Newsweek reached out to Acton's and Ramaswamy's campaigns for comment via email.
Ohio, once a premier battleground, voted for President Donald Trump in each of his three presidential bids. The Buckeye State has steadily drifted toward Republicans, giving Trump a double-digit victory last November against then-Vice President Kamala Harris. Ohio backed Trump by about 11 points in 2024, a rightward shift from his eight-point victories in 2020 and 2016.
But Democrats are hoping to make a comeback in Ohio in this year's Senate and gubernatorial races as Trump's declining approval rating fuels optimism about the midterms.
Acton, the former Ohio Department of Health director who helped manage the state's COVID-19 response, is viewed as the Democrats' presumptive nominee. Ramaswamy, who rose to national prominence when he ran for president in 2024, is viewed as the Republican frontrunner.
A Quantus Insights poll released Monday gave Acton a slight lead over Ramaswamy. She received 45.9 percent support in the poll, compared to Ramaswamy's 44.9 percent. It surveyed 809 likely voters from March 13-14 and had a margin of error of plus or minus 3.8 percentage points.
"Neither candidate reaches the fifty percent mark, a reminder that the electorate remains fluid eight months before the election. In modern Ohio politics, races that begin within a point or two during a competitive environment often remain that way well into the campaign season," the polling report reads.
It noted that the results "suggest a state still open to persuasion rather than firmly aligned behind either party."
It found that 47 percent of Ohio voters approve of and 50 percent disapprove of Trump's job performance.
Just last week, a poll from the Ohio Environmental Council showed Ramaswamy trailing Acton by 10 points. In that poll, Acton received support from 53 percent of respondents, while Ramaswamy received support from 43 percent. It surveyed 1,343 likely voters from February 10-22 and had a margin of error of plus or minus 2.7 percentage points.
Acton is a physician who was appointed to lead the Ohio Department of Health by Republican Governor Mike DeWine in 2019. During her tenure, she played a major role in leading the state's response to the COVID-19 pandemic. She resigned from that position in 2020 but continued as a health adviser to the governor. She has never held elected office.
Ramaswamy ran for president as a Republican in 2024. He struggled to garner enough support to overtake Trump, but became a favorite among many conservatives during his run. He also gained national political attention through his criticisms of "woke" corporate culture.
Ramaswamy was also selected by Trump to co-lead the Department of Government Efficiency (DOGE) upon his return to the White House but ultimately stepped away from the position in its early days, later announcing his gubernatorial run.
An Emerson College poll from late 2025 showed Acton leading Ramaswamy by a single point (46 to 45 percent). It had surveyed 850 registered voters from December 6- 8.
A Bowling Green State University/YouGov poll, on the other hand, gave Ramaswamy a 3-point lead over Acton (50 to 47 percent). It surveyed 800 registered voters from October 2-14, 2025, and had a margin of error of plus or minus 4.5 percentage points.
Ohio had shifted right in recent cycles -- Trump carried the state by about 11 percentage points in 2024, an improvement on his 2020 and 2016 performances in the state. He won Ohio by about eight points in 2020 and 2016. But former President Barack Obama narrowly carried Ohio in 2008 and 2012. It has shifted as Trump performed well among the state's working class voters.
Still, it has been competitive in recent elections. Former Democrat Senator Sherrod Brown won reelection in 2018. He lost in 2024 by fewer than four percentage points. Democrats hope their candidates can improve on that in a more favorable national environment this November. Brown himself is seeking a comeback in this year's Senate race.
Amy Acton wrote in a March 14 post to X: "The problems we're facing don't care if you're a democrat or a republican - they're just problems that need to be fixed. I've worked across the aisle to solve hard problems throughout my career, and as governor, no Ohioan, community, or concern will be overlooked by me."
Vivek Ramaswamy's campaign wrote in a March 12 press release: "Since receiving President Donald Trump's endorsement on the first day of his campaign and the Ohio Republican Party's endorsement in May 2025, Vivek has built a broad coalition of support from conservative lawmakers, community leaders, labor unions, law enforcement, and business leaders across the state."
Forecasters give Republicans an advantage in the race. Both the Cook Political Report and Sabato's Crystal Ball classify the race as Likely Republican.
Ohio's primary is set for May 5, 2026.