Will the Blue Dogs hunt for president?

Opinion: March 17, 2010 at 12:00a.m.

The most important member of Congress this month may be a man many have never heard of: Jason Altmire, a painfully earnest former hospital executive from near Pittsburgh.

Why? Because as Jason Altmire goes, so goes the nation — at least when it comes to the Democrats’ quest for health-care reform.

Altmire, 41, is a centrist “Blue Dog” Democrat — a fiscal conservative who opposes big spending and higher taxes. His Republican-leaning district voted for John McCain in 2008 even as it returned Altmire Congress for a second term.

In November, Altmire was one of 39 Democrats who voted against his party’s health-care bill in the House. The bill squeaked through without his vote, 220 to 215.

But now the House is being asked to pass the Senate’s health-care bill, which is a bit more conservative than the House bill. And this time, unlike last year, President Obama and House Speaker Nancy Pelosi need Altmire.

Some of the Democrats who voted for health care last year, spooked by growing opposition, are likely to vote no this time. So to win, Obama and Pelosi need to move some of last year’s no votes into the yes column, and Altmire is a prime target.

Tough decision

Altmire says he is torn. He wants Congress to pass a health-care bill, mostly to give the government ways to help control the cost of medical care. But most of his constituents are skeptical that an Obama health-care bill will be fiscally responsible. A Republican polling firm reported last week that voters in Altmire’s district oppose the Senate bill 58 percent to 30 percent. The Republicans have identified him as a vulnerable Democrat who could be defeated this year, and a vote for healthcare reform could make him an even bigger target.

“If I vote yes, I know that would attract (unwanted) attention from across the country,” he told me last week. “But health care is important to me. In the end, it’s a choice between doing nothing and passing a bill that I have problems with.”

At this point, the Senate bill isn’t good enough to vote yes on, Altmire said. “About half of it I like; about half of it I don’t.” But if House-Senate negotiations produce fixes, including stronger cost controls, he could be persuaded.

Even then, he’s not sure Obama and Pelosi can succeed. And that’s an important factor: an endangered congressman doesn’t want to risk his job for a bill that’s going to lose.

Altmire, an expert on health care thanks to his earlier job as a hospital executive, is carrying on a conversation with his constituents through town meetings and television appearances.

Last week, he met with 46 “tea party” activists from his district who boarded a chartered bus at 5:30 a.m. for a chance to confront him in a House committee room.

Losing battle

Altmire gamely tried to convince his visitors that the Senate bill was better than the House bill. “You said don’t do the ’public option,”’ he said. “You said don’t do an income tax increase. Your voice was heard. You won. Those things are not in the bill.”

But the tea party folks weren’t impressed. “If you have 12 bad apples in a basket and you take three out, you still have nine bad ones,” Charles W. Robinson, an attorney from Middlesex Township, retorted.

Altmire insisted that he “will not vote for a bill that adds one penny to the federal deficit.”

But the conversation ran aground when he asked a fundamental question: Shouldn’t the government help low-income people afford basic health insurance?

“No!” most of the visitors shouted.

The tea party group, he knew, didn’t fully reflect his district; many of them hadn’t voted for him before and weren’t likely to now. But he also knew that the Obama healthcare plan is a tough sell when his constituents are more worried about federal spending and the economy than they are about health coverage for the nation’s uninsured.

Despite the polls, he said he thinks his district is “evenly divided” on the healthcare issue, although “there’s more passion on the opposition side.”

Doyle McManus is a columnist for The Los Angeles Times. Distributed by McClatchy-Tribune Information Services.