Rep. Stephanie Herseth Sandlin announced Friday she will oppose the health care reform legislation being voted on by the House of Representatives Saturday — but said she hopes to be able to vote yes on future versions of the bill if changes she wants are made.

In a hastily-called conference call with reporters Friday morning, Herseth Sandlin said she believes the bill doesn't do enough to contain costs and objected to two major components of the bill: the financial impact expanded Medicaid eligibility would have on South Dakota's budget, and the effect of Medicare cutbacks on nursing homes.

"Done right, health care reform will both ensure that more people have access to qualtiy health care, and just as critically make the common-sense reforms that are necessary to fix an unsustainable system that threatens our fiscal future," Herseth Sandlin said. "These twin goals of addressing access, quality and cost on one hand and solidifying our fiscal future on the other aren't mutually exclusive. In fact, they're complimentary. Unfortunately, the House bill misses this critical opportunity."

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But Herseth Sandlin said she believes the bill has many positive qualities and hopes her concerns will be addressed when the House bill and the Senate bill are merged in conference committee.

"Unfortunately, in my view, the House bill has not come far enough from where it's started," she said. "Nonetheless, I'm optimistic that with the House and Senate working together with the President we can achieve a good bill for South Dakota in this Congress."

Herseth Sandlin said she had recently talked with Gov. Mike Rounds and other leaders around the state about the impact of expanding Medicaid eligibility on South Dakota's budget deficit. Opening up that federal program to more people would require states like South Dakota — already facing major deficits — to pay even more in mandatory costs. Medicaid is already a huge sector of South Dakota's budget, and Rounds (among others) have long pointed to this measure as a serious, under-discussed problem.

"Early analysis susggests that the House bill Medicaid provisions would impose at least $87.6 million more in new Medicaid costs on the state than the Senate Finance Committee bill would," Herseth Sandlin said. "Given that budgetary impact, we have to consider the likelihood that dramatic service cuts would be the end result in South Dakota if the House bill was implemented, and that's a source of serious concern for me."

Underlying her objections to the bill's impacts, Herseth Sandlin said, was disappointment that it doesn't go far enough in containing costs.

"When it comes to the net change in the federal budgery committment to health care, the House bill is seven times greater in budgetary committment dollars than the Senate Finance Committee bill while falling far short of the long-term cost containments in that bill," she said. "Any bill with such a significant increase should have a similar committment to cost containment. Otherwise we'll find ourselves in the same situation we find ourselves in with Medicare: an essential program for South Dakotans going broke because we can't make the tough decisions now and are putting those choices off until we face an immediate crisis."

Stay tuned for more updates on this story.