Sanders told a boisterous crowd Tuesday night in Louisville that Trump has reneged on his promises to working-class voters. He said Democrats should reach out to disillusioned Trump supporters as the out-of-power party tries to recover from last year’s election losses.

“You don’t stand with the working people of this country by supporting health care legislation that throws 24 million people off of health insurance,” former presidential candidate Sanders said of the languishing health care overhaul backed by Trump.

Sanders and Democratic National Committee chairman Tom Perez took their nationwide tour to Kentucky, where downtrodden Democrats saw their series of election losses mount last November when Republicans claimed the state House. Trump won 118 of Kentucky’s 120 counties.

Democrats who once dominated Kentucky politics have since lost the governor’s mansion and majorities in both chambers of the state legislature. Republicans hold both U.S. Senate seats and all but one of the state’s U.S. House seats.

Sanders, an independent who caucuses with the Democrats, called for a grass-roots resurgence in which progressives run for offices ranging from local school board to Congress. He said the party’s strategy should include building a strong base in all 50 states, not just on both coasts.

“Real change … never, ever takes place from the top on down,” he said. “It is always from the bottom on up.”

Sanders and Perez are seeking to jump-start grass-roots opposition to Trump by focusing on such issues as raising the minimum wage, guaranteeing health insurance coverage for all and making public colleges and universities tuition-free.

U.S. Rep. John Yarmuth, the state’s only Democratic congressman, spoke in favor of a “single-payer” health care system, drawing sustained applause from the crowd.

Yarmuth, who represents a Louisville-area district, said the “single-player” plan would loom as the biggest advantage that Democrats would have in next year’s election if the national party embraces it.

Touching on a vital issue to Kentucky’s coalfields, Sanders embraced legislation to protect health care and pension benefits for tens of thousands of retired coal miners.

He ventured into a politically volatile issue in coal-friendly Kentucky by noting that scientists are “virtually unanimous” in saying climate change is real and caused by human activity. Sanders endorsed efforts to transform energy policies away from fossil fuels toward sustainable energy sources.

“But when we do that, we do not forget about the people who kept the lights on for decades,” he said.

Sanders said he supports legislation that would rebuild coal-based communities hurt by the decline of coal.

Earlier in the day, Sanders met with six Kentuckians at a Frankfort coffee shop.

Sanders told reporters he did not come to Kentucky “to convince anybody,” but said it was “absurd” that Kentucky’s elected officials, including the Senate Majority Leader McConnell, would push so hard for a repeal of the Affordable Care Act. The act has resulted in more than 400,000 people getting health insurance through an expanded Medicaid program in Kentucky.

“I suspect that the Democratic Party here in Kentucky has not done the kind of job that it should have done,” Sanders said. “It’s an investment. If people are getting health care, it’s an investment.”

Most Kentucky Democrats have tried to distance themselves from the Affordable Care Act, mostly because of its association with former President Barack Obama. The exception has been former Gov. Steve Beshear, who embraced the law and delivered the Democratic response to Trump’s speech to a joint session of Congress earlier this year.

Republican Gov. Matt Bevin said Kentucky can’t afford to keep the Affordable Care Act, which will cost taxpayers an extra $257 million in the state’s most recent spending plan.

“Kentuckians have roundly rejected the ultra-liberal, anti-jobs platform of coastal elites like Sanders and Perez,” Kentucky Republican Party spokesman Tres Watson said.