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Who Controls Health Reform?

Paul Krugman's column today has some good analysis of the House Blue Dogs, who have been raising a ruckus over health care reform. I disagree, though, with Krugman's premise: "Right now the fate of health care reform seems to rest in the hands of relatively conservative Democrat." I think the ultimate bottleneck remains the Senate, where Democrats need 100% of their members, many from conservative states, to stop a filibuster. In the House, Democrats only need 50% plus one, which doesn't take you very deep into red America.

Last Friday, I gave my take on the political dynamic:

The Democrats want the House to pass a liberal bill, so that whatever gets passed out of the Senate can get nudged to the left. But the Blue Dogs don't want to have to vote for a more liberal bill than what gets signed into law. So there's a conflict between their interests and the party's interest.

That's what I think's playing out right now. Today's Wall Street Journal reports:

So-called Blue Dog Democrats continued to resist key aspects of their party's health-care overhaul Sunday, despite pressure from party leaders who fear they will endanger President Barack Obama's most ambitious legislative effort.

A leader of the fiscally conservative group of representatives said he expects any vote on the House's health proposal would have to wait, likely until after Labor Day. "I think the American people want to take a closer look at this legislation. They want to feel more comfortable with it," Rep. Jim Cooper, a Blue Dog from Tennessee, said on CBS's "Face the Nation."

This isn't a fundamental clash over ideology. It's a skirmish over the timing of a vote. The Blue Dogs don't want to have to vote for a more liberal bill than what ultimately becomes law. A lot of the fighting we're seeing a a result is probably kabuki theater. The real bounds of reform will beset by the Senate.

--Jonathan Chait