Rural Democrats push leverage in health reform

As health-reform legislation begins to take shape in bills marked up by committees, and the Congressional Budget Office warns that no version it has seen so far would rein in costs, rural Democrats are having an impact and figuring in negotiations for a final product.

Fiscally conservative Blue Dog Democrats, many of them from rural areas, "joined Republicans to provide the winning edge for an amendment aimed at preventing the creation of duplicative government health programs," notes Alex Wayne of Congressional Quarterly. The amendment in the House Energy and Commerce Committee passed 29-27 and got seven Democratic votes, six from Blue Dogs. On the other two House committees with jurisdiction, "four of the five Blue Dogs who have had a chance to pass judgment on the bill have voted against it, with only Mike Thompson of California, a close ally of Speaker Nancy Pelosi, supporting it in committee," CQ reports.

Meanwhile, President Obama today aligned himself with West Virginia Sen. Jay Rockefeller, "suggesting that a new independent board make the decisions on how Medicare pays hospitals and doctors," Noam Levey reports for the Los Angeles Times.

"Until now, the president has carefully deferred to lawmakers developing healthcare legislation, in part because many believe that the Clinton administration's decision to write its own healthcare bill 15 years ago alienated Congress and contributed to that initiative's failure," Levey writes. "But pressure has been growing on the administration and its congressional allies to do more to restrain the nation's $2.5-trillion healthcare tab. And many specialists believe one key to curbing costs is to remove reimbursement decisions, which are now made by Congress, from the political process."

For the House Education and Labor committee summary of the bill, click here. For a good roundup of increasing party and interest-group advertising on the issue, much of it targeting individual House members and senators, click here.