Ralph Alvarado, a Republican physician from Winchester who served in the Kentucky Senate from 2015 to 2023 and then as Tennessee's health commissioner, is running for the U.S. House in Kentucky's 6th District in the November 3, 2026 general election against Democrat Zach Dembo, a former federal prosecutor.
In the state Senate, Alvarado voted for the laws that ended nearly all abortions in Kentucky, against an exception for pregnancies from rape or incest, for a cut in how long laid-off workers can draw unemployment, and for a tax law that an analysis found would raise taxes on the poorest fifth of Kentuckians while cutting them for the richest. As a candidate, he praised the Medicaid changes in the 2025 Republican tax and spending law, changes KFF projects will leave 200,000 more Kentuckians uninsured in 2034.
About Ralph Alvarado
- Full name
- Ralph Alvarado, Republican, on the 2026 ballot for Kentucky's 6th Congressional District
- Current role
- No current office; physician; former Kentucky state senator
- Prior offices
- Kentucky Senate, 28th District, January 2015 to January 2023; Tennessee commissioner of health, January 2023 to July 2025
- Seeking
- U.S. House, Kentucky's 6th District, on November 3, 2026, against Democrat Zach Dembo; the seat is open because Representative Andy Barr is running for the U.S. Senate
- Key votes, actions and positions
- sponsored the 2019 six-week abortion ban; voted for 2022's unemployment benefit cut; sponsored the 2017 medical review panel law; voted for the 2022 congressional map; praised the 2025 law's Medicaid changes
What Ralph Alvarado Is Responsible For
- Abortion bans. Ralph Alvarado was a sponsor of Kentucky's 2019 six-week abortion ban and voted for it, and on March 14, 2019 he voted for the state's trigger law, which passed the Kentucky Senate 32 to 5. Both have been enforced since August 2022, and Kentucky reported 13 abortions from January through July 2023, against 2,591 in the same months of 2021.
- Rape and incest exception. On March 29, 2022, Alvarado voted against an amendment that would have exempted pregnancies from rape or incest from House Bill 3's abortion requirements; the Senate rejected it, 9 to 26. Kentucky's trigger law has no rape or incest exception, and JAMA Internal Medicine researchers estimated 2,965 rape-related pregnancies in Kentucky in the ban's first 17 months.
- Unemployment benefits. Alvarado voted for House Bill 4 on March 3, 2022 and to override Governor Andy Beshear's veto on March 21, 2022. Starting in 2023 the most a laid-off Kentuckian could draw fell from 26 weeks of benefits to 12; a 2023 law set the minimum at 16 weeks.
- 2018 tax shift. Alvarado was one of the 20 senators who passed House Bill 366 on April 2, 2018, 20 to 18, and voted to override Governor Matt Bevin's veto. The Institute on Taxation and Economic Policy found the poorest fifth of Kentuckians would pay a little more than $90 more a year, while the richest 1 percent would save an average of $7,086.
- Sales tax on services and the income tax phase-down. Alvarado voted for House Bill 8 in March 2022 and to override the governor's veto on April 13, 2022. From January 1, 2023 Kentuckians paid sales tax on 35 more categories of services, among them parking, fitness training and household moving, and the bill's fiscal analysis projected a net revenue loss of $1.3965 billion over two budget years.
- Teacher pensions. Alvarado voted for House Bill 258 in March 2021, which put Kentucky teachers hired from 2022 on into a hybrid retirement plan. The Equable Institute estimated a teacher who works more than 20 years will receive $2,846 a year less in retirement income than under the old pension.
- Prevailing wage. On January 7, 2017, Alvarado voted for House Bill 3, which repealed Kentucky's prevailing wage for public construction. A legislative staff survey of 46 prevailing-wage projects cited in the bill's fiscal note found workers on them earned 24% more.
- Redistricting. Alvarado voted in January 2022 for Kentucky's new congressional and state House maps and to override the governor's vetoes. A Franklin Circuit judge wrote that "there is no doubt" the maps were "partisan gerrymanders" but upheld them, and the Kentucky Supreme Court affirmed in December 2023. The congressional map moved Franklin County and Frankfort out of the 6th District.
- Amendment 2. On March 30, 2021, Alvarado voted for House Bill 91, which put Amendment 2, declaring no state constitutional right to abortion, on the 2022 ballot. Kentucky voters rejected it, 52.35% to 47.65%.
- Malpractice lawsuits. Alvarado sponsored the 2017 Medical Review Panel Act, which made injured patients take claims against doctors, hospitals and nursing homes to a panel before suing. A year in, panels had been assigned for 11 percent of 531 claims, and the Kentucky Supreme Court struck the law down in November 2018 because it delayed access to the courts.
- Medicaid cuts. In August 2025 Alvarado said the Republican megabill would "help Medicaid be used for the people that it was intended for" and that more changes must come. KFF estimates its Medicaid changes cut federal Medicaid spending in Kentucky by $22.21 billion over ten years, and expansion adults must meet a work requirement from January 1, 2027.
- Tariffs. At a February 2026 debate Alvarado said the President was using tariffs "as a means of getting a transaction done." The Yale Budget Lab estimated in August 2026 that tariffs under current law cost the average U.S. household about $1,100 a year.
- Rural hospitals. Launching his campaign in July 2025, Alvarado promised to "save rural hospitals." The law whose Medicaid changes he praised cuts rural Medicaid spending in Kentucky by $10.92 billion over ten years, the most of any state, and Clark Regional Medical Center in his hometown of Winchester was among 35 rural Kentucky hospitals named at risk in a June 2025 estimate by Senate Democrats, using University of North Carolina Sheps Center data, of the House-passed bill's Medicaid cuts.
- Bourbon. At the same debate Alvarado said of the tariffs, "But we're seeing success." U.S. spirits exports to Canada fell 85% in the second quarter of 2025 after Canadian provinces pulled American liquor, and Jim Beam said it would halt bourbon production at its Clermont distillery for at least a year.
- The Canada tariff. When the 50% tariff on Canadian imports took effect on August 22, 2026, Alvarado's campaign told WKYT he was unable to give an interview or a statement. Canada bought $8.4 billion of Kentucky goods in 2025 and answered with tariffs on about $20 billion of American goods.
How This Page on Ralph Alvarado Is Sourced
Ralph Alvarado's Kentucky Senate votes on this page were read from the official vote histories of the Kentucky Legislative Research Commission, and his sponsorships from its bill records. His statements are quoted from the outlets that reported them, chiefly the Kentucky Lantern, Spectrum News 1 and WKYT. State and district figures come from KFF, Georgetown University's Center for Children and Families and the Yale Budget Lab, and court rulings from published opinions and news coverage of them. Every link points to an outside source.
Frequently Asked Questions About Ralph Alvarado
What is Ralph Alvarado's record under Trump?
Ralph Alvarado praised the Medicaid changes in the tax and spending law President Trump signed in July 2025 and called for more. He backed the President's tariffs at a February 2026 debate, and when the 50% tariff on Canadian goods took effect in August 2026 his campaign gave no statement.
Did Ralph Alvarado vote for Kentucky's abortion ban?
Yes. Ralph Alvarado voted for both of the laws that ban nearly all abortions in Kentucky, the 2019 trigger law and the 2019 six-week ban, which he also sponsored. On February 16, 2023, the Kentucky Supreme Court left both in force while a lawsuit continued.
Does Ralph Alvarado support the Medicaid cuts in the Big Beautiful Bill?
Ralph Alvarado said in August 2025 that the law's Medicaid changes would make Medicaid a "more efficient system," and that "There's got to be more changes to come." In Kentucky's 6th District, 134,000 people, 21.3 percent of residents, were covered by Medicaid or CHIP in 2023.
Did Ralph Alvarado vote to cut unemployment benefits in Kentucky?
Yes. Ralph Alvarado voted in 2022 for House Bill 4 and to override the governor's veto of it. Besides shortening benefits, the law requires people collecting them to take any job offered after six weeks that pays more and lies no more than 30 miles away, even outside their field.
Did Ralph Alvarado sponsor a law limiting medical malpractice lawsuits?
Yes. Ralph Alvarado sponsored the 2017 law that required malpractice claims to go to a medical review panel first. Records showed panels had issued findings in just 3 percent of claims in its first year, and the Kentucky Supreme Court held on November 15, 2018 that the law violated the state constitution's guarantee of access to the courts.
What has Ralph Alvarado said about tariffs?
Ralph Alvarado said at a February 2026 debate that the President was using tariffs to get deals done and that "from that angle, it can be [effective]." Yale Budget Lab economists projected in August 2026 that the tariffs in force under current law will raise consumer prices by about 0.7%.
Last updated: 2026-10-26