Amy Acton projected to win Ohio governorship after bitter race with billionaire Ramaswamy

Ramaswamy said his campaign would spend $4m (£3m) to air the ad across the state.

After the ad began airing, the editorial board of local Ohio news outlet the Columbus Dispatch endorsed Acton, describing the ad as "revolting and unsettling".

The billionaire biotech entrepreneur ran against Trump for the Republican nomination in 2024. He switched gears to the Ohio governor's race and pitched himself as a political outsider - like Trump - who wanted to develop the president's "America First" agenda.

In his concession speech, Ramaswamy said he is "rooting" for the state, as well as Acton.

Acton is a physician and public health official who talked about her experience with homelessness as a child while campaigning for affordability.