FRANKFORT, Ky. — State lawmakers heard urgent testimony on rural healthcare challenges at an Interim Joint Committee on Health Services meeting on August 19, as national experts warned of hospital closures and physician shortages threatening rural communities across the country, including Kentucky.

A senior official from the National Rural Health Association told legislators that more than 190 rural hospitals have closed nationwide since 2010, with 430 additional facilities vulnerable to closure, according to a report from the Kentucky Legislative Research Commission. Zil Joyce Dixon Romero said 62 million Americans live in rural areas and depend heavily on Medicaid, Medicare and marketplace insurance plans.

Kentucky faces particular challenges with physician shortages. While the nation needs approximately 15,000 doctors to fill rural gaps, Kentucky alone needs to fill about 388 positions in underserved areas. Romero said about 16 to 20 percent of Kentucky hospitals are considered financially vulnerable.

The comments come as Kentucky has prioritized rural health transformation. The state received nearly $213 million in federal funding for 2026 through the Rural Health Transformation Program, placing it among the top states nationally for rural health support.

Sen. Stephen Meredith, R-Leitchfield, a committee co-chair with nearly 40 years of healthcare experience, expressed skepticism despite Romero's optimism about rural health's future. "I can tell you for this particular issue, I'm not optimistic because looking back over the last 40 years, a lot of problems we're seeing today we saw 40 years ago, just magnified," Meredith said.

Representatives from the University of Kentucky's Center of Excellence in Rural Health, established in 1990 to address rural health disparities, presented updates on workforce programs and community health initiatives. The center operates the Kentucky Homeplace program, which pairs rural residents with health and social services through community health workers.

William Mace Baker, the center's interim director, said expansion of successful programs like Kentucky Homeplace could improve outcomes statewide, noting such initiatives have prevented worse health outcomes in rural Kentucky. He said he would welcome expanding the program's reach across the commonwealth.

Rep. Lindsey Burke, D-Lexington, raised concerns about noncompete clauses in provider contracts, saying healthcare professionals report they hinder rural medical practice. The committee committed to gathering additional information on the issue.