Rural Kentucky voters are showing declining enthusiasm for Republican candidates ahead of this November's midterm elections, driven largely by frustration with rising inflation and healthcare costs, according to a new survey by the healthcare research organization KFF and The Associated Press.

The poll of more than 2,000 rural voters nationwide found that 74% of rural Republicans say they are "absolutely certain" to vote in November, compared to 80% of rural Democrats—a notable gap that could affect turnout in a region traditionally favorable to the GOP. The decline in Republican enthusiasm tracks with mounting economic concerns among voters who say they are struggling with inflation-driven price increases for groceries, medicine, utilities, and other essentials.

Stacie Fugate, a lifelong Appalachian resident from Hazard in Perry County, said Trump supporters in her community are increasingly vocal about their financial distress. "That has been a chain reaction that I've seen from all kinds of people that are speaking up about how they can no longer support him because of all of the inflation, of all of the rising prices," Fugate observed.

Despite the GOP's economic struggles, Republicans retain a narrow advantage on the issue: 40% of rural voters believe Republicans can best address cost of living concerns, compared to 25% who believe Democrats can handle the job. However, disapproval of the Trump administration's healthcare policies is significant. The survey showed 54% of rural voters disapprove of Trump's handling of healthcare, citing concerns that his policies have contributed to rising costs.

The healthcare debate carries particular weight in rural Kentucky. More than 90% of rural voters surveyed said Medicaid is important for their communities, and nearly half reported having a family member or friend utilize the program. Last year, Republicans passed the One Big Beautiful Bill Act, which cut roughly $1 trillion from the Medicaid program.

The Nov. 3 election will decide all 435 House seats and determine who will replace U.S. Sen. Mitch McConnell, R-Ky., who is retiring after seven terms.