Facing a deluge of letters from (mainly conservative) party members, House leaders have delayed unveiling their health care reform bill for at least a few days as they address a number of members’ concerns. But the prime mover in their decision seems to have been pressure from Blue Dog Democrats, who delivered a letter to Speaker Nancy Pelosi and Majority Leader Steny Hoyer last night.
“From where we are today, significant progress on the draft tri-committee health care reform proposal needs to be made in order to address each of these concerns,” the letter reads. “We cannot support a final product that fails to do so. ”
The letter, which you can access here, was signed by 40 of the 52-member coalition. Their concerns include deficit neutrality (the Blue Dog hobby horse) but also, financing, and the public option–which they say should not be able to use Medicare, or Medicare-like reimbursement rates (about 20 to 30 percent below the private market) but ought to compete on a level playing field. “We also wish to reiterate our support for the recommendations previously made by our Coalition regarding how to appropriately structure a public option,” the letter reads. “In order to establish a level playing field, providers must be fairly reimbursed at negotiated rates and their participation must be voluntary.”
That’s fairly gentle language, and pretty remarkable when you consider that, until recently, a number of Senate Democrats were vying to scrap the public option altogether. I’ll have more on this later today, but my immediate read on all this is that the Senate–its rules and its political makeup–remains the biggest hurdle to health care reform.