Overhaul Puts ‘Blue Dogs’ in Middle
March 9th, 2010 - Congressional Quarterly
By Rebecca Adams

As House Democratic leaders woo fiscally conservative members ahead of a tough health care vote, the deliberations of Jason Altmire offer some insights into the challenges facing lawmakers in the Blue Dog Coalition.

After back-to-back discussions with the White House last week in which he was personally courted by President Obama, the two-term Pennsylvania Democrat sounded as if he might be considering the administration’s arguments.

“Many of the serious concerns I had about the House bill have been resolved,” he said March 5, noting that the current Democratic proposal is less costly and has a less expansive government role than the version he opposed in November.

But when the former health care executive visited his district over the weekend, he heard an earful from constituents who believe the plan will cost them money or undermine their current health care coverage. Not incidentally, the 4th District is one of the House’s most competitive, and GOP presidential candidate John McCain took 55 percent of the district’s vote in 2008.

At one point, Altmire asked the audience of a local Chamber of Commerce meeting for a show of bill supporters and opponents. The room was equally divided.
“That’s the problem I have,” he said.

Courted by both sides — and also marked for potential retaliation by those he disappoints — Altmire’s high-wire juggling act reflects the predicament in which many centrist Democrats find themselves. Of the 39 Democrats who voted against the House bill in November, 24 consider themselves Blue Dogs. Without the support of at least some of them, the measure stands little chance of passing in the House.

Altmire, for one, remains undecided.

Speaker Nancy Pelosi, D-Calif., must coax 216 members of her caucus to vote for the Senate version of the health care overhaul (HR 3590), as well as a “corrections” bill containing fixes agreed to by the Democratic leaders of both chambers and the White House. But while the original House bill (HR 3962) squeaked through last fall, 220-215, three Democratic supporters and one Democratic opponent have since left the House.

Further complicating Pelosi’s task, about a dozen Democrats who supported the House bill and the one Republican who voted for it, Anh “Joseph” Cao of Louisiana, have suggested they will vote “no” unless changes are made to the abortion language in the Senate bill.

The Blue Dogs, therefore, are a key element of gaining passage. But persuading a significant number to support the health care overhaul looks like it will be tough. Many question why the government cannot contain health care costs first and expand coverage later, even though the Congressional Budget Office says the House and Senate bills would reduce the deficit over time and lower the rate of Medicare cost growth by 2 percentage points per year.

“Individual members who are reported to be most anxious are concerned about the economic stuff, because the people back home are most scared about the economic future of the country and the contribution of health reform to or against that,” said Len Nichols, a health policy expert at George Mason University.

“The battleground is over which interpretation of what reform would do,” said Nichols, who was a former top health care adviser in the Clinton administration during its failed overhaul effort. “People hear the arguments for and say, ‘I don’t want to tax my children.’”

That is part of the reason Obama began stumping for passage around the country Monday, attempting to give political cover to wavering Democrats by rebranding the plan as an effort to protect the middle class and rein in costs.

“I think it’s having a gradual effect to influence people,” said Sen. Arlen Specter, D-Pa., who accompanied Obama to a speech in suburban Philadelphia. “I think you see more members of the House now say that they’ll rethink it, they’ll try to find a way.”

Courting Outgoing Lawmakers

Lawmakers who are retiring are also receiving significant attention from House leaders. Among those believed to be in play is Democrat Bart Gordon of Tennessee, who said late last week that he was “pleased to see the discussion moving in a more fiscally responsible direction now.” While Gordon did not specifically say that he would vote for the Senate bill, he signaled that he was leaning in that direction.

John Tanner of Tennessee, a Blue Dog who won’t be seeking re-election this year, pointed out that the bill “is a different bill” than the one he voted against. But he also has declined to say how he will vote until he sees how the corrections bill is scored.

Also on the fence is Democrat Brian Baird of Washington, who has also decided against running for another term. He said the bill was not one that he would have written but was better than the “status quo.”

Some Promise No Change of Heart

Some lawmakers who voted against the House bill are showing no inclination to reconsider their stance. Blue Dog co-chairwoman Stephanie Herseth Sandlin of South Dakota told reporters in a conference call that she would not support any changes that come from the Senate via the budget reconciliation process.

Jim Marshall, a Blue Dog from Georgia, said March 5 that his vote against the House bill in the fall was “a good vote” that he will cast again this time around. He cited the legislation’s inability to control skyrocketing costs as a concern.

Many more are in the “maybe” column. In a March 7 appearance on “Fox News Sunday,” John Adler, D-N.J., said he was “one of the guys who believes I should read the bill first before making up my mind.”

House members who are on the fence want time to study the bill after the Congressional Budget Office releases its cost estimates, which may occur by the end of the week. The demand makes it all but impossible to meet the administration’s suggested March 18 deadline for passing the overhaul in the House.

Republicans and some Democrats also are expected to demand that both bills be posted online for at least 72 hours before the first House vote on the package.

Adriel Bettelheim and Kathleen Hunter contributed to this story.