Holding signs urging health care reform, more than 25 people quietly marched back and forth on the sidewalk in front of U.S. Rep. Jason Altmire's McCandless home Sunday afternoon.

The Democratic congressman was not at his house, but in Washington, D.C., to take part in the vote on health care legislation.

Health care reform supporters planned Sunday's vigil after Mr. Altmire announced Friday he would vote against it. In a statement, he said the majority of his constituents were opposed to it and that he believed the bill would "compound the problem of skyrocketing health care costs."

Neal Bisno, the president of SEIU Healthcare Pennsylvania, and others at the Health Care for America Now campaign used Facebook, e-mails and phone calls to organize a vigil in front of Mr. Altmire's house, a last-minute push to urge him to change his mind and vote for the bill.

"The bill's not perfect, but contrary to what he said, the bill would bring tremendous benefits to his district," Mr. Bisno said.

Ryin Gaines, 27, of Squirrel Hill, believes he will benefit from health care reform. Mr. Gaines, who works at Mellon Arena and PNC Park, had no health insurance when he injured his knee two years ago playing hockey. He went to the emergency room for initial treatment, but has had trouble securing follow-up care, and more trouble obtaining health insurance now that he has a pre-existing condition.

He purchased health insurance for a few months to cover follow-up visits for his injury, but the monthly costs became prohibitive.

He's been calling and e-mailing government officials, including Mr. Altmire, and urging them to support health care reform legislation. He said there are many others in the middle and lower classes that have to make choices similar to the one he made -- between a mortgage or rent payment and paying for health care.

"We are struggling," he said. "We are absolutely struggling for this and shouldn't be struggling for it."

After 24 years as a nurse, Cathy Doerfler, 44, of Shaler, has a different perspective from Mr. Gaines but the same conclusion. She also believes health care reform is imperative, and was in front of Mr. Altmire's home Sunday to urge him to reconsider his vote against the legislation.

Over the past two decades, she said, she has seen patients forgo preventative care, arrive at the hospital sicker and leave more quickly than they should. She has lobbied for health care reform with e-mails and office visits to government officials.

"I'm a nurse. I'm going to advocate for my patients. And this is what's best for my patients," she said.

Mrs. Doerfler said she also has personal reasons for supporting health care reform. Her sister has been unable to procure health care due to a pre-existing condition, rheumatoid arthritis, that makes it hard for her to lift her arms, a necessary movement in her job as a hairdresser.

Her father, who recently turned 72, is a barber who hasn't been able to retire due to high health care costs.

"Reform has to happen on so many levels," she said.

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