Why I voted no on the health care bill

I have long been — and continue to be — supportive of reforming our health care system in a way that brings down costs and provides affordable health coverage to all Americans. But I could not in good conscience vote for the Senate health care bill or for the changes presented in the reconciliation package. I am very supportive of many provisions in the bill, particularly the efforts to provide strong consumer protections and reduced health care costs for small businesses, but I remain concerned about the effect this package will have back at home.

My district has no public or city hospitals. I fear that the changes proposed to the disproportionate share hospitals reimbursement rates will cut millions from our local hospitals at a time when they can least afford it. Maimonides and Lutheran Medical Center in Brooklyn will be affected, with estimated cuts totaling approximately $112 million and $70 million, respectively.

I am hopeful that these cuts can be reversed at a later time, but without the assurance that these funds will be restored, I could not vote for a bill that might lead to another hospital closure in our district. These bills also fail to address adjusting the rate of payment doctors get and may cause many to no longer accept Medicare and Medicaid. Further, the package reduces Medicare Advantage on which 40 percent of our seniors rely and cuts Medicare overall by over $400 billion.

I believe we need to reform our health care system, but this legislative package was not the way to do it. We must contain the costs of health care and not hurt our local hospitals and doctors. The bill doesn’t go far enough in my mind to hold the hospitals of my district harmless from future cuts, nor does it guarantee to hold down costs for those with insurance.

I am strongly supportive of many provisions in this bill. This reform package expands coverage and bans insurance companies from denying insurance to someone with a pre-existing condition. It will allow children to stay on their parents’ plans until age 26. It will give an annual cap on out-of-pocket expenses, thus preventing people from going into bankruptcy to pay for health care. And the insurance exchanges will provide the same quality insurance options available to Members of Congress and their staff. These are all good provisions that should be supported broadly across our community.

Throughout the entire process, I listened and learned from local nurses, doctors and health care professionals about what works with our health care system and what needs to be fixed. I thoroughly reviewed the drafts of the bills and considered their local and national impact. Whether people are in favor of this health care reform effort or not, I hope my constituents understand that this was not a decision made lightly.

My vote is not a referendum on this Congress or Administration. The debate on health care was robust, but also troubling. When I ran for Congress, I pledged to be an independent voice for Staten Islanders and Brooklynites and to work together with my colleagues in a bipartisan manner. Our country is facing tremendous challenges, from rising deficits and wars in Afghanistan and Iraq to aging infrastructure and budget gaps in our city. I look forward to working with our president, and both parties in Congress, to improve the economy of Staten Island, Brooklyn and the rest of New York City, to create jobs, improve our infrastructure and make our city stronger.

Rep. Mike McMahon is in the middle of his first term in Congress.