Ashford considered running against Bacon again after he voted for the American Health Care Act of 2017 which would had partially repealed the Patient Protection and Affordable Care Act. In June 2017, Ashford announced that he would seek the Democratic nomination to run against Bacon for another term. On September 20, Ashford formally announced his campaign at the Old Mattress Factory in Omaha, Nebraska, and filed to run in the election on January 30, 2018. During the campaign he received organizational and fundraising support from the Democratic Congressional Campaign Committee as a member of the Red to Blue program. Ashford was also endorsed by Giffords, a gun control advocacy organization that was founded by former Representative Gabby Giffords and her husband Mark Kelly.