Gov. Andy Beshear has called on U.S. Rep. Andy Barr to provide legitimate support for Kentucky's rural hospitals, directly responding to what he characterized as misleading statements from the Lexington Republican.

In a letter sent Aug. 25, Barr challenged Beshear's repeated warnings that 35 Kentucky rural hospitals could close due to Medicaid cuts included in the federal tax and spending law. Barr questioned why the state's $212.9 million Rural Health Transformation Program plan does not specifically identify or prioritize those hospitals.

Beshear rejected Barr's characterization during his weekly update, calling the congressman's letter "misleading and inaccurate" and suggesting he consult the Kentucky Hospital Association to verify the claims. "The big, ugly bill — which Barr supported doing the president's bidding — cut $21 billion over 10 years in Medicaid funding for Kentucky. That is a fact," Beshear said. "That is $21 billion fewer dollars running through our health care system. Of course, that's going to impact hospitals."

The dispute centers on the source of the 35-hospital figure. A University of North Carolina study commissioned by Senate Democrats identified financially vulnerable rural hospitals but did not predict closures. Barr argues the analysis was conducted before the bill became law and does not account for the Rural Health Transformation Program created to mitigate impacts.

Beshear emphasized that rural hospitals often serve as the second-largest employers in their counties after public schools. If closures occur, patients in rural Central, Southern and Eastern Kentucky would be forced into urban areas, potentially straining city hospitals and raising care costs.

The exchange reflects a broader political dispute as Barr runs for the U.S. Senate seat being vacated by Mitch McConnell. Beshear's response suggests the rural health debate will remain central to Kentucky politics heading into the 2026 elections.