Can Pelosi Win Over Wary Dems on Health Care?

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Jim Watson / AFP / Getty

Speaker of the House Nancy Pelosi outside the White House after meeting with President Obama on health care

As Congress returned to Washington on Sept. 8, House Democrats spent much of the day trading war stories and tending to one another's wounds from the bruising town halls that dominated their August recess. And if they weren't unhappy before, few of the survivors of the summer of discontent are now in a mood to deal with the controversial, politically perilous legislation to reform the nation's health-care system.

"I don't know if I would call the month freaky," says Representative Zach Space, laughing. The Ohio Democrat has yet to decide how he'll vote on the legislation. "I love the fact that people are engaging and expressing themselves, but I had a guy sleeping on the sidewalk in front of my office for a week," he says. "It's important that the debate be healthy — one with structure, not destruction — where we debate issues, not urban myths."

For all the attention being paid to the painstaking negotiating process that is under way in the Senate, the House now holds as much, if not more, risk for health-care reform. Already, 23 moderate Democrats have said they will not vote for any of the three bills on the table. Representative Mike Ross, an Arkansas Democrat and a leading member of the Blue Dogs, the fiscally conservative House Dems, said this week that he would not vote for any bill that includes a public plan. If there was one major casualty of the talk of death panels, Nazi comparisons and screaming matches at all those town-hall meetings — which reverberated through the echo chamber of cable-TV news — it was the public plan. Democrats had hoped to include a government-run insurance program in the bill as a way to provide enough competition with private plans to keep costs down, but opponents derided it as the first step toward socialized medicine. House Speaker Nancy Pelosi now faces a tough predicament: all three House bills that passed out of committee before the recess include a public plan, and conventional wisdom was that a final version of the bill, which would marry the three together, would include such a plan.

"I believe that a public option will be essential to our passing a bill in the House of Representatives," Pelosi told reporters on the White House driveway on Tuesday afternoon, after a meeting with the President. However, when pressed about whether she might accept a compromise that would allow for a public plan only if lack of competition in the marketplace triggers it a few years down the line, Pelosi for the first time equivocated, as her Democratic-leadership colleagues had already done. "This, as you know, is the legislative process. And right now, we will have a public option in our bill."

As much as Obama has repeatedly underlined his preference for a public plan, in the past few months, he has slowly backed away from making the bill contingent upon its inclusion. And House majority leader Steny Hoyer on Tuesday seemed to indicate for the first time that the House might move to pass a bill without a public plan. When asked if legislation without such a feature could pass the House, Hoyer hedged. "I think the public option is a very good choice for consumers to have," he told reporters in his first-floor Capitol Hill offices. "On the other hand, I have said that I hope to move a bill forward that can garner majority support." Even progressives, more than 50 of whom had signed a pledge before the recess not to vote for any bill that did not include a public plan, have shown some willingness to bend on the issue — an indication of how spooked the caucus is by the summer theatrics. "I'm willing to look at the public plan if it means getting [Maine Republican Senator] Olympia Snowe's support for it to pass the Senate," says Representative Bill Pascrel, a progressive New Jersey Democrat. "But I'm leery about it — there better not be 14 exit signs written into it."

If Pelosi can't resolve the public-plan standoff and loses more veteran moderates like Mike Ross, she'll have to strong-arm vulnerable freshmen and sophomore lawmakers to vote for the bill in order to pass it — a big gamble in an uncertain electoral atmosphere. So skittish are a few vulnerable Democrats that they are actually considering skipping President Obama's much-touted speech on health-care reform before a joint session of Congress on Sept. 9, for fear of being caught on camera applauding any health-care initiatives. "There are a lot of freaked-out moderate and swing-district Democrats who are now gun-shy, regardless of what is in the bill," says Charlie Cook, editor of the nonpartisan Cook Political Report, which tracks congressional races. "The question might be how much a bill would have to be shrunk to get a majority of 218 votes, and if they do shrink it enough, do they lose liberals on the other side? Quite simply, they have a disaster on their hands."

Republicans would like nothing more than to see the House pass a bill that includes a public plan, since the provision is all but sure to be dropped in the Senate. Republicans have already been celebrating the Democrats' passage of a bill to address global warming earlier this summer. The Senate has yet to act on it, and given the current atmosphere, poisoned by health-care, the environment bill may never see final passage. The GOP calls the climate-change bill a massive new energy tax on consumers and likens it to the doomed BTU energy tax that was passed at the urging of President Bill Clinton in his first term and cost several Democrats their seats in the following midterm elections.

"The question Democrats have to be asking themselves is, How many times is Nancy Pelosi going to make them walk the plank and cast a vote for a fatally flawed bill?" asks Ken Spain, spokesman for the National Republican Congressional Committee, which helps elect GOP candidates to the House. "This kind of overreach would be a policy disaster for middle-class Americans, but a dream scenario for any Republican opponent."

Which is why what many Democrats are hoping to hear from Obama on Wednesday night is, first and foremost, political cover: some indication that he is staking his still formidable political capital on this process. "I'm leaning no, but I really want to get to yes," says Representative Tom Perriello, a Virginia Democrat and top Republican target. "What I think people are looking for and what I heard back home is, they understand that we're trying to do really important things. They want to understand how these things fit together, and I think the President is in a great position to make the case of what a new generation of politics that focuses more on solutions than on the ideological debates looks like. Because there's so much uncertainty right now, I want for the American people to hear and to understand what connects these issues." Still, speeches only get a person so far, even in Washington. If Obama wants to salvage his top priority, he must form a concrete plan and remind Democrats that, as happened in 1994, failure to pass legislation now will cause major political damage come next November.