Posted: 12:00am on Nov 9, 2009; Modified: 1:28am on Nov 9, 2009

WASHINGTON — Rep. Ben Chandler, D-Versailles, who faced sharp push-back from conservatives over his failure to hold health care reform town hall meetings during the August recess, was one of 39 Democrats to vote Saturday evening against the historic health care overhaul at the top of the Obama administration's domestic agenda.

"I voted against the bill because I do not believe it is the best course of action for the people of Central Kentucky, specifically our working families, small businesses, and seniors," Chandler said in a statement late Saturday.

With the exception of U.S. Rep. John Yarmuth, D-Louisville, every House member of Kentucky's congressional delegation voted against a measure that would create a government-run health insurance plan in an effort to help Americans meet the measure's requirement of obtaining health insurance.

"The citizens of Louisville, Kentucky, sent me here to this body largely to help bring us to this historic moment," Yarmuth said Saturday. "It is the day we take a giant step toward that more perfect union that we all seek. I am very proud to be a part of this day."

In contrast to Yarmuth, whose district is largely composed of a primarily Democratic urban center, Chandler hails from a region that includes Democratic enclaves like Lexington and more rural and Republican-leaning towns and swaths of farmland. As a result, Chandler often found himself the target of conservatives who wanted him to reject a public health care option and liberals who wanted him to support it.

Chandler's position was also a difficult one because Democratic leaders pushed hard for his election during the 2004 special election after then-Rep. Ernie Fletcher resigned to become governor. Chandler is also one of the few members to sit on the powerful Appropriations committee while sitting on other committees, and he endorsed Barack Obama in the Democratic primary against Hillary Clinton.

But in the weeks leading up to the House health care vote, Chandler expressed misgivings about the Obama administration-backed plan's protection for rural hospitals and health care providers, concerns that were not allayed by tweaks to the bill designed to tackle such problems as additional money and incentives to help rural hospitals to cover their costs and recruit talented medical professionals. Those changes did not go far enough, Chandler said.

"I am also concerned the reform bill would not adequately protect our rural hospitals and our small businesses — the engines of job creation. I have had these same concerns throughout this difficult debate, and in the end, do not believe this bill is the best for the Sixth Congressional District," he said.

"I appreciate the efforts of President Obama and the Democrats to put together a bill which incorporates a number of reforms that are long overdue, including greater regulation of insurance companies, the elimination of lifetime caps on coverage, and prohibiting denial of coverage due to pre-existing conditions," Chandler added. "There is no doubt that our health care system is broken, but I am not convinced that this bill today would lower costs, improve coverage, and maintain quality care in the long term."

Chandler's opposition puts him in the company of a small club of Democrats, many of them conservative Blue Dogs who hail from conservative Southern and Midwestern districts, freshmen who narrowly won their 2008 elections and those who probably will face tough 2010 re-election bids. The National Republican Congressional Committee is targeting Chandler in anticipation of next year's race. After about three weeks of fund-raising, Republican Andy Barr raised $186,000 to Chandler's $160,000 during the third quarter.

Meanwhile, the state's Republican members were unified in their rejection of the Democrat health care reform push.

"Instead of working to turn our economy around and create new jobs, Speaker (Nancy) Pelosi and her leadership team have instead decided to jam through Congress dangerous and misguided health care legislation which will decrease the quality of care many Kentuckians receive while raising prices, increase the already sky-high deficit and hurt small business owners," said Rep. Ed Whitfield, R-Hopkinsville. "The American people deserve better than this. I hope the Senate can produce a more common-sense plan that will improve access to quality, affordable health care without bankrupting our nation."

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