The political process of moving health reform legislation hit a major roadblock last week and has come close to grinding to a halt. Blue Dog Democrats and other moderate members in the House spent most of the week publicly squabbling with the House leadership and Energy & Commerce Committee Chairman Henry Waxman, D-Calif., over the process, contents and cost of the health care reform legislation (H.R. 3200). The House Energy & Commerce Committee – the last of the three Committees with health care jurisdiction to consider the legislation – has suspended its debate because it lacks sufficient support to vote the bill out of the Committee. Chairman Waxman has agreed to keep negotiating with Democratic Committee members.

Blue Dog and moderate Democrats have numerous concerns about the bill, including geographic disparities in Medicare payment rates; the significant tax increases proposed ($800 billion over 10 years); the proposed public insurance option; the employer mandate; and the long-term costs of the legislation. House speaker Nancy Pelosi instructed staff to work through the weekend to try to address these concerns.

It is unclear whether House leaders will be able to bring a bill to the floor before their month-long recess which begins August 1. However, Pelosi insists she has the votes to pass a bill and may try to bypass the Energy & Commerce Committee and move a bill without the Committee taking a vote. Democratic opponents of the bill said Pelosi's vote count was somewhere between wildly optimistic and dead wrong. Regardless, the bill could become a major test of Pelosi's leadership, and unless she gets it moving soon, Republicans will claim victory throughout August and into September.