Bevin has increasingly attacked Beshear — or as Republicans have taken to calling him, “Abortion Andy” — for refusing to defend the state’s anti-abortion laws, which are among the strictest in the country.

A businessman turned politician, Bevin came into office four years ago on an anti-Obamacare message and is still threatening to throw hundreds of thousands of poor people off Medicaid if he can’t overhaul the program around work requirements, which the Trump administration approved but the courts so far have rejected.

Beshear — the son of former Democratic Gov. Steve Beshear, the first Southern governor who embraced and fully implemented the Affordable Care Act — has made defending Medicaid expansion and Obamacare’s patient protections a central theme of his campaign. That strategy propelled Democrats to victory across the country last year, and it has resonance in Kentucky, where more than a half million people gained coverage under the health law.

Bevin, who has tied his reelection fortunes closely to his support for Trump, frequently draws attention to abortion, often using inflammatory language reminiscent of Trump. A recent Bevin campaign ad called Beshear “pro-death.” He’s also accused Beshear of taking “blood money” for receiving a campaign contribution from the owner of an abortion clinic.

Democrats respond that Bevin is attempting to distract voters from his divisive record and rhetoric. In four years he’s gained a national reputation for bombastic statements, like the time he suggested that public school teachers on a sickout were to blame for the shooting of a 7-year-old girl at her home in Louisville.

Privately, however, some Democratic strategists worry that Beshear’s support for abortion rights could alienate swing voters even if they’re not fond of Bevin.

Beshear was the first Kentucky gubernatorial candidate to earn an endorsement from the prominent abortion rights group NARAL Pro-Choice America, which is running digital ads against Bevin through Tuesday’s election. Of the Democratic candidates for governor in three Southern races this fall, which are all seen as competitive, Beshear is the only one supporting abortion rights.

Anti-abortion opponents are closely watching the Kentucky race for hints about 2020, particularly whether voters will care enough about restricting abortion to cancel out their reservations about an unpopular incumbent — be it Bevin or Trump.

“At the end of the day, they have been incredibly strong on the life issue and this isn’t something only that motivates pro-life base voters but also people that we would call persuadable,” Mallory Quigley, a spokesperson for the national anti-abortion group Susan B. Anthony List, said of Bevin and Trump.

The group is behind a $750,000 campaign in the state to attack Beshear and the Democratic candidate for attorney general. Bevin has released at least four ads since mid-September attacking Beshear on abortion and emphasizing his own anti-abortion credentials.

“Kentuckians overwhelmingly support pro-life protections, and Gov. Bevin has been proud to fight vigorously on behalf of the Commonwealth’s most vulnerable since day 1 of his Administration,” Bevin campaign manager Davis Paine said in a statement.

Kentucky in recent years has ranked among the states most hostile to abortion, according to polling from the nonprofit Public Religion Research Institute. Just over half of Kentucky adults last year said abortion should be illegal in all or most cases, while most Americans say it should be legal.

Anti-abortion sentiment in Kentucky is driven by higher-than-average rates of white evangelicals in the state, said Robert Jones, the head of the religion institute. The group’s polling has found, however, that abortion is the deciding issue for fewer Kentuckians on both sides than might be expected.

“If you’re thinking about people who would use it as a litmus test for voting, it’s only about a quarter of Kentuckians,” Jones said.

Beshear, who was narrowly elected attorney general four years ago, has refused to defend some of Kentucky’s anti-abortion laws. That includes a ban on abortion after six weeks, which was approved by state lawmakers this year after he warned them it was unconstitutional.

Beshear characterizes Bevin as an “extremist” on abortion, hitting him for supporting legislation that didn’t provide typical exemptions for pregnancies resulting from rape or incest. At the same time, Beshear has tried to make clear his support for limits on abortion.

“Yes, I believe in Roe v. Wade,” Beshear told reporters on a campaign stop Saturday. “But I also believe in reasonable restrictions, especially on late-term procedures.”

Bevin, who touts himself as America’s “most pro-life governor,” brags that he shut down one of the state’s two abortion clinics, leaving Kentucky as one of six states with a sole facility. Bevin is also trying to shutter the remaining clinic in Louisville.

According to Bevin’s campaign, he has signed 10 anti-abortion bills, aided by a legislature that swung to full Republican control in 2017. His record includes a 20-week ban in 2017 and the six-week ban this spring — both of which impost time limits earlier than those allowed under Supreme Court precedent in Roe v. Wade. The six-week ban, which has been blocked by a federal judge, made Kentucky part of a recent wave of red states approving restrictive measures meant to trigger the Supreme Court to reconsider the Roe decision.

SBA List President Marjorie Dannenfelser, appearing at a campaign event for Bevin last month, said the contrast between Bevin and Beshear on abortion is a “gift” that should seal the election for the Republican incumbent.

“The only way Andy Beshear can win is if people don’t know what his position is,” she said.

Steven Shepard contributed to this report from Mt. Sterling, Ky.