WASHINGTON — North Carolina Rep. Mike McIntyre has announced that he will vote against a $1.2 trillion health-care bill in the House of Representatives, saying that reform needs to fiscally responsible and done in targeted steps.

"The need for health care reform is clear, but the focus should be on lowering the skyrocketing costs of health care, bringing down the cost of premiums and ensuring access and affordability of health care for all," McIntyre, a Democrat who represents nine southeastern counties, said in a statement.

President Barack Obama met with Democratic lawmakers in closed-door meetings Saturday to woo last-minute commitments. The House could vote on the bill as early as this evening, but House leaders have said the vote could slip to early next week.

Democrats hold 258 seats in the House and can afford 40 defections and still have a majority of 218 votes. All 177 Republicans are expected to vote "no."

"During these tough economic times, I could not support this bill, because it was flawed in four major ways," McIntyre said. He identified the flaws:

• The bill "costs way too much – more than $1 trillion dollars on top of a $12 trillion national debt."
• It doesn't address long-term health costs.
• It raises too many taxes and includes new requirements "that will harm the ability of too many small businesses to compete and create jobs."
• "It tries to do too much too soon, instead of targeted changes that can immediately help people."

The bill is aimed at providing health coverage to millions of uninsured Americans and would require most employers to offer health insurance and ban insurers from denying coverage based on pre-existing conditions.

The most contentious issue in the bill is a new government-run insurance plan that would compete against private coverage in new purchasing marketplaces, or "exchanges," in which individuals and small businesses could shop for and compare options.

The bill's cost is calculated over a decade. The health care industry makes up one-sixth of the U.S. economy.

McIntyre outlined what he believes are better changes to the health care system:

• strengthening Medicare and Medicaid
• improving Medicare reimbursement rates for rural health providers
• expanding the use of electronic medical records
• expanding and strengthening community health centers
• allowing small business owners to join pools of coverage to access better insurance rates
• allowing states to form compacts to allow the purchase of insurance across state lines
• providing tax credits for long-term care

“These are just some of the many examples where we can make needed health care changes without further bankrupting the country, and I remain committed to meaningful reform that maintains cost-effective principles that put our nation again on the path to reform," McIntyre said.

Since 1997, McIntyre has represented Bladen, Brunswick, Columbus, Cumberland, Duplin, New Hanover, Pender, Robeson and Sampson counties.