Counting Health Noses

As Democratic leaders met with President Obama at the White House, their vote counters were still trying to figure out on Thursday how many members were in the "yes" column when it comes to health care reform.

And there were conflicting signals for those watching the hallways of the Capitol as well.

Democrats in the House have been doing all they can in recent days to foster a sense of inevitability about health care reform - that it is going to be approved by the Congress.

"We will have a bill that will go to the floor, and it will have a public option in it," said Speaker Nancy Pelosi at a news conference.

"And there is support in our Caucus to do that; I have said that over and over again and I stand by it.  The question is, what form does that (public option) take? "

Presumably, the issue came up while the Speaker had lunch with President Obama on Thursday.  Later that day, Senate Democratic Leader Harry Reid had his own sit down with Mr. Obama as well.

"I think the President is still confident that we can go home for the holidays with a health reform bill that bears his signature," said White House Press Secretary Robert Gibbs.

Meanwhile, Democratic moderates were beginning to make more noise about issues of concern to them.

For the most part, the public insurance option has been getting all the press, but Blue Dog Democrats say this fight is about much more than just that.

"Members votes are going to be determined by the bill as a whole, not by just one issue," said Rep. Jason Altmire (D-PA).

Altmire is a former hospital executive from the Pittsburg, PA area, who is in his second term.  He keeps making noise in the press about problems with the bill, but says Democratic leaders have been over-focused on the public option.

Altmire described to me being asked by Democratic Whips how he would vote on a public option.  His reponse was that he could vote for it under the right circumstances.

So they put him down as a likely "Yes" vote, which had Altmire saying, "wait a minute", going into more detail as to why he was still a "No" vote.

Meanwhile, a group of Blue Dogs led by Rep. John Barrow (D-GA) sent Pelosi a letter that reinforced the notion of cost containment and holding down budget deficits, making very clear this is not just about a public option.

More liberal blogs last night were enthusiastic about talk that Senate Democrats may go ahead and put a public option in a bill destined for floor debate.

That would be a gamble by Sen. Majority Leader Harry Reid.

But sooner or later, Democrats will have to put their cards on the table, and actually put a bill on the floor.

November is right around the corner.

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