Rep. Stephanie Herseth Sandlin said her decision to oppose the current version of health care reform was influenced by discussions with constituents — but not by organized protests or concerns about her reelection.

"This is all part of a very vibrant democratic process," Herseth Sandlin said. "We have different constituent groups in the state that have raised various points of support or points of opposition. Some have been better-informed than others in terms of really understanding the bill and the various implications of the bill on coverage and reforms and cost-containment."

Herseth Sandlin said she has heard from many people both supporting and opposing the bill.

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"Since we started hearing from people in greater numbers about health care, the breakdown here more recently has been more evenly split, although earlier in the process we heard more people concerned about the bill — and rightly so, because HR3200 (the initial House health care reform bill), I could not support that at all. This bill has moved in the right direction."

Herseth Sandlin said she hasn't been subject to a lot of pressure from the White House or from legislative leaders to vote for health care reform.

"I've had so many meetings with the Speaker (Rep. Nancy Pelosi, D-Calif.) and the Majority Leader (Rep. Steny Hoyer, D-Maryland) that there was no surprise here," she said. "The pressure hasn't been great."

But Herseth Sandlin emphatically denied that her decision to vote no was based on a political calculation about the 2010 election.

"I have been so focused on the policy and the policy objectives on behalf of my constituents that the political noise back home or here inside the Beltway has not been a factor in this decision," Herseth Sandlin said. "I take great offense to that suggestion when I have worked tirelessly with my constituents on health care reform and have met with thousands of South Dakotans on this very important issue."

Herseth Sandlin said, she might still vote for a final bill if her concerns are addressed.

"Look, I'm hoping to support a final bill out of the conference committee and I will take just as much grief that way if I vote in support or against. It's going to be based on whether or not this bill can be improved to achieve the kind of fundamental reform that we need for South Dakotans and the country as a whole," she said. "This bill has not come far enough to be just as serious on expanding coverage as it should be, on containing costs and reforming the delivery system. The leadership understands why I've been focused on that issue and I think my constituents and I think that my constituents will understand that I take a responsible approach to this policy."