Speaker Nancy Pelosi, along with fellow Democratic Reps. George Miller, Steny Hoyer, Dave Obey, John Larson and Charles Rangel, has been shepherding health care legislation through the House. Dems double down on health care

House Speaker Nancy Pelosi and Majority Leader Steny Hoyer are double-teaming powerful chairmen and rank-and-file members to save health care reform from a repeat of the Democratic Party infighting that helped kill it in 1994.

In a closed-door session Tuesday, Pelosi assured rank-and-file Democrats that she won’t move forward on a bill without their consent. “We have to hear from you,” one participant quoted Pelosi as saying.


In a separate closed-door session in the speaker’s office, Pelosi and Hoyer urged Education and Labor Committee Chairman George Miller (D-Calif.), Ways and Means Committee Chairman Charles Rangel (D-N.Y.) and Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) to heed the concerns of moderate Democrats.

That meeting came on the heels of a joint memo prepared by top aides to the speaker and the majority leader.

While Hoyer has been marshaling support for health care reform for months, Pelosi’s increasingly hands-on involvement reflects the pressure to move quickly on President Barack Obama’s top first-year legislative priority — and it’s a signal that there’s no daylight to exploit between the speaker and her No. 2.

“The point is to send a message clearly that they’re not going to play the speaker off of Hoyer on this stuff,” said a Democratic health care lobbyist.

Waxman, Miller and Rangel — along with their respective aides — are trying to draft legislation in concert with each other so their committees will take up the same bill later this summer.

“This is the year we have to do it,” Waxman told reporters after the caucus meeting. “There’s an overwhelming commitment to getting this done.”

“We’ll all go together,” Miller said Tuesday.

“Ultimately,” said Rep. John Larson (D-Conn.), “our job is to come together as a caucus.”

But that’s easier said than done — especially on an issue as contentious as this one.

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Moderate Democrats have been warning their leaders for weeks against pushing proposals that undermine the private market, particularly a so-called public option that could dissuade consumers or businesses from purchasing private insurance. In a letter to their leaders last week, fiscally conservative Blue Dog Democrats said a public option should be created only if insurance market reforms and increased competition don’t lower costs on their own.

Rangel and Waxman have both rejected this argument.

“Everyone can’t get everything,” Waxman told reporters Tuesday. “Why should private companies object to competition?”

In addition, both the Blue Dogs and members of the New Democratic Coalition want to make sure the public plan isn’t based on Medicare rules; they want the plan to pay for itself and operate under the same guidelines as private plans.

But more-liberal members want a more expansive — and expensive — plan. During the closed-door session Tuesday, Rep. Brian Baird (D-Wash.) told colleagues that any bill should include mental health and dental insurance.

California Rep. Pete Stark, an outspoken liberal who chairs the Health Subcommittee on Ways and Means, would like to see more government funding than party leaders will allow. But he predicted that members will put their individual priorities aside in the hopes of getting a bill through Congress.

“This is not going to be the bill I’d write,” he joked Tuesday.

Plenty of hurdles are sure to arise as the committees draft a bill. But after making numerous concessions in the climate change measure that recently cleared the Energy and Commerce panel, Pelosi seems more reluctant to make fundamental concessions on this bill.

“We have to have something that works, not just that passes the House,” she reminded her members Tuesday, according to the notes of one person present. But she is cognizant of the political concerns.

“She wants to get stuff done but she wants to protect her members, and I think that’s always on her mind,” said a Democratic health care lobbyist. “She does a good job protecting those members. She’s just a damn good inside pol, and she protects her flock.”

The most impassioned appeal for unity Tuesday came from Michigan Rep. John Dingell, the dean of the House deposed by Waxman late last year as chairman of the Energy and Commerce panel.

Dingell has offered a universal health care bill every year since he came to Congress in 1955. Toward the end of Tuesday’s caucus meeting, he rose on his crutches and told the audience that this measure has the promise of becoming a legacy like Social Security — a program his father helped create in the 1930s.

As he closed, he told members they should have the courage to move forward, eliciting a standing ovation from his fellow Democrats. Pelosi announced Tuesday that the bill will bear Dingell’s name.

House Democrats expect to introduce actual legislation next week, Waxman and others said Tuesday. The preliminary goal is to move legislation out of the committees by the Fourth of July and then clear the House by the August recess, setting up a fall showdown with the Senate over a final bill.

Democrats on Sen. Ted Kennedy’s Health, Education, Labor and Pensions Committee Tuesday released a 615-page bill, but details on the most contentious issues, such as the public insurance option and the employer mandate, were left out for now.

Sen. Chris Dodd (D-Conn.) said he didn’t fill in the blanks in those areas because “I wanted my Republican colleagues on the committee to know I wanted to their ideas. I want to hear what they have to say.”

The bill calls for insurance market reforms, a prohibition on insurers’ denying coverage to sick people, a mandate on individuals to own coverage and the creation of marketplaces where people can compare and buy coverage.

Opinions on the bill are decidedly mixed.

R. Bruce Josten, a lobbyist for the U.S. Chamber of Commerce, said, “We are disappointed, clearly.” He participated in weekly meetings with Kennedy’s committee, and the bill that resulted suggests “the only person who has skin in the game is the employers,” Josten said.

On the other side, Andy Stern, president of the Service Employees International Union, issued a statement praising Kennedy and his committee for channeling their “courage and passion into a vision of reform that provides Americans with more choices and more affordable health care options, including one guaranteed by the government that puts the good of the American people ahead of profits.”

Carrie Budoff Brown contributed to this story.