Why It Matters
The Kentucky Hospital Association has shifted its federal lobbying operation, moving from Polsinelli PC to TSG Advocates DC LLC as of May 4, 2026. The change comes as Kentucky hospitals face what the association has called an existential threat from federal Medicaid cuts. The KHA is not a newcomer to Washington, having spent $160,000 annually on federal lobbying through Polsinelli in each of the four quarters before this switch. The firm change signals a deliberate strategic pivot, not a retreat.
By the Numbers
The KHA spent $40,000 per quarter with Polsinelli PC across its second quarter 2025, third quarter 2025, fourth quarter 2025, and first quarter 2026 filings, totaling $160,000 over the past year. The new registration with TSG Advocates does not yet list a contract amount. Two lobbyists are assigned to the account: Harry Sporidis and Tim Perrin, both of whom previously represented the KHA at Polsinelli. The pair carried their client relationship directly to the new firm.
The Agenda
The KHA's lobbying disclosure lists Health Issues as the sole issue area, with no specific legislation or bills named. In prior filings, the stated focus was "issues pertaining to the delivery of health care." No specific bills are cited in any of the four quarterly reports filed over the past year.
Broader Context
According to the Kentucky Center for Economic Policy, Kentucky faces the highest number of rural hospitals at risk of closure of any state in the country, with 35 facilities potentially shuttered under federal Medicaid cuts included in the "One Big Beautiful Bill Act." Louisville Public Media reported the KHA warned those cuts could eliminate 20,000 jobs.
The Kentucky Lantern reported the association placed that figure as high as 33,000. The Kentucky Center for Economic Policy estimated the state could lose up to $28 billion in federal Medicaid funding over ten years. The KHA's position on the legislation was notably specific: the association supported the House version of the bill but opposed the Senate version, according to the Lexington Herald-Leader.
Between the Lines
Congressional attention to Kentucky's hospital situation has been visible. At an April 2026 House Small Business Committee hearing, Rep. Morgan McGarvey (D-KY-3) cited the KHA directly, stating the association had predicted 35 rural hospital closures resulting from Medicaid cuts. McGarvey had also warned in public communications that the cuts would eliminate 133,000 Kentuckians' health coverage and 20,000 health care jobs.
Sen. Edward J. Markey (D-MA) named 34 specific Kentucky hospitals at risk in a June 2025 communication. On the other side of the ledger, Rep. Hal Rogers (R-KY-5) announced in December 2025 that Kentucky received $212.9 million from the Rural Health Transformation Fund for 2026.
The Bottom Line
The Kentucky Hospital Association's move to TSG Advocates keeps the same two lobbyists in place while changing the firm behind them. The lobbying disclosure is broad, covering health care delivery without naming specific legislation.
The policy environment around Medicaid funding and rural hospital sustainability gives the engagement its urgency, though the disclosure itself does not specify what outcomes the association is pursuing in Washington.
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