Heavy Lift for Health Care

Moderates Balk at Yet Another Tough Vote

Posted July 10, 2009 at 6:33pm

House Democratic leaders pushing a massive health care overhaul are facing a major drag from moderate Democrats soured by the political backlash to the climate change vote.

Call it the hangover effect.

Democrats who helped the sweeping climate change bill squeak through before jetting home for the July Fourth break got a surprisingly ugly homecoming, encountering a barrage of protests, attack ads and negative press. Police turned up at a local protest aimed at Rep. Allen Boyd (Fla.), a leader of the moderate Blue Dog Coalition. Freshman Rep. John Adler (N.J.) told a local paper he got shoved.

The bruising endured by the moderates — along with serious substantive concerns —prompted them last week to derail the planned Friday rollout of the health care bill. And it presents a continuing challenge to leaders hoping to wrap work on the package this month. “They are completely and totally rattled,— one senior Democratic aide said of the centrists. “I’ve never seen them as bad as they are now.—

After huddling with Blue Dogs on Friday, House Ways and Means Chairman Charlie Rangel (D-N.Y.), one of three chairmen drafting the bill, said it would be unveiled Monday. He said he made some changes to the package to accommodate their concerns but also sought to show them the depth of the changes the bill writers were already making to reform the health care system to improve quality.

Beyond delaying the bill, Democratic leaders are taking steps to reassure their rank and file that they have registered their concerns. A common gripe about the climate change bill centered on process: that the bill’s authors did not seek the input of a broad swath of the Caucus, then dropped a sprawling manager’s amendment in the dead of night hours before the vote.

Last week, in an effort to allow the entire Caucus to weigh in, House Majority Whip James Clyburn (D-S.C.) hosted six separate meetings with the Democratic rank and file, grouped by region. Participants snacked on fresh fruit while they aired their thoughts to the whip team. And House Majority Leader Steny Hoyer (D-Md.) assured lawmakers in the first of three closed-door huddles on the issue last week that the manager’s amendment for the health care bill would be posted publicly 48 hours before the vote.

Rep. Mike Ross (D-Ark.), who chairs the Blue Dog health care task force, launched a pre-emptive strike against the three chairmen last week, warning that the overwhelming majority of Blue Dogs were prepared to vote against the health care bill unless major changes were made. Ross said previous attempts and meetings on the issue had failed to make the bill palatable to moderates, saying that there weren’t enough cost cuts nor was there enough consideration given to rural areas and small businesses. Blue Dogs also have serious concerns about the proposed public insurance option, which they said must not be based on Medicare payment rates.

Democratic leaders led by Speaker Nancy Pelosi (Calif.) held an emergency meeting with the Blue Dogs on Thursday that lasted for more than two hours and ultimately forced the three chairmen to postpone action on their bill. The Blue Dogs again met with the chairmen Friday for more than two hours but did not reach a deal, Ross said.

“The issues we raised today aren’t really different than the issues we’ve been raising,— he said. “The difference is now they seem to be listening.—

Other moderates remain skeptical. Rep. Jim Cooper (D-Tenn.) said groups are already pressuring lawmakers back home both on the climate vote and on health care, and he said the pressure on the latter is about to ratchet up dramatically. “The pot is starting to simmer, and in a couple of weeks it’ll be boiling,— he said.

A major source of concern for the centrists is that the legislation crafted by the three liberal chairmen is so far to the left that the House is being left out of the real deal-making between the White House, the Senate and key interest groups.

The three House chairmen writing the bill have said they aren’t bound by deals the White House and the Senate cut with drug companies, hospitals and other groups since they weren’t included in the negotiations.

That has caused heartburn among Democrats from swing districts worried that they will again be asked to cast a tough vote on a bill many of them think is too liberal and is unlikely to become law — just as they were on the climate bill.

“I’m just looking for the bill to be in the mix in terms of what’s realistic in terms of the final outcome,— said Rep. Jason Altmire (Pa.), a Blue Dog and a New Democrat who voted against the climate bill. “If we put ours so far to the left, we’re not going to have any influence in the final product,— Altmire said.

And unless the House bill is close to what will ultimately be signed into law, “you are going to hang out a lot of those ’08 freshman on two votes … that are hard to explain,— Altmire said.

Pelosi, asked about concerns by some Members that the House would back a public insurance plan only to see it defeated in the Senate, dismissed them as typical.

“Some of you said this about the recovery package, and then it was said about the budget, and then it was said about the energy bill,— she told reporters at her weekly press conference last week. “But the fact is that we believe that a public option is — by one name or another — is essential to the success of real reform that will work for the American people and change the system. So we’re committed to that.—

Rep. Frank Kratovil (Md.), a freshman Democrat who cast a tough vote for the climate bill, said he’s happy with that vote but has concerns about the health care package, in large part because Members like him haven’t been included in the negotiations and haven’t seen the legislation.

“Nobody yet knows what we’re talking about,— he said.