On January 14, Cramer announced that he would run for North Dakota's seat in the United States House of Representatives for a third time in the 2010 election. In early 2010, he appeared at North Dakota town hall meetings, where he opposed the Affordable Care Act. Cramer attended numerous Tea Party rallies in North Dakota, speaking about energy, taxes, jobs and the U.S. Constitution. At the state Republican Party convention in March 2010, former House Majority Leader Rick Berg won the Republican congressional nomination; Berg was elected to Congress in November.