Dems Divided Along Regional, Ideological Boundaries

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When it comes to health care, Democrats in specific and lawmakers in general will face deep policy differences when they return to work next week.

USA Today: "Angry voters have captured all the attention at town hall meetings across the country this summer, but it's the passionate response from lawmakers that will affect the health care debate when Congress returns. Dozens of lawmakers used the meetings in August to stake out positions on health care - making promises on everything from abortion to the deficit - that could leave little room for compromise as they close in on a final bill" (Fritze, 9/3).

Geography and the urban-rural split also will be in play. "Congress' efforts to overhaul the nation's health care system are plagued by an age-old urban-rural, east and west coast vs. the heartland schism in the Democratic Party," McClatchy/The Kansas City Star reports. The divide is particularly apparent regarding issues such as the co-op proposal and the public option. Last week, for example, Rep. Pete Stark, D-Calif., spoke about health care co-ops: " 'Well, the only co-op I know about is when I used to milk cows and we sold the milk to Golden Guernsey. And I think there's only one co-op left,' said Stark, who considers the co-op idea a non-starter. 'There aren't many of you listening who remember the co-ops of the '30s, which was a - just kind of a Roosevelt outgrowth of rural electric co-ops, phone co-ops.' " Blue Dog Coalition leader Rep. Charlie Melancon, D-La., on the other hand, promised "a 'more bipartisan, more disciplined' approach, and touted himself as a 'pro-life, pro-gun Southern Democrat.' "

"The public option idea has been endorsed by Democrats on committees led by Reps. Henry Waxman of Los Angeles, George Miller, who represents the San Francisco Bay area, and Christopher Dodd, a Connecticut senator," but "small-town Democrats, however, worry about the cost and the government's reach. The 52 members of the House's conservative Blue Dog Coalition have threatened to derail any plan with a public option unless costs are reined in." Meanwhile, "to a lot of urban lawmakers and their constituents, the co-op concept is foreign" (Lightman and Douglas, 9/3).

When Congress returns on Tuesday, "lawmakers will resume grappling with crafting a comprehensive health care bill as Democrats try to mend rifts within their ranks over its scope and cost," McClatchy/The Miami Herald reports. "House Democrats, who control 256 of the chamber's 435 seats, remain as divided as they were before the recess." And while the public option remains a controversial proposals, it is "likely to remain unchanged," along with proposals to create a health exchange. "The terms in the draft legislation that are most likely to see some changes are provisions that affect small business and some tax increases" (Douglas and Lightman, 9/3).

Meanwhile, House Majority Whip Jim Clyburn, D-S.C., "is pushing a compromise on the most contentious part of President Barack Obama's bid to provide medical benefits to uninsured Americans," McClatchy/The Sun News reports. "Instead of a nationwide government insurance program, Clyburn is urging other Democrats to accept a scaled-down public option that would be tested as a pilot program in several parts of the country." The proposal may be "the latest signal that Obama may back off his previous insistence on a full public option when he addresses a joint session of Congress on Wednesday" (Rosen, 9/3).

The Associated Press/The Atlanta Journal Constitution: "Democratic U.S. Rep. John Spratt of South Carolina is spending the last few days of Congress' summer break trying to advocate his party's health care reform proposals while also insisting he's not just hewing to a party line." At a town hall meeting, Spratt was "asked repeatedly whether he would vote his party's line on health care or the will of his constituents," to which he responded, "It's possible for the two to converge" (Adcox, 9/3).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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