Among those cheering loudest when the Republican plan to remake the U.S. health-care system collapsed last week were some of Donald Trump's strongest supporters.

"Tickled plumb to death," said Robin Taylor, who — like so many in fiercely Republican Kentucky — voted for Trump in November and would vote for him again.

But she'd been desperately worried the president was actually set to keep his pledge to repeal and replace Obamacare. It's a system she and her husband Mike rely upon to survive.

Robin has diabetes and a heart condition. Mike has coal worker's pneumoconiosis, also known as black lung disease, an often fatal disease he developed while spending years working as a trucker in the coal industry. Mike, who's 56, has a tumour in his chest the size of a lemon and can't walk more than about 50 metres without needing help from an oxygen tank to breathe.

Until Obamacare, the Taylors had no health insurance.

President Donald Trump in Louisville, Ky., on March 20 called Obamacare 'a catastrophe,' but for many thousands in Kentucky — including his supporters — the program represents a welcome benefit. (Marie Claudet/CBC)

"His employer didn't provide it," says Robin. "We didn't qualify."

But when Obamacare broadened coverage for Americans in need, the Taylors, who've spent their lives in this tiny southeast Kentucky town, suddenly found themselves able to visit a doctor for the first time in memory.

Under Obamacare they're now given medicines worth roughly $6,000 US a month, about triple their gross monthly income.

'Costs too much to breathe'

Without Obamacare, says Robin, "there is no way we can pay for that."

"To me, it's like a death sentence," says Mike. " A silent death sentence because it costs too much just to breathe.

The Taylors are among an estimated 24 million Americans who risked losing affordable health insurance had the Republican plan gone forward.

And although the president has often labeled Obamacare "a catastrophe," as he did at a rally last week in Louisville, for many thousands in Kentucky the program represents a welcome benefit.

Since Obamacare took effect, some 440,000 Kentuckians have gained access to health insurance, many of them in the state's impoverished southeast, which is among the poorest and least healthy regions of the U.S.

Robert Goe, a Republican backer of Obamacare, thinks lawmakers should set aside politics when it comes to health care. 'We all need health care. We all need coverage.' (Marie Claudet/CBC)

Few regard Obamacare as perfect, but many emphasize that when Republicans next consider a health-care makeover, it's critical they listen to those throughout the state and country — including countless fellow Republicans — who would not be able to afford coverage without it.

At a diner in Booneville, northwest of Whitesburg, Republican voter Robert Goe urged lawmakers to set aside politics when it comes to health care.

"It doesn't matter, in my opinion, if you're a Democrat, Republican (or) Independent," he said. "We all need health care. We all need coverage."

I don't want to raise my children in a place where they don't have guaranteed health care. - Brooke Fleming, Whitesburg, Ky.

"I thank Obama for (Obamacare)," he added. "I'm a Republican and I'm saying that."

At one of the leading health clinics in the region, Mountain Comprehensive in Whitesburg, there have been so many new patients lately that it had to expand its services.

Clinic chief executive Mike Caudill credits Obamacare.

"I'm not into the politics of it, but I think that this country has to sit down and decide its priority," he says. "While health care may not be a legal right (in the U.S.), I think it is something whose time has come — that we need to be able to look at our people and see to it that they are provided basic health care.

That's a central question for Americans when it comes to health care: is it the government's role to ensure it's provided for everyone?

Assessing Obamacare, Brooke Fleming, a young woman who'd come to the clinic for a vision test, said: "(Obamacare) really saved some people's lives — especially here, where we can't afford to not have health care or to buy it, as Republicans want us to."

'It's watch him die'

She added: "I don't want to raise my children in a place where they don't have guaranteed health care. It's really sad, it really is."

For many in Whitesburg, the hope now is that when health-care reform is debated next time, the voices of those who need what Obamacare offers will be listened to. If it's to be improved, they say, that's fine. Just don't toss out its benefits.

The Taylors worry that next time they might not be as lucky as they were last week.

If they were to lose their insurance, says Robin, "we'll have to sit and watch (Mike) smother to death, because we [won't] be able to afford to send him to the doctor.

"So it's watch him die."