BUFFALO — WASHINGTON — House members from Western New York will split their votes today when the House takes up a Senate-passed health care reform bill and a separate package of changes to the bill.

Freshman Republican Rep. Chris Lee of Clarence said Friday he’s comfortable voting no after listening to constituents.

“The more you peel back, the more it’s not what it appears to be,” he said of the legislation.

Democratic Rep. Mike Arcuri of Utica also cited tens of thousands of e-mails and phone calls from constituents when he said Thursday he’ll be among several dozen Democrats who join Republicans in opposing the legislation.

Arcuri said his constituents are confused about what’s in the legislation and want Congress to take an incremental approach.

The bill’s supporters, like its critics, say they’re responding to constituents.

When Democratic Rep. Dan Maffei of DeWitt announced Tuesday he would vote yes, he was joined at the East Syracuse office of the American Red Cross by a woman suffering from terminal cancer.

The latest version of health care reform legislation would extend insurance coverage to 32 million Americans by 2019. Most people would be required to buy insurance. Larger employers would have to offer it or face a penalty.

Insurers couldn’t reject customers with pre-existing health conditions or impose lifetime limits on benefits.

“No longer when you are in the operating room will they tell you what you are about to be operated on is not covered,” Rep. Louise Slaughter, D-Fairport, said Friday. “What’s the most important is to insure more people. Every family will save about $1,000 because they won’t have to pick up the cost of the uninsured.”

Rep. Maurice Hinchey, D-Hurley, described Sunday’s vote as “an easy vote in the context that it improves the situation significantly.”

He criticized Republicans for spreading false information about the legislation.

“The bill is going to protect seniors by improving and strengthening Medicare benefits,” he said.

Slaughter offered this big-picture assessment of Sunday’s vote: “We’re the only industrial country in the world that doesn’t provide health care for its citizens. We rank 37th in the world in the quality of our health care. Our life expectancy is down at about the same number.”

The legislation’s $940 billion cost over 10 years would be largely offset largely by penalties, taxes and fees. The congressional budget office estimates the legislation would reduce the deficit by $138 billion over 10 years.

Deficit reduction is a big issue for Rep. Brian Higgins, D-Buffalo, who also supports the bill.

“The CBO score is important,” Higgins said. “It provides some clarity. It’s important because it will slow the growth of Medicare.”

In a meeting with House Speaker Nancy Pelosi two weeks ago, 15 House Democrats from New York objected to the Senate’s proposed reimbursement rate for Medicaid health services for the poor and the Medicare payments to hospitals.

Those were make-or-break issues for many members of the New York delegation.

Gov. David Paterson and New York City Mayor Michael Bloomberg say proposed Medicaid payments to the state under the Senate bill likely would create a $1 billion hole in the state budget. That’s because 1 million more residents would be added to the state’s Medicaid rolls, with the federal government paying just over half the cost, they say.

The changes scheduled for a House vote on Sunday would provide the state with a 75 percent federal reimbursement rate — instead of 57 percent — beginning in 2014. In 2015, the rate would climb to 80 percent, instead of the 67 percent rate in the Senate bill. Likewise, the new rates would be more generous in 2016 through 2018.

But in 2019, New York would receive only a 93 percent reimbursement rate, compared to the 95 percent rate in the original Senate bill.

In 2020, the federal government would begin reimbursing all states at a 90 percent rate.

Contact Brian Tumulty at btumulty@gannett.com