Consensus forming among most Democrats on health reform

Democratic leaders have begun moving the rank and file closer to acceptance of basic tenets of health reform proposals, but concerns remain among the fiscally conservative Blue Dog Democrats on how it will be paid for, Politico reports.

"House Speaker Nancy Pelosi and Majority Leader Steny Hoyer are double-teaming powerful chairmen and rank-and-file members to save health care reform from a repeat of the Democratic Party infighting that helped kill it in 1994. In a closed-door session Tuesday, Pelosi assured rank-and-file Democrats that she won't move forward on a bill without their consent. 'We have to hear from you,' one participant quoted Pelosi as saying." In other meetings, Pelosi and Hoyer asked Education and Labor Committee Chairman George Miller, D-Calif., Ways and Means Committee Chairman Charles Rangel, D-N.Y., and Energy and Commerce Committee Chairman Henry Waxman, D-Calif., to engage moderate Democrats.

"Moderate Democrats have been warning their leaders for weeks against pushing proposals that undermine the private market, particularly a so-called public option that could dissuade consumers or businesses from purchasing private insurance. In a letter to their leaders last week, fiscally conservative Blue Dog Democrats said a public option should be created only if insurance market reforms and increased competition don't lower costs on their own" (O'Connor and Frates, 6/10).

"Mr. Rangel said 'there won't be any consideration' of that approach in the House. 'We have to have a public plan' from the start,' Mr. Rangel said. 'We are not going to wait two, three or five years to see what happens and then trigger it,'" The New York Times reports. The plan goes against some moderate Democrats' wishes that a public plan be triggered only if the private insurance market doesn't "rein in costs and offer affordable coverage to everyone" (Pear, 6/9).

Roll Call: "Waxman said a trigger did not have broad support in the Democratic Caucus, although he noted that the chairmen's draft incorporated other Blue Dog principles, including that any public option compete on a level playing field with private plans. 'The consumer should be able to make a choice, and that's what we're going to be pushing for,' Waxman said. 'I don't see why it should be objectionable to anybody for the consumer to have a choice.' Waxman said each side is going to have to compromise" (Dennis and Newmyer, 6/10).

But Kaiser Health News says the Blue Dogs could still have a role in shaping the bill: "That's because the administration would need two-thirds of the coalition members to pass a bill in the House without any Republican support, a growing possibility in light of Republican opposition to creation of a government insurance entity and imposition of employer mandates to provide insurance" (Pianin, 6/9).