At town hall in Benton, U.S. Rep. James Comer defends and explains his vote for House Republican health-care legislation

UPDATE, May 21: The Washington Post's Chico Harlan has a more detailed report on Comer's town halls in Benton, Albany, Edmonton and Calhoun.

U.S. Rep. James Comer in Benton (M.C. Daily photo)

"The atmosphere was, at times, tense as constituents gathered from around the First Congressional District of Kentucky to participate in a town hall meeting with U.S. Rep. James Comer Wednesday at the Marshall County Courthouse in Benton," Mary Garrison Minyard reports for the Marshall County Daily.

Comer, a first-term Republican from Tompkinsville, acknowledged that he had been criticized for supporting a Republican health bill that did not have a Congressional Budget Office analysis, but "said lawmakers had little choice in passing the bill," Minyard reports.

Comer told the crowd that 31 of the district's 35 counties "only have one insurance carrier," and noted that the main carrier for such counties in Iowa is pulling out of Obamacare. "I think we’re going to see more of that if a health care bill is not passed," he said.

"Comer said constituents needed a bill that would protect its most vulnerable residents – those with pre-existing conditions and those on Medicaid – but would lower premiums and deductibles," Minyard writes. "He said he voted for the bill because he felt it would do those things. Still, some concessions had to be made."

Minyard reports Comer said it would be "a budget breaker" for that state to pay "10 percent of the health insurance bill for almost half a million people in Kentucky," which is what the state would pay in 2020 for people covered by the 2014 Medicaid expansion. This year it is paying 5 percent.

"Comer said he supported the core concept of Medicaid, which was to provide health care assistance for poor children, low income single parents and pregnant women and the 'truly disabled.' Comer said many had taken advantage of the system, however," Minyard writes.

The biggest issue in passage of the bill was coverage of pre-existing conditions. "Comer told attendees that the bill failed on its first run several weeks ago because ultra-conservative Republicans wanted complete ACA repeal, while others wouldn’t budge on protections for pre-existing conditions," Minyard reports. The new bill lets states allow insurance companies to charge higher premiums to people with such conditions but allocates "$130 billion to set up high-risk pools to help states cover those most expensive to insure," but critics have said that is inadequate.

Jennifer Smith, a two-time cancer survivor from Paducah, said the funding would be inadequate. She told Comer, "You stated your commitment to protecting all of us with pre-existing conditions, our access to insurance and health care, but instead on May 4 you reneged on that promise and voted for the horrendous bill the AHCA. In response to the outrage from your constituents you stated on your Facebook page that the bill protected pre-existing conditions and that those protesting and distorting the truth were far left liberals like the DNC and Planned Parenthood. … The radical left wing organizations that you say are against you include the American Cancer Society, Komen, the National Patient Advocate Foundation and over 25 other cancer and health advocators, the American Medical Association, the American Nurses Association … and the AARP have also come out strongly against the bill. All the organizations have cited the catastrophic impact this will have on those of us pre-existing conditions and every other consumer of health care."

"You also neglect to mention the states have the right to opt out, so that’s almost a certainty that Kentucky’s Governor Bevin would take that option," Smith said. "The reality is that this bill will drive up cost for the poor and those with health issues to the point that there is no access, because we will not be able to afford to pay the premiums or out-of-pocket expenses."

Other constituents at the meeting objected to the provisions. "Some lay on the courthouse lawn prior to the meeting with tombstones at their heads and feet and signs that read 'I had a pre-existing condition'," Minyard reports.

Comer said "Kentucky still has a funding mechanism that other states don’t" for high-risk pools. "They don’t have to worry about getting the General Assembly to pass … it’s already in there." A 1 percent fee on insurance policies funded a high-risk pool that stopped taking new enrollees when Obamacare was implemented. The state kept the fee to pay for a health-insurance exchange that has been largely abolished, but the fee remains in place.

"Here’s the bottom line," Comer said. "If nothing is done, people with individual insurance plans and group plans are going to continue to have to pay more and more insurance costs and it’s just putting people [where] they’re choosing health care costs over food. They’re not buying medicine because they’re spending all their money on health-care premiums.”