Lexington, July 3, 2025 — Appalachian Regional Healthcare (ARH) is deeply disappointed by the passage of the Big Beautiful Bill. While we support efforts to strengthen Medicaid for the long-term, this legislation falls short in addressing the real needs of rural healthcare providers and the large percentage of patients covered by Medicaid who depend on us to care for them and their families. The changes made to Medicaid supplemental funding will significantly reduce the stable State Directed Payments that sustain hospitals like ours, replacing them with an underfunded and unpredictable Rural Health Transformation Fund that must be spread thinly across all rural providers nationwide.

Unlike many stand-alone rural hospitals facing these same funding threats, ARH is fortunate to have the benefit and strength of being a large, multi-hospital system with a solid foundation built through years of careful planning and thoughtful financial decisions – giving us more stability to manage changes like these. While these changes do bring about an increased level of uncertainty, we want to assure our patients and communities that we have no immediate plans to close any of our ARH hospitals and we are not planning for any layoffs due to this legislation. We remain committed to protecting the level of care our patients have become accustomed to receiving, as well as ARH’s nearly 70-year legacy as the region’s largest provider of care. We will navigate these challenges with the same resilience our system has always shown while continuing to provide high-quality care close to home for the people of eastern Kentucky and southern West Virginia.

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