Few thought last year that Kentucky’s Sixth Congressional district including Lexington and surrounding counties would be in play this election cycle. The district voted for President Donald Trump by 15 percentage points in 2024 and incumbent Republican Congressman Andy Barr won the district with 63% of the vote the same year.
But in a midterm election where Democrats are polling well and Trump’s job approval rating continues to crater, election handicappers have moved the race from a safe Republican territory to one that merely leans toward the Republican nominee.
On Nov. 3, Democrat Zach Dembo will face off against Republican Ralph Alvarado for the chance at picking up an unlikely second Democratic Kentucky seat in Congress. Alvarado meanwhile, is looking to hold on to the Republican seat as current Rep. Andy Barr runs to replace Sen. Mitch McConnell.
Alvarado is a former Tennessee health commissioner and former Kentucky state senator; he gained statewide name ID when he ran as former Gov. Matt Bevin’s running mate in 2019 in an unsuccessful bid against Gov. Andy Beshear. Dembo is a former federal prosecutor and Navy veteran who previously worked under Beshear’s administration.
Alvarado focuses heavily on affordability and healthcare, including giving physicians and patients more control over choices than insurance companies and the federal government. Dembo has heavily criticized the Trump administration’s tariffs and funding cuts and pushed for anti-corruption measures in both the executive branch and Congress.
Even if Dembo is doing better than some originally anticipated, Alvarado is still the favorite. A couple election predictors moved the race to a “leans Republican” designation last week. In many ways the race has become a proxy war, as Dembo works to tie Alvarado to Bevin and promote his connections to Beshear. Alvarado for his part has distanced himself from Trump — whose endorsement he promoted heavily during the primary — and is advancing himself as an “independent” leader instead.
Spending has grown significantly in the race, with PACs affiliated with both Trump and Beshear spending top dollar on the seat. Trump’s No Going Back PAC has spent more than $1 million to support Alvarado while Beshear’s In This Together PAC has spent $500,000 on attack ads against Alvarado.
National outlets are reporting that Beshear is getting more involved in the race, including appealing to national groups to assist Dembo. Meanwhile Trump’s campaign funding apparatus is already spending big to support Alvarado — even as they keep the president’s name out of their advertising. Dembo has proudly promoted his ties to Beshear, who won the district in 2023 by 20 points, exceeding Trump’s 15-point win the following year.
Alvarado did not agree to an interview with Kentucky Public Radio in time for this report.
Alvarado emphasizes healthcare background, downplays Trump endorsement
Before running for the state Senate, Alvarado was a longtime physician. He lost two races for the state legislature in 2006 and 2010 before making it there in 2014 as Kentucky’s first Hispanic senator. He was quickly propelled to a national stage and spoke at the 2016 GOP National Convention.
As a legislator, he pushed for public health issues, including passing a bill banning tobacco products on public school grounds and a substantial bill amending requirements and policies for long-term care facilities.
In 2019, he joined Bevin’s ticket to be lieutenant governor — an ill-fated run, as the duo lost to Beshear. That run still haunts Alvarado in campaign ads attempting to tie him to the wildly unpopular governor who is still making headlines for his lame-duck pardon scandal and the accusations made by his adult adopted son and subsequent child-support case. Alvarado has since repudiated Bevin and said he did not support his ignominious pardons, although it does not appear Alvarado personally spoke out when the scandal was first making headlines.
“Here’s the truth: I, along with the Senate Majority Caucus in Frankfort, condemned Matt Bevin’s grotesque pardons and opposed them publicly and in the strongest possible terms when they happened,” Alvarado said in a statement. “In fact, we voted to rein in a governor’s pardon powers during the final days of an administration.”
In 2023, Alvarado left the state Senate to serve as Tennessee’s health commissioner. The Lexington Herald-Leader reported in September that Alvarado maintained several other paid jobs while overseeing the Tennessee Department of Health, including running his own medical practice in Winchester, serving as medical director for up to eight different facilities and the Kentucky branch of Eventus WholeHealth, which provides medical care to nursing homes and assisted living facilities.
“He genuinely loves to work and is deeply passionate about both practicing medicine and healthcare policy,” campaign manager Andy Westberry told the Herald-Leader. "Medicine has been a central part of his life for decades, and continuing to care for patients is something he takes seriously and makes time for, regardless of how demanding his schedule may be."
Alvarado left his job in Tennessee after Congressman Barr announced he would run for U.S. Senate instead. Shortly after, Alvarado announced he had moved back to the Sixth Congressional district and would run for Congress.
During the heavily contested Republican primary, Alvarado campaigned aggressively on Trump’s endorsement. On his campaign website, his stated top issues were supporting the president, securing the border and fighting the “woke agenda.” He also supported the Make American Health Again movement and has referred to himself as a “MAHA doctor.”
“I think the Democrats are gearing up,” he said the night he won the primary. “They think they have a chance here. We’re going to make sure that they realize that they don't have a chance here in winning this seat and we're going to work very hard at raising the money to make sure we get our message out.”
NBC News reported in August that Alvarado had significantly changed his website since winning the primary. He swapped out photos with the president to solo shots and deleted references to Trump. Instead, he called himself “independent leadership.”
He also changed his stated platform significantly — now he prioritizes lower prices, “clearer” health insurance choices and affordable healthcare. The one constant is an emphasis on bringing jobs to Kentucky.
Alvarado’s campaign did not return several requests to set up an interview.
Alvarado received endorsements from the Fraternal Order of Police and the U.S. Chamber of Commerce. He has attacked Dembo and claimed Dembo supports increasing taxes — Dembo has not said he wants to increase taxes, but he has criticized tax cuts for the wealthy and Trump’s signature tax and spending package that extended tax cuts and slashed spending for Medicaid and food stamps.
Alvarado has focused on healthcare throughout his campaign, advocating for more state control in federal healthcare programs and more oversight of insurance companies. In an interview with the National Federation of Republican Women, Alvarado said he has the expertise to tackle rising healthcare costs.
“We need people that have expertise in this to help reduce those costs, make things more affordable for people every day and be able to put more power back into patients and doctor's hands and back into the hands of states, away from insurance companies, away from the federal government,” Alvarado said.
He said he doesn’t want to shift too far from the country’s existing health system.
“I think we need to protect the system that we have,” Alvarado said. "‘It's the best in the world, but we've got to give doctors and patients control."
Dembo leans into fighting corruption, independent voting
Zach Dembo served as an officer in the Navy Judge Advocate General’s Corp, often referred to as a JAG office, before becoming a federal prosecutor in the U.S. Department of Justice Civil Rights Division. In 2020 he was a policy advisor and legislative director during Beshear’s first term as governor.
He went on to become the assistant U.S. attorney in Lexington. He said he resigned from the DOJ over corruption and politicization under the Trump administration. Alvarado has criticized Dembo’s prosecutorial record, saying he brought charges as police officers. He prosecuted 38 police and corrections officers from 2016 to 2025 — all but three ended in convictions.
The Democratic Congressional Campaign Committee targeted the district early on as a long-shot opportunity for Democrats. The DCCC has significantly expanded the number of districts it considers “in play” to include those it says are “deep into traditional Republican territory.” The national campaign committee said it is investing in nearly double the number of House districts it did in the 2024 election cycle.
Dembo has been endorsed by the AFL-CIO and the National Education Association.
Not dissimilarly from Alvarado, Dembo has said he would be an “independent” voice in Congress and said he is not a career politician. At a Democratic picnic in rural Fleming County, at the far northeastern edge of the district, Dembo said he wants to fight corruption coming out of the Trump administration and within his own party.
He said he would support term limits, a ban on stock trading and prohibit former members of Congress from working as lobbyists.
“How is it legal for members of Congress to trade individual stocks based on information you and I don't have? That's just corrupt, y'all. That is corrupt, and so we see members of both parties, Democrats and Republicans, making millions in the stock market, and we'll never know exactly why,” Dembo said. “I can pledge to you all: I am not going to be trading individual stocks, but we got to do more than that.”
He also denounced Trump’s tariffs and the Iran War, saying they have raised prices for farmers, at the pump, and in grocery stores. Dembo said he would take a page from Beshear’s book on governance.
“All these constituents and everyone I've talked to are being crushed by the costs and corruption coming out of D.C. that's what we've got to focus on,” Dembo said. “Why politicians are bought and sold under these campaign finance laws. Why healthcare is still a mess that doesn't work for anyone. Why immigration is still a mess. Why all these huge issues aren't being dealt with.”
Dembo also criticizes Trump’s One Big Beautiful Bill Act, which extended tax cuts while slashing funding for Medicaid and SNAP. He pointed to Fleming County Hospital, one of many rural hospitals that rely heavily on Medicaid reimbursements and frequently operate at a loss.
“If there was any risk of it shutting down, or even just cutting back on services, it would be a completely unnecessary kick in the gut to a community that's already working hard and trying to do its best, and was just relying on the support that it was promised from Congress for years and years,” Dembo said.
Election Day is November 3. Early no-excuse voting runs Oct. 29 through 31.
