she said.

Hours later, at the rally for Lahn, I talked with Zen Honeycutt, founder and executive director of Moms Across America. Since 2013, Honeycutt’s group has published reports, exposing what it says are dangerous levels of “toxic chemicals” in everything from school lunches and Girl Scout cookies to baby formula and breakfast cereals. The group’s claims often garner media attention, and debunking from scientists and statisticians who say that the science behind the reports is lacking, that Moms Across America misunderstands both statistics and toxicology, and that the group’s findings are misleading and inspire unnecessary fear in parents.

Before her speech, where she argued that Lahn was the best candidate to take on pesticides and chemicals in Iowa’s food and water, Honeycutt told me the loyalty of MAHA mothers to the Republican party wasn’t binding. But she said that Democrats — despite being the party most identified with conservation and public health — refused to budge on vaccines, leaving MAHA voters with no other options. The MAHA grassroots, she said, would never abandon the vaccine issue, even if it was unpopular and divisive.

“We moms are never going to ‘chill’ on the vaccines,” Honeycutt said, repeating my question back to me.

It wasn’t politics; it was personal for Honeycutt, as it was for most anti-vaccine activists. She said vaccines killed her father and her brother, and that vaccines caused or worsened the depression that led to her son’s recent suicide. I didn’t press her.

I asked what a loss in Iowa would mean for MAHA; whether a win for Sand could delegitimize a movement that had spent years demanding the public acknowledge its unverifiable stories and heed its warnings, just when Kennedy had finally delivered them a taste of power. Honeycutt responded the same way Tony Lyons did when I asked him later that night by text.