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Also, fiscally-conservative Blue Dog Democrats on the House Energy and Commerce Committee remain at odds with members of their own party. The Blue Dogs are demanding changes to the bill, such as greater cost controls. They continue to negotiate with committee chair Henry Waxman, D-Calif.

Energy and Commerce is one of three House committees with jurisdiction over health reform and the only committee yet to approve the reform bill. There is no word on whether or not Energy and Commerce will continue markup hearings this week – which could lead to a committee vote.

House: Strange turn of events
Health reform momentum also swung back and forth three times in the space of just a few hours late last week. It appeared for a moment that Waxman and the Blue Dogs had reached an accord. But a short time later, the deal collapsed, and Rep. Mike Ross, D-Ark., the Blue Dog health care task force chair, accused Waxman of reneging on deals, including one to establish an independent panel to set Medicare reimbursement rates.

“We are actually trying to save the bill and we are trying to save our party,” Ross told Roll Call. “It is my understanding that will be the last meeting we will have.”

Adding fuel to the fire, Waxman had threatened to bring the bill directly to the House floor, bypassing his own committee. But just hours after Ross made his comments, media outlets reported that Waxman and the Blue Dogs had returned to the negotiating table.

Senate: Finance charts a bipartisan course
The drama in the House unfolded one day after Senate Majority Leader Harry Reid, D-Nev., put the brakes on health reform and confirmed the Senate will not pass a reform bill before its August recess.

The delay creates some breathing room for the Senate Finance Committee and six of its members – three Democrats and three Republicans – that have been meeting to craft the only bipartisan bill to reform health care. (Democrats dictated the direction of bills from the House and the Senate Health, Education, Labor and Pensions – or HELP – Committee.)

Now, details of the Senate Finance Committee’s legislation are starting to emerge, even as the so-called “coalition of the willing” completes its work.

Reportedly, the Finance bill will not include a controversial government-run plan to compete with private health insurers – a primary feature of the other health reform bills and an idea backed by President Barack Obama.

Instead, Finance favors a network of private, nonprofit health care cooperatives. “The co-op is certainly one of the prominent options that is on the table,” Sen. Olympia Snowe, R-Maine, told the Associated Press. “It’s safe to say that’ll probably remain in the final document.”

The co-op idea originated with Sen. Kent Conrad, D-N.D., who was asked on ABC’s “This Week” whether Senate Democrats could pass reform without Republican support. “It is not possible, and perhaps not desirable either,” said Conrad.

The committee also appears ready to abandon a requirement that employers offer health insurance to their workers or face penalties. Companies would instead have to pay the cost of any government subsidies available to their employees, as a deterrent against businesses dropping coverage and shifting workers onto federal aid.

But despite agreement on some issues, Senators caution that others remain unresolved, including funding for the measure. Where the House would impose a surtax on high-income individuals, Finance is leaning toward an excise tax on insurance plans with high annual premiums.

Finance Chairman Max Baucus, D-Mont., has also had to referee differences between fellow Democrats, as some push for swift action, while others prefer a more conservative approach. Nine freshman Democratic Senators backed Baucus last week in a letter that stressed “any final bill must include innovation, hard decisions, and incentives to bend the cost curve.”

It’s unclear whether Finance can complete, mark up and approve its bill before the Senate’s recess begins on August 8. Senators could use the down time to merge the Finance bill with the measure already passed by the Health, Education, Labor and Pensions Committee. Reid will work with other Democratic leaders to decide what to include from each proposal before a final bill goes to the Senate floor – presumably in September.

Obama: Keep working
President Barack Obama remained dogged in pushing his reform message, even as the Blue Dogs pushed back.

For four straight days last week, health reform’s salesman-in-chief made his case in public appearances – from a roundtable discussion at the Children’s National Medical Center, to a town hall meeting in Cleveland, to – most importantly – a prime-time White House news conference.

Most of the Wednesday news conference was devoted to health reform – or, as Obama called it several times – health insurance reform. Read his opening statement here.

The big news? There really was none. He restated his principles: that the status quo is a crisis for the economy and for American families, that he doesn’t want the middle class to shoulder the cost of reforms, that a public plan option would keep insurance companies honest, and that the delivery system needs to be altered so patient care is evidence-based. And he referred to “unwarranted subsidies to insurance companies that do nothing to improve the health of our seniors.”

But there were no real surprises; there was no announcement, for example, about a specific mechanism for paying for reforms. The President continues to sound more flexible regarding the timetable, talking about passing reforms “this year” instead of by mid-October.

And no doubt because of criticisms from the Congressional Budget Office, the fiscally conservative Blue Dog Democrats and the Mayo Clinic – and because he has said from the start that he wants to slow health care inflation – Obama emphasized his intention to create “an independent group empowered to eliminate waste and inefficiencies on an annual basis”; “a panel of doctors and health care experts advising how we can get more value for Medicare,” as he later put it – a way of “getting politics out of decision-making.”

An Independent Medicare Advisory Council (IMAC) would be an independent body of health care experts that would have the authority to insert cost controls into Medicare. The President and Congress would have the power to say no to the group’s package of recommendations. Although the proposal to empower an independent body pleased the Blue Dogs, it has caused some concerns in the provider community, since, in theory at least, the independent council would be removed from the give and take of politics.

The Wall Street Journal noted that Obama “is significantly raising his personal stake in the effort to overhaul America’s health care system, as Democrats and the public express growing unease about the costs” (a USA Today/Gallup poll says 50 percent of Americans now disapprove of his health reform policies; 44 percent approve).

During his visit to Cleveland, Obama reacted to the Senate’s delay by saying “That’s okay. I just want people to keep on working. Just keep working.” He visited Cleveland to spotlight the high-quality, cost-efficient care delivered by the Cleveland Clinic.

And on Tuesday, the president sought to reassure seniors that they would gain, not lose with health reform. In a “tele-town hall” meeting organized by AARP, a group that represents retirees, Obama addressed questions on everything from prescription drugs to end-of-life care. “Nobody is trying to change what works in the system,” said Obama. “We are trying to change what doesn’t work in the system.”