Politics & Government

Pressure builds on 'Blue Dog' Democrats over health care vote

WASHINGTON — With a Capitol Hill showdown only days away, two San Joaquin Valley congressional Democrats remain crucial and undecided votes on a controversial health care bill.

The pressure is building on Reps. Dennis Cardoza of Merced and Jim Costa of Fresno. In some ways, they hold in their hands the bill's fate, as well as several political futures — their own, the president's and their party's. The White House has summoned both in recent days. Television ads and Republican talking points target them.

"I have had good friends who have called me in recent weeks, who have made good arguments on both sides," Cardoza said Friday.

Costa went to the White House on Thursday night. A week ago, it was Cardoza's turn. As counterweight, corporate opponents of the health care reform bill have been running television ads urging viewers to tell Cardoza to vote no. Phone bank operations have been deluging both offices, similarly urging a no vote.

Inevitably, bargaining over one issue blends into another. Costa said Friday that he used some of his time with President Barack Obama to urge more consideration for the Valley's water and employment needs. Obama said he understood, Costa reported.

In a memo Wednesday, Republican leaders identified the two Valley lawmakers as among those who will ultimately determine the success or failure of the legislation. They are both part of the Blue Dog coalition, whose members have more moderate voting records than other Democrats.

In November, Cardoza and Costa joined the majority in approving the initial House bill by a 220-215 margin.

Since then, negotiators have revised the package, but the final bill, spanning well over 1,000 pages, isn't expected to be available for inspection until Monday. The Valley lawmakers say they can't commit until then.

"We've gotten the summaries, but we don't know what the actual language is going to be yet," Cardoza said.

Costa, too, stressed that "I want to see the bill in print, what we're actually voting on," before making a decision.

Costa and Cardoza both support elements in the health care package, including insurance coverage for those with pre-existing conditions and portability of coverage when employees move from one job to another. The bill's final cost remains a potential concern for both.

Both lawmakers oppose federal funding of abortions, though they are leaving to others the details of how to write the necessary legislative language.

Because of congressional vacancies, House Speaker Nancy Pelosi needs 216 votes. No Republican is expected to vote for the health care package, leaving Democrats to pick their own way.

Politically, legislators see danger everywhere.

Failure to pass the bill would invariably brand Obama and congressional Democrats as weak or inept. That would hurt the party in November's elections. But in conservative-leaning San Joaquin Valley districts, support for Obama and Pelosi could also be costly.

In this fraught environment, even modest clues invite interpretation. Cardoza, for one, seemed to emphasize on Friday the problems of uninsured San Joaquin Valley residents and the pain of rising insurance costs.

"We have real problems with a lot of my folks not having insurance," Cardoza said.

An estimated 28 percent of the residents of Costa's congressional district in Fresno, Kings and Kern counties lack health insurance, according to the Physicians for a National Health Program. An estimated 22 percent of the residents of Cardoza's congressional district in San Joaquin, Stanislaus, Merced and Fresno counties are uninsured.

The Valley's uninsured population is much higher than in other parts of the country.

Cardoza and Costa both cited funding for new medical schools in their votes in November. The original House bill authorized $500 million over five years for new medical schools in underserved areas. The University of California at Merced was an unnamed but presumed beneficiary.

The health care package to be considered next week omits the medical school funding.

Instead, Cardoza noted, the Obama administration in its fiscal 2011 budget request is seeking $100 million next year for the same medical school purpose.

Cardoza serves on the leadership-controlled House Rules Committee, which will play a crucial behind-the-scenes role in coming days. The panel sets rules for how bills are put together and debated, and often is lambasted by Republicans for cutting off GOP alternatives.

Congressional action is expected to be concluded by March 21.

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