Kosmas explains in Florida why she voted against health-care legislation

Over the past several months, I have met with families, small business owners, doctors, and others across Central Florida to discuss health care. The concern I've heard most often is the fear that they will lose the ability to maintain or access quality health coverage due to skyrocketing health care costs.

In 2007, the U.S. spent 16.2 percent of GDP on health costs, nearly twice the average of other developed nations, and costs are projected to rise to 25 percent of GDP in 2025. Small businesses have seen their premiums rise 129 percent over the last nine years. We are on an unsustainable path that is hurting job growth, overwhelming the federal budget and creating debt for future generations.

While the health care reform bill before the U.S. House of Representatives has many positive elements, I believe that it does not do enough to slow the growth of health care costs or to rein in spending on care. That is why, after careful consideration and with great difficulty, I decided that I could not in good conscience support this bill.

According to the Congressional Budget Office, the House health care bill will actually increase federal health care spending over the long term, while proposals being considered by the Senate would have a net decrease.

Furthermore, the total cost of the House bill is nearly $1.2 trillion, significantly more than the president's stated goal. Because it is our obligation to be fiscally responsible, I cannot support a plan that spends so much, but doesn't significantly slow the growth in health care costs.

This vote was an extremely difficult decision for me. I have long been a champion for efforts to improve health care, such as the expansion of health coverage for children of working families, protecting seniors from an increase in Medicare Part B premiums, and working to secure the funding for the new Orlando VA Medical Center to improve care for Central Florida's veterans.

I believe fiscally responsible health care reform is attainable, but we must improve upon the House bill. We need reform that truly rewards quality outcomes and moves us away from the fee-for-service system that rewards quantity alone. We need reform that gives real incentives to maintain healthy lifestyles. We need reform that makes a serious effort to control waste, fraud and abuse. And we need reform that leads to health insurance plans that are more cost-effective.

Though I voted against the House plan, the bill does have promising aspects. It begins to hold insurance companies accountable by preventing them from denying coverage based on pre-existing conditions, by eliminating lifetime caps on coverage and by taking steps to lower premiums. The bill also establishes health insurance exchanges that will help provide additional options for many individuals and small businesses. However, in the long run, these reforms will be in vain if we don't take significant steps to rein in rising costs.

It is important to note that this is an ongoing process. I will continue working with my colleagues and I am hopeful that a fiscally responsible health care reform bill will soon be passed that truly addresses growing costs and moves us toward affordable, accessible and sustainable health care. But the House plan was not that bill.