John Katko, (NY24) is the only New York State Republican House member who has declared that he will not vote for the  Trump/Ryan American Health Care Act. You can see the whole list of hold outs here. The NY-24 includes all of Cayuga, Onondaga, and Wayne counties, and the western part of Oswego County.  It includes Syracuse.

Katko will not be easily swayed to vote for the AHCA. The Finger Lakes Times reported Sunday he said:

• “My position on Obamacare has been clear since I first ran for office in 2014: We need to repeal or radically restructure the law, and have a replacement ready at the time we do so. Despite some promising reforms, I do not support the proposal before the House in its current form.”
• The congressman said he does not “believe this proposal provides an adequate market-based option for insurance access, nor does it address out-of-control costs. Further, I am confident the proposal would harm hospitals across my district. Hurting New York State, to benefit other regions, does not sit well with me.”
• He said Republicans need to “take the time to ensure a viable market-based alternative to Obamacare is ready simultaneous with the repeal. I believe we can get there.”

Katko knows his district well. It has been considered as a swing state, changing swung from a Democratic representative  to a Republican for four elections in a row between 2008 and 2014. Katko changed that trend when he won his second term in 2016.

Despite President Trump’s reminder (or threat) that those who vote against the AHCA they will be defeated in 2018, Katko will not flinch.  The district went for Clinton, 48.9% to 45.3%.  Katko did not endorse President Trump in the last campaign and easily defied his democratic opponent, 60.6% to 39.4%.

He has been criticized for not holding Town Hall meetings.

Claudia Tenney, R-New Hartford, of the neighboring 22^nd Congressional District, told Syracuse.com on Wednesday that she is leaning toward voting against the GOP bill because some of its changes are bad for New Yorkers.