President Barack Obama signed sweeping health care reform into law on Tuesday, following Sunday’s U.S. House of Representatives vote by 219 Democrats, including Southampton’s Tim Bishop, approving the legislation.

When the bill passed the Senate in December, Mr. Bishop was not in favor of it, but he said on Monday that he was satisfied with changes made to the bill using the legislative procedure called reconciliation.

He pointed out that he had also voted yes for the health care bill the House passed in November.

“I was a ‘lean-yes’ this time, but I had a couple of issues that were of paramount importance to me in terms of getting things right for New York and getting things right financially,” he said.

While the original House bill would have saved New York money, the Senate bill would have cost the state $1 billion in the first year, Mr. Bishop noted. “I was withholding my commitment to vote yes or no on the bill until I saw how New York was treated, and New York was treated very fairly in the reconciliation package,” he said.

Reconciliation resulted in a $1.3 billion savings for New York in the first year, and the savings will escalate over time, he said.

Mr. Bishop said that while his office received calls and letters from all over the country urging him to oppose the health care legislation, the feedback from his constituents in the 1st Congressional District was nearly evenly split—with slightly more in favor.

“I don’t know how it will affect my reelection,” he admitted. “I do know that I made the judgment that I made based on what I think is in the best interest of our district.”

His Republican challengers in the 2010 race sharply criticized Mr. Bishop’s vote.

“It’s really just disappointing that Congressman Bishop would side with Washington, D.C., and San Francisco guys instead of Suffolk County guys, and I think we really need representation in Congress that’s going to do the right thing to lower health care cost in the right way—not with some massive government takeover of one-sixth of the U.S. economy,” candidate Chris Cox of Westhampton Beach and New York City said on Wednesday.

Mr. Cox, grandson of former President Richard Nixon and son of New York State Republican Committee Chairman Ed Cox, went on to say that “the bill strong-arms individuals into buying insurance, and that’s the heavy hand of government getting involved.”

“We should come up with common sense solutions, not ones that are forcing individuals into buying something they might not necessarily want,” he said.

Projections estimate the legislation will insure 32 million currently uninsured Americans by 2019. Mr. Bishop said the costs of the newly insured will primarily be paid for in two ways: an increase in the Medicare withholding tax on families that make $250,000 a year or more, and a tax on “Cadillac” health 
insurance plans—expensive insurance policies that are part of employees’ compensation packages but not subject to taxation.

Mr. Bishop said he was concerned with how the Senate bill defined “Cadillac” plans, but the reconciliation package ensured the tax would only affect very expensive, high-premium plans.

Randy Altschuler of St. James, who is also vying for the GOP nomination, said passing the health care bill using reconciliation—which allows a simple majority of the Senate to pass House amendments to a bill—was unfair to the American people.

“This is a legislation that is affecting one-sixth of the economy, and the fact that it wasn’t done through a real vote just shows it’s business as usual,” he said. “This is the kind of shenanigans that you see in Washington, and, frankly, that’s why you need to bring in outsiders like myself and other candidates around the country, who aren’t professional politicians. In business, you can never get away with this kind of nonsense.”

Mr. Bishop defended the decision to use reconciliation, which was created in 1974. “Seventy-two percent of the time that reconciliation has been used since it was first established as a mechanism, it has been used when the Republicans were in control of Congress,” he said. “So it’s both disingenuous and hypocritical for the Republicans to be screaming now that this is an illegitimate practice, when they, in fact, have used it almost three-quarters of the time that it has been used.”

Reconciliation was designed to drive down deficits, and in this instance, it did, Mr. Bishop said, adding that it is one of the reasons he voted in favor of the bill.

The Congressional Budget Office reported last week that the health care overhaul would reduce the national deficit by $143 billion over the first 10 years, followed by $1.2 trillion over the second decade.

“That’s not a Democratic number or a Republican number,” Mr. Bishop said. “That’s the Congressional Budget Office, which is a nonpartisan arm of the Congress.”