Dozens of activists gathered at Rep. Jason Altmire's Aliquippa office yesterday to assail the Democrat for his vote against the House version of a bill to revamp the nation's health care system.

Reading from a copy of a letter she had sent to the second-term congressman, Charlene Gill said, "Your 'no' vote is the reason I will vote for whoever runs against you."

The New Castle retiree won a smattering of applause from the crowd of about 35 as she continued, "I hope the insurance industry you're trying to protect gives you your old job back."

Mr. Altmire, a former congressional staffer, was a government relations executive for UPMC before winning his House seat in a district that includes Beaver County and many of the suburban communities north of Pittsburgh.

Mr. Altmire voted against an earlier version of the House measure in committee. And while he said that the version that prevailed narrowly over the weekend was an improvement in some respects, he said in a statement that he was disappointed in what he characterized as its failure to provide meaningful reform.

"This bill is inadequate in two key areas that are critical to meaningful health care reform: cost containment and delivery system reform," he said, while emphasizing that he would work for the enactment of a more acceptable measure.

Yesterday's demonstration was one part of the grass-roots lobbying occurring across the country as supporters and opponents of the overhaul prepare the ground for a Senate vote on the proposal and a subsequent House vote on a final version of the bill expected to be brokered by House and Senate conferees.

Mr. Altimire's decision on the weekend vote was closely watched because he represents a swing district. He won his seat from a Republican, former Rep. Melissa Hart, in 2006. While he defeated her by a comfortable margin in a rematch two years ago, his district voted heavily for the Republican presidential candidate, Sen. John McCain.

While his vote upset some members of his district, other demonstrations in recent months have shown that any decision is bound to irritate some segment of his constituency.

In September, a crowd of nearly 2,000 showed up in a Cranberry park, in another part of the 4th District, loudly denouncing the Obama administration over its call to change the nation's health care system.

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