This weekend's vote presents a defining moment for Blue Dog Democrats

Blue Dog Democrats face a dilemma this weekend: Should they oppose legislation they believe is flawed, or move the bill out of the House in the hopes of it changing in conference?

That core question was on the minds of many of the 52 fiscally conservative Democrats after a meeting Tuesday with Douglas Elmendorf, the director of the Congressional Budget Office (CBO), to get an in-person explanation of the differences between the House and Senate healthcare bills.

The number of Blue Dogs leaning toward or committed to “no” votes could be in the 30s, according to members, although Blue Dog leaders stress that they’ve done no whip count. But perhaps just as many have strong preferences for the healthcare bill approved by the Senate Finance Committee.

Many Blue Dogs acknowledge Tuesday’s well-attended meeting with Elmendorf may not have changed many minds one way or another.

“I think these discussions are in the context of people trying to get to ‘yes’ or trying to support their ‘no,’ ” explained Rep. Earl Pomeroy (D-N.D.), who is a committed “yes.”

What many Blue Dogs in attendance took away from the meeting was a reaffirmation that the House bill fails to rein in federal healthcare spending over the long run, while the Senate bill manages to do so.

“He reiterated … that the House bill has a net contribution and increases federal healthcare spending over the second decade, and the Finance Committee has a net decrease in federal commitment to healthcare spending in the second decade,” said Blue Dog Co-Chairman Jim Matheson (D-Utah).

The vote is set to take place Saturday, and House leaders have indicated they do not intend to alter the bill beyond potential changes to language pertaining to abortion and illegal aliens. That has Rep. Dennis Cardoza (D-Calif.) leaning toward a “no” vote.

“We don’t have to have every concern alleviated, but there has to be some movement now,” Cardoza said. “I’m not waiting for a conference report to fix my concerns.

“If the construct is something you just have serious, serious reservations with, and there’s an unwillingness to work on those issues now, then it’s very likely that those issues will not be incorporated into the conference report,” he said.

Many Blue Dogs are expected to face the grimmest reelection prospects of any Democrats, and the upcoming healthcare vote is giving some significant pause.

But the prospect of a final health reform bill that accomplishes what the Senate Finance bill proposes — most notably, creating a new panel to study Medicare rates and raising revenue by taxing high-cost health plans and not income — has given many of them reason to believe what becomes law will meet their requirements of “containing the skyrocketing costs of healthcare.”

Even if they’re not whipping, Blue Dog leaders are making an effort to ensure that each of their members understands what’s at stake. If they vote for the House bill, it could emerge intact after negotiations with Senate conferees.

After hearing Elmendorf’s explanation on how the House and Senate bills affect federal health spending and deficit projections, Rep. Loretta Sanchez (D-Calif.) said she went from leaning yes to undecided.

Freshman Democratic Rep. Frank Kratovil (Md.), one of the newest Blue Dogs, said Elmendorf’s briefing is weighing on his decision.

“My biggest concern, again, is in terms of the cost,” Kratovil said. “And I think ultimately we’re still looking at big problems in terms of the impact on the deficit … I do think that in terms of controlling costs, the Senate side has been better.”

Pomeroy is among the Blue Dogs who are committed to voting for a bill, despite believing it is flawed, because he hopes his concerns will be addressed during conference.

“The Senate bill does a better job, in my view, of getting at the issue of runaway medical costs,” he said. “I think that will be an area in which we hope that the House product would be subject to continued improvements as we go forward.”

But there are others who aren’t as confident, especially given Speaker Nancy Pelosi’s (D-Calif.) stated determination to fight in conference for the policies crafted in the lower chamber.

“We have no assurances about anything at this point, White House or otherwise,” said Cardoza.

House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.), a key Pelosi ally and a possible conference negotiator, on Wednesday said House leaders still believe their bill is superior to the Senate’s.

“We’re not in the position to say to them take it or leave it, nor are they in the position to tell us take it or leave it. Everything will be up for discussion,” Waxman said. “But we’ll fight for the House position because we think it’s a better one.”

Voting for what they believe is a flawed bill just to advance the process is “clearly the case that leadership’s making” to skeptical Democrats, Blue Dog Co-Chairwoman Stephanie Herseth Sandlin (D-S.D.) said. “That’s the same case they were making on the climate bill.”