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House Democrats returned to Capitol Hill on Tuesday after a brutal August recess to begin the difficult work of stitching together a consensus on health care reform.
And while Democratic leaders searched for unity in advance of a pivotal Wednesday address to Congress by President Barack Obama, deep cracks in the Caucus were barely beneath the surface.
Divisions started at the top, with Speaker Nancy Pelosi (D-Calif.) once again declaring a public insurance option essential to the success of a broader package hours after her No. 2, House Majority Leader Steny Hoyer (D-Md.), suggested it might need to be cut loose to garner enough votes to pass the chamber.
Pelosi also appeared to open the door a crack to a trigger that would use the public insurance option only as a fallback if private insurance companies fail to hold down costs and improve quality.
But Pelosi warned the insurance industry that if a trigger is included, it would be tied to an even stronger public insurance option down the road.
They'd be better getting a public option now than one that is triggered because if you have a triggered public option, it's because the insurance industry has demonstrated that they're not cooperating, they're not doing the right thing, and I think they'll have a tougher public option to deal with, Pelosi said after a meeting at the White House with Obama and Senate Majority Leader Harry Reid (D-Nev.).
Majority Whip James Clyburn (S.C.), the No. 3 Democratic leader, had signaled earlier Tuesday that a trigger might be necessary. There are ways to get a public option, he told MSNBC on Tuesday morning. "I do believe we can have a health care reform bill that includes a public option that is acceptable to people who dont want a public option.
Despite the apparent fissures, House Democratic leaders made a show of unity after an early evening huddle Tuesday, claiming broad consensus on the need for reform and 85 percent on the substance. Theres no division, Pelosi said. We all support a public option.
Pelosi has been working hard to keep a public insurance option alive opposition is strong in the Senate and the White House has been waffling on the issue but faces a tough job convincing conservative Democrats bruised by weeks of angry town hall meetings.