Rural Democrats demand changes in health-reform bill, delaying its unveiling

Rural, conservative Democrats have forced leaders of the House's Democratic majority to delay unveiling of President Obama's health-care bill. Their concerns "include the need for more cost containment measures, protections for small businesses and a focus on rural health care," Erica Werner reports for The Associated Press.

The rural Democrats are part of a group of moderates and conservatives, domimated by the fiscally conservative Blue Dogs, who have millions of rural constituents. Their message to party leaders: "Don’t model public coverage on Medicare. Don’t force doctors or small businesses to participate. And don’t shut out Republicans," Patrick O'Connor reports for Politico.

O'Connor writes that a Friday meeting of members and leaders "centered on Medicare’s already controversial reimbursement rates for health care providers. Moderates echoed long-standing complaints from doctors and private insurers that the current rates are too low, particularly in under-served, rural communities. Authors had already taken steps to remedy this perennial problem, one Congress addresses each year by approving tens of billions to reconcile the annual shortfalls. But they need to go further before many of these disgruntled moderates will sign on."

However, O'Connor notes. "Giving more money to rural states would either make the entire system more expensive or divert money from other communities that will make their own arguments for funding. One of the ideas floated late last week, according to an aide, was to use whatever savings lawmakers can muster from these public plans into more money for rural communities that are struggling to recruit sufficient doctors and nurses."