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WASHINGTON — Gov. Andy Beshear, D-Ky., warned last summer, as lawmakers prepared to pass the president’s signature tax and spending law, that the bill could lead to the shuttering of dozens of Kentucky’s hospitals due to proposed Medicaid cuts.
“One policy group has estimated that 35 rural hospitals in Kentucky will close,” Beshear said on a press call hosted by the Democratic Governors Association in June 2025.
He also wrote on social media: “With the passage of the ‘big, ugly bill,’ the U.S. Senate said it was okay to fire 20,000 Kentucky health-care workers, close 35 rural hospitals in our state and throw over 200,000 of our people off insurance.”
The 35 figure came from a list of at-risk rural hospitals published by Democratic senators, following analysis from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.
This week, Rep. Andy Barr, R-Lexington, sent Beshear a letter calling on him to provide the analysis his administration used to assert 35 hospitals would close because of the law.
“That figure was not a Sheps Center projection of hospital closures,” Barr wrote. He added that the senators’ criteria “identified financially vulnerable hospitals.”
Beshear defended his statements Thursday.
“First, the big ugly bill, which Barr supported doing the president’s bidding, cut $21 billion over ten years in Medicaid funding for Kentucky,” said Beshear. “That is a fact. That is $21 billion fewer dollars running through our health care system. Of course, that’s going to impact hospitals.”
Congress set up the Rural Health Transformation Program as part of the president’s tax and spending law.
Barr criticized Beshear, saying despite the governor’s concerns, he didn’t prioritize any of the 35 hospitals for nearly $213 million in funds Kentucky received for year one of the program.
“The federal government laid out five models, and states were encouraged to follow those if they wanted to get approved,” Beshear said Thursday. “None of those five models gave an opportunity to provide direct funding to rural hospitals. None.”
In response to Beshear’s comments, Barr told Spectrum News, “Medicaid spending is rising year-over-year” and “all 35 hospitals he said, ‘will close’ are still open.”
Most major changes to Medicaid are not expected until next year.
According to Barr’s office, the Centers for Medicare and Medicaid Services does not prohibit funds from going to or directly benefiting rural hospitals.
