The tortuous congressional wrangling over health care reform has enhanced the public profile and the clout of the band of Democratic House moderates known as Blue Dogs.

The coalition, formed in 1994 in the wake of a Republican takeover of the House — and another attempt at health care overhaul — was formed by Democrats from the South and is still widely thought of as a Southern phenomenon. But five Pennsylvania Democrats, nearly half of the state’s Democratic congressional delegation, are members of the increasingly powerful caucus.

That’s more than any single Southern state’s roster on the 52-member group. That fact sheds light on the state’s potential impact on the signature issue of the Obama administration, and helps explain why Pennsylvania’s reputation and potential as a classic swing state endures despite five straight Democratic successes in capturing its electoral votes.

 

The Blue Dogs name is a play on and conscious contrast to the expression “Yellow Dog Democrat.” According to William Safire’s political dictionary, it referred to Southern Democratic loyalists’ willingness to “vote for a yellow dog if he ran on the Democratic ticket.”

Rahm Emanuel, President Barack Obama’s chief of staff, met on Capitol Hill with some Blue Dog leaders on Thursday but did not overcome their objections to the health bill gestating in the House. On Friday, Rep. Henry Waxman, D-Calif., the chairman of the Energy and Commerce Committee, continued efforts to get the agreement of leading members of the Blue Dogs.

His committee, one of those with jurisdiction over the legislation, is a key leverage point for the moderate group because it has enough members on the panel, combined with the Republican opponents, to block the measure there.

Under House rules, it would be possible to bypass the committee and bring the measure to the floor without a positive vote from Mr. Waxman’s panel. But that would run the risk of further estranging Democratic moderates whose votes may be needed for a majority in the entire House.

Opponents of the House bill and the overall Obama administration effort on the issue have been cheered by the Blue Dogs’ role. Members of the group, however, insist that their goal is not to obstruct the reform effort but to rein in its costs.

While their positions are not monolithic on the issue, the group has been generally resistant to the effort to pay for the bill with new taxes on the wealthy, and its threat of penalties on smaller employers who do not offer health insurance. Other Blue Dogs have cited the fear that reimbursement rates in the plan will be structured in a way that shortchanges the rural areas that many of them represent.

Rep. Mike Ross, D-Ark., one of the group’s key negotiators on the issue, noted in an interview on NPR earlier this month that he had received praise from some of the bill’s opponents, but he predicted that they would end up disappointed in the group’s eventual role.

Mr. Ross insisted that the negotiators are trying to “improve the bill, not watering it down.”

But after another negotiating session with Mr. Waxman on Friday, Mr. Ross told reporters in Washington that they remained at an impasse.

Rep. Jason Altmire, D-McCandless, is one of the Pennsylvania Blue Dogs, and a veteran of health care debates. He sits on the Education and Labor Committee, another panel with jurisdiction over the reform effort. As a congressional aide during the Clinton administration, he also was a member of the task force that helped craft then-first lady Hillary Rodham Clinton’s failed proposal for health care reform. Before running for Congress, Mr. Altmire was a lobbyist for UPMC.

“I come at it from a lot of different perspectives,” Mr. Altmire said. “The role that the Blue Dogs are playing is critical in preventing us from moving forward with bad legislation. The bill that the House leadership put before us is a bad bill.”

He faults the measure for not doing enough to curb costs. He argues that if the legislation were altered to more fundamentally change the economics of the health care delivery system, it could obviate the need to raise taxes to keep it revenue neutral.

Referring to Massachusetts’ closely watched effort to expand coverage, he said, “Massachusetts made exactly the mistake that the House bill right now makes. It added costs to the existing delivery system.”

The Massachusetts plan, enacted under then-Gov. Mitt Romney, has been successful in expanding health care coverage, but critics like Mr. Altmire have faulted it for failing to curb the escalation of health costs.

“I don’t think we need to raise taxes to get this done in a reasonable way,” Mr. Altmire said.

In a statement released by her office, a Blue Dog from an adjoining district, Erie’s Rep. Kathy Dahlkemper, also suggested her support for changes in the current House leadership proposal.

“It’s critically important that we take the right approach to creating a long-term, sustainable health-care system in America,” she said. “Therefore, I am actively working to strengthen the bill to ensure that small businesses are protected, the unique concerns of rural communities are taken into consideration, and the final package is deficit neutral.”

Mr. Altmire and Ms. Dahlkemper are part of successive Democratic waves that transformed Congress and its Pennsylvania delegation over the 2006 and 2008 election cycles. Mr. Altmire won his first re-election comfortably last year; Ms. Dahlkemper managed a narrow victory over longtime Erie Republican Phil English.

Both of their districts produced majorities for Sen. John McCain in the November election, however, despite Mr. Obama’s landslide victories nationally and in Pennsylvania. The Arizona senator, in fact, ran ahead in the districts of four of the state’s five Blue Dogs. He also carried the districts of Reps. Chris Carney, D-Lackawanna, and Tim Holden, D-Schuylkill.

The remaining Pennsylvania Blue Dog is Rep. Patrick Murphy, D-Bucks, whose district was the only one among the coalition members in the state captured by Mr. Obama. Mr. Holden, first elected in 1992, is the only real veteran in the group. Mr. Murphy and Mr. Carney came into office with Mr. Altmire in the Democrats’ 2006 sweep.

The conservative constituencies evidenced by those presidential results helps explain the willingness of some Pennsylvania Democrats to stray from the more liberal leadership of the House on issues such as health care and this summer’s energy bill with its controversial cap-and-trade provision governing greenhouse gas emission.

Four of the state’s Blue Dogs — Ms. Dahlkemper, Mr. Altmire, Mr. Holden and Mr. Carney — were among the 44 Democrats who split from the House leadership in opposing the energy bill.

The presidential results are also a counterweight to the image of Pennsylvania as an increasingly liberal player in national politics. That picture was reinforced by Mr. Obama’s overwhelming victory in the state last November with the largest margin of any presidential candidate since Lyndon Johnson’s 1964 landslide.

Mr. Obama won a majority of those districts, but his impressive margin in the state was grounded in overwhelming showings in a handful of districts. He won 90 percent of the vote in Philadelphia’s 2nd District, 88 percent in the adjoining 1st District, and 70 percent in Allegheny County’s 14th district.

Statewide, he won majorities in 10 congressional districts. Mr. McCain, despite his overall thumping in the state, still carried nine districts. If Pennsylvania apportioned its electoral votes as Nebraska and Maine do, in fact — district by district, rather than winner-take-all — the Republican would have managed a 12-9 electoral vote split in the state.

Five of the Pennsylvania districts in which Mr. McCain pulled the most presidential votes were won by Democratic House candidates. There were 49 similar splits across the country, according to a compilation by Congressional Quarterly. No other state had more than three similarly split districts.

All of which suggests that Pennsylvania’s congressional delegation, and its Blue Dogs, can be counted on to be a wild card in House deliberations and to provide an occasional headache for their leadership vote-counters.