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.