The Associated Press has projected late on Tuesday evening that Democrat Amy Acton has defeated Republican Vivek Ramaswamy in Ohio’s gubernatorial election, flipping the office from Republican control and electing the state’s first woman governor.

With roughly 85% of the vote counted, Acton held about 50.7% to Ramaswamy’s 46%, with Libertarian Don Kissick taking the remainder. She will succeed term-limited Republican Gov. Mike DeWine to lead the state. Ohio had not elected a Democrat as governor since Ted Strickland in 2006. The state has voted for Republican presidential nominees by large margins in recent cycles, including President Donald Trump’s 11-point win in 2024.

Acton, 60, is a physician from Youngstown who earned her medical degree from Northeast Ohio Medical University and a master’s in public health from Ohio State University. She served as director of the Ohio Department of Health from 2019 to 2020 under DeWine, becoming a public face of the state’s early COVID-19 response through daily briefings. She resigned in June 2020 amid legislative pressure and protests outside her home over pandemic restrictions. Before and after that role, she worked in public health, teaching, and philanthropy at the Columbus Foundation. She ran on cost-of-living concerns, school funding, and criticism of Republican policies on education and taxes. Her running mate was former Ohio Democratic Party chair David Pepper.

Ramaswamy, a Cincinnati-born biotech entrepreneur and founder of Roivant Sciences, rose to national prominence as a 2024 Republican presidential candidate before dropping out and endorsing Trump. He later worked briefly with the Department of Government Efficiency. Trump endorsed him early for governor and reiterated support on Election Day. Ramaswamy campaigned on tax cuts, deregulation, economic growth, and alignment with the administration’s priorities. He cleared the Republican primary with little opposition after receiving the state party’s endorsement; his running mate was state Senate President Rob McColley.

The campaign was marked by unusually personal attacks. In the closing weeks, Ramaswamy’s campaign aired a multimillion-dollar advertisement featuring Acton’s estranged mother calling her a liar. Acton has long described a difficult childhood in Youngstown that included poverty, frequent moves, and abuse by a stepfather. Court records and family accounts have supported key elements of her account. The ad drew bipartisan criticism, including from DeWine and some other Republicans, and election forecasters shifted the race toward Acton afterward. Pre-election polling had shown her with a consistent narrow lead of roughly 3 points or more.

The result represented a Democratic pickup in a state that has trended Republican at the statewide level for the last decade. Official certification remains pending as the remaining ballots are counted.