North Dakota GOP Senate hopeful Rep. Kevin Cramer mockingly appeared to question the intelligence of incumbent Sen. Heidi Heitkamp (D-N.D.) on health care issues during their final debate Friday night.

“The plans I’ve supported take the money, send it to the states and puts the states in charge,” Cramer (pictured above left) said. “Our governor supports the Republican plan, our lieutenant governor, our attorney general, the insurance commissioner, the congressman, the other senator. I’m pretty sure Heidi Heitkamp is not the smartest person out of that whole group and the only one that is right.”

Cramer tried to continue, but was interrupted by sustained booing from the audience at North Dakota State University in Fargo.

Cramer was responding to a question about an ongoing lawsuit against the Affordable Care Act, aka Obamacare, led by Texas Attorney General Ken Paxton and Republican officials from 19 other states.

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“Let’s not fool ourselves,” Heitkamp (above right) said. “When you vote five times to repeal the Affordable Care Act, where that patient protection exists, you have voted to eliminate that patient protection. When you support a lawsuit which the sole purpose is to eliminate the protection against pre-existing conditions, you don’t support protection for pre-existing conditions.”

Heitkamp also asserted it was wrong to vote to repeal Obamacare without a replacement that would protect patients with pre-existing conditions. She admitted the law has had issues but that she has worked to fix them instead of voting for bad plans for political gain. She also took issue with the people whom Cramer said support the Republican plans.

“He mentioned all the politicians, the Republican politicians, who support those plans,” Heitkamp said. “Guess who didn’t? The North Dakota Hospital Association, the Physicians Association, all of the patient protections, AARP. There was not one group in North Dakota other than the Republican Party and their officials who supported any of those plans.”

Cramer argued he has a record of protecting pre-existing conditions and that Obamacare failed to do what it promised. The program was signed into law in 2010 by President Barack Obama. Republicans have tried to repeal and replace the law numerous times since becoming the majority on both sides of Congress, but have succeeded only in ending the individual mandate.

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“Those officials are elected by large margins by the people of North Dakota,” Cramer said. “Not the associations. The people of North Dakota. And when you work for lobbyists instead of the patients, the people, the small businesses that hire people, that’s when you start thinking like [Senate Minority Leader] Chuck Schumer [D-N.Y.] instead of what the people think.”

The exchange marked the most intense point in a campaign that has seen Cramer with leads of as much as 14 points over the embattled Democratic incumbent. Republicans targeted Heitkamp early on in the 2018 midterm election campaign as a potential pickup to increase their present razor-thin 51-49 majority.

Friday night’s debate started on a more civil note, as the candidates agreed the country needs to protect the border better and to reform immigration laws. Heitkamp claimed to have supported President Donald Trump’s proposals on immigration, though Cramer noted she supports sanctuary cities.

The candidates disagreed on what should be done to save Social Security.

Heitkamp and Cramer also agreed on Trump’s decision to end a Cold War-era arms control treaty with Russia. Cramer said that he would have taken a slower approach but that Russia is clearly cheating. Heitkamp said Russia has “pushed the envelope” and something needs to be done.

The candidates disagreed on what should be done to save Social Security. Heitkamp accused Cramer of wanting to privatize the program, which he denied and then proposed raising the income cap so higher-income individuals would pay more into the system. Heitkamp argued the cap should be scrapped entirely.