Making Blue Dogs Blue

The Hill reports that the Speaker will respond to pressure from progressives and move the health care bill back to the left when she merges the competing measures from committee:

Speaker Pelosi is nixing a deal she cut with centrists to advance health reform, said a source familiar with negotiations.

Pelosi’s decision to abandon the agreement that was made with a group of Blue Dogs to get the bill out of committee would steer the healthcare legislation back to the left as she prepares for a floor vote.

Pelosi is planning to include a government-run public option in the House version of the healthcare bill. She wants to model it on Medicare, with providers getting reimbursed on a scale pegged to Medicare rates.

"The speaker is full-steam-ahead," said a senior Democratic aide.

Let's be clear who broke the agreement. The Blue Dogs and Waxman negotiated a deal to water down the public option but still include it in a final bill. Mike Ross came back from recess and said he could not support a public option whatsoever. At that point, the deal ended. And Ross, secure with his payoff from a pharmacy chain from a couple years back, has nobody to blame but himself.

This puts the House bill in the best negotiating position for the inevitable conference committee. Obviously the public option is a compromise in itself, but further grinding it into nothing would have made it nearly impossible to defend its inclusion in conference. Pelosi is determined to have the House be an equal player in this debate, and that starts by her passing the best bill possible from her chamber.

In other good news, the single-payer bill, HR 676, will finally get a score from the Congressional Budget Office. This score could be an excellent tool for advocates down the road, and it's sad that it's taken this long for such a score to be calculated.

Always Darkest Sausage-Making Before The Dawn

Ezra gives the 10,000-foot view of today's health care crackup in the House, and Henry Waxman's dicey choice on how to resolve it:

The central issue here is simple enough: The Blue Dogs want Waxman to make concessions he doesn't want to make. The sticking points, according to sources close to the process, are the public plan -- Blue Dogs still want a trigger option -- and the administration's proposal, which the Blue Dogs support, to create an independent commission able to set Medicare payment rates and make reforms. Waxman and others worry that a Republican administration and Congress could use this panel to undermine the Medicare program.

You can take Waxman's statements one of a couple ways. His willingness to bring the bill directly to the floor undermines the bargaining power of the Blue Dogs: It means they don't have veto power over the bill. This could, in other words, be a negotiating tactic on Waxman's part to soften the Blue Dogs' position. But if that doesn't work, it could also mean exactly what it says: That he's going to push the bill straight to the floor.

That would ensure some bad headlines, and an angry Blue Dog caucus. But versions of this bill have passed two other committees. Energy and Commerce isn't strictly necessary. Waxman's threat to bring the bill to the floor means that Pelosi and Waxman think they have the votes whether or not Energy and Commerce approves the legislation. And that may not be such a bad outcome, either for the Democrats or the Blue Dogs.

But Blue Dogs might balk, because they don't want to walk the plank on a bill if the Senate Finance Committee won't walk it either. We're basically seeing a game of chicken, between Waxman and the Blue Dogs as well as between the House and the Senate. Nobody wants to take the tough vote first. But somebody has to, in order to get the ball rolling.

Brian Beutler discerns tension and chaos on the Hill, but I've heard different. I heard Waxman and Mike Ross have stated that talks are ongoing and that a markup could be held as early as Tuesday. And that Steny Hoyer said publicly at a press conference that votes could happen next week. So we don't really know what's going on quite yet. It's hard not to despair just as a reflex, but I wouldn't just yet.

Selling The Drama

The media likes to create great stories, with twists and turns, ups and downs, major characters and minor villains. I don't know if they are secretly gleeful to see Barack Obama's health care plan fail, but they certainly don't mind seeing it in trouble. It creates a story that they can expound upon, connect to the history of health care efforts in the past, and they can chronicle every public comment (as opposed to any detail in the bill) to fill hours of cable news. This narrative doesn't have to be perfectly true - it just has to feel like it. Chuck Todd is skeptical about all of it:

TODD: Look, I absolutely believe that, I sometimes think we're getting played here a little bit. You know, we've created this drama that he's struggling to get this done. And there's no doubt, this is a tough road ahead for members of Congress. And they're struggling, and they don't want to vote for this thing, and they're nervous about it. They don't know what it's going to look like a year from now, and they're worried about explaining how, "Hey guess what, that health care reform bill we passed, well you're not going to feel it for three or four years." So they're nervous about this whole thing. But Chris, 15 years ago, we had industry spending millions. There was more money on TV being spent to kill health care than to pass it. We have the exact opposite now... more money has been spent advocating the President's health care proposal than defeating it. That environment makes it like, look they're going to get something. They're not going to do nothing. They're going to get something. Now what it looks like in the end, that's a whole other story.

I think that's right, but "what will health care reform look like" isn't an exciting enough story for the media, or at least not as exciting as pass/fail. So they try to set up a left-right continuum, although the two sides aren't on the same level, and Republicans need Democratic help to scuttle any bill. But they give substantially more weight to a Newt Gingrich and a Michael Steele, and on the other side, a Mike Ross, a conservative Democrats who refuses to listen to his own constituents back home. This part of the story rarely gets heard in Washington:

Rep. Mike Ross, who grew up in this tiny town of 3,600, represents residents like 62-year-old Sandy Barham, a restaurant owner with a heart ailment who can’t afford health insurance for herself or her employees.

"I can’t tell you the stress of living on the edge, just wondering, ‘Am I going to get sick?'" she said in an interview at the Broadway Railroad Café, where fried catfish with hush puppies is a popular feature. "I feel embarrassed, almost, when I go to the doctors and tell them I don’t have insurance."

Many people in and around this economically depressed town can’t afford insurance, even as the battered economy has made it harder for employers to provide coverage for workers. They're looking to Washington for help, and Ross, a conservative Democrat with a strong voice in the debate over health care legislation, says he’s on their side.

Yet Ross stands ready to try to block passage of a House bill that, its supporters say, would provide exactly what Arkansas needs: guaranteed insurance and a wider choice of coverage at competitive prices.

We only hear from people like Ross about the cost of health care, not the fact that they want to raise reimbursement rates for rural hospitals, which would INCREASE that cost.

If only we heard a little from Mike Ross' constituents instead of just Mike Ross.