WASHINGTON — After months of marching in line as senior Democrats worked with the White House to develop healthcare legislation, liberal lawmakers from solidly Democratic districts are threatening a revolt that could doom President Obama's bid to sign a major bill this year.
In the House, liberals are furious at their leaders for striking a deal with conservative Democrats that would weaken the proposal to create a government insurance program, a dream long cherished on the left.
On Thursday, 57 of these liberals sent a letter to Speaker Nancy Pelosi (D-San Francisco) warning that they would vote against any bill that contained the terms of the deal.
"We have compromised and we can compromise no more," an angry Rep. Lynn Woolsey (D-Petaluma) said at a raucous news conference outside the Capitol.
Meanwhile in the Senate, a growing number of Democrats and Republicans were taking aim at an effort led by finance committee Chairman Max Baucus (D-Mont.) to develop centrist healthcare legislation that could attract GOP support -- in part by eliminating a government plan entirely.
The rising tide of liberal anger sent the White House scrambling, with Obama calling at least one left-leaning lawmaker to offer reassurance before Congress leaves town for its August break.
On Thursday, Pelosi and other House Democratic leaders also met privately with a group of labor leaders, consumer advocates and AARP to enlist their support.
Ever since the Democrats won congressional majorities in 2006, party leaders have struggled to balance the demands of their liberal and more conservative members.
And although the leadership has more than a month to rally enough votes to pass healthcare bills when Congress returns in September, the latest unrest is raising a menacing specter for the president and his allies. Some worry about a possible repeat of the healthcare debacles in the early 1970s and '90s, when divisions within the party helped doom bids to create universal coverage.
"Historically, the good has become the enemy of the perfect," warned Ron Pollack, a veteran of past healthcare battles who heads the consumer group Families USA. "I'm afraid we have seen that repeated a little bit in the past several days."
Scores of liberal Democrats favor a single-payer system similar to those in Canada and Britain, where the government controls the delivery of healthcare. (Eighty-six House Democrats are cosponsoring a bill to create a single-payer system in the U.S.)
But most, eager to break the decades-long logjam blocking a healthcare overhaul, decided that they would have to compromise this year.
During the presidential campaign and after taking office, Obama voiced his support for liberal healthcare principles. And many lawmakers put their faith in liberal leaders such as Pelosi and Reps. Henry A. Waxman (D-Beverly Hills), Charles B. Rangel (D-N.Y.) and George Miller (D-Martinez), the three committee chairmen who wrote the bill being debated in the House.
That measure -- and a similar one developed by Sen. Edward M. Kennedy (D-Mass.) and his staff -- includes a provision creating a government-run insurance plan as an alternative to private coverage.
"What the American people want, very clearly, is a Medicare-type public option in 50 states in this country which will give them the choice against private insurance companies," said Sen. Bernie Sanders, an independent from Vermont who caucuses with the Democrats. Polls have shown consistently that a large majority of Americans favor such a plan.
But senior House and Senate Democrats are contending with a growing cadre of party centrists, many of whom are uneasy about expanding government's role in healthcare.
"It's the moderates that give [Democrats] their majority," said Will Marshall, president of the centrist Progressive Policy Institute. "The bigger the Democratic majority grows, the more moderate it becomes. Democrats are a center-left coalition, so big legislative initiatives need to be shaped accordingly."
House leaders bowed to that idea this week. Facing the prospect that a group of conservative Democrats in the 52-member Blue Dog Coalition might block a healthcare bill from moving through the energy and commerce committee, they modified the bill.
The backlash was swift and severe.
"We're at a point where there's no retreat, and we can and must hold the line," said Rep. Raul M. Grijalva (D-Ariz.), co-chairman of the liberal Congressional Progressive Caucus.
In a letter, liberal lawmakers attacked the deal.
"We regard the agreement reached by Chairman Waxman and several Blue Dog members of the committee as fundamentally unacceptable," they wrote. "This agreement is not a step forward toward a good healthcare bill, but a large step backwards."