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LINDA WERTHEIMER, host:

It's MORNING EDITION from NPR News. I'm Linda Wertheimer, in for Renee Montagne.

STEVE INSKEEP, host:

And I'm Steve Inskeep. Good morning.

We're going to report this morning on an irony in the debate over health care. President Obama faces fierce opposition from Republicans and from conservative Democrats. Many of those same lawmakers represent Southern or Western states, and it turns out those states have unusually high concentrations of people without health insurance. This morning, we'll look at the role of the conservative Democrats known as Blue Dogs.

NPR's Peter Overby is part of our Dollar Politics team.

PETER OVERBY: Mike Ross is the lead health care negotiator for the 52 Blue Dog Democrats. His district covers Southern Arkansas and among its people younger than 65, more than one out of five doesn't have health insurance. That's 30 percent higher than the national average. The health care bills would help the uninsured in several ways. One possibility is a public option; that is, a government run insurance plan that would compete with private insurers. It would give the uninsured a low priced alternative and it would shake up the near monopoly that insurance companies have in places like rural Arkansas. But in June, Ross and the Blue Dog Coalition held up the House bill for two weeks, and they insisted on promoting co-ops instead of a public option.

At a town hall meeting last month, Ross spoke passionately about the need for health care reform.

Representative MIKE ROSS (Democrat, Arkansas): I was negotiating 10 hours a day with everybody from the president to the speaker to the majority leader to the chairman of the committee. I wasn't negotiating to kill the bill. I was negotiating to give us the kind of common sense health care reform that we need and that reflects Arkansas values.

OVERBY: This meeting was a chance for Ross's constituents to be heard. It ran well over two hours, but there was mostly the familiar bickering over illegal immigrants and the role of government. Only three people without insurance asked questions. That bothered Kevin Motl, who was there. He is a history professor at Ouachita Baptist University.

Professor KEVIN MOTL (Ouachita Baptist University): Many of those individuals who would need a public health care option are those who are not likely to be able to take two hours out of their day to go to a public event like that town hall. They were too busy earning hourly wages, trying to keep roofs above their children's heads. Those voices are not going to be present in that discourse.

OVERBY: In fact, political scientists say low income people, the people most likely to be uninsured, are less likely to be at a town meeting, less likely to vote, and they're less likely to make campaign contributions. Unlike corporations and professional groups, so far this year the Blue Dog political action committee has received $300,000 from PACs in health care and health insurance. And another 100,000 has gone from those same sectors to Mike Ross.

He got together with donors from the health care industry in June, right around the same time the Blue Dogs were challenging the House bill. The fundraiser brought in at least $20,000 from health care PACs. Ross's office didn't respond to NPR's repeated requests to interview him over the past two weeks. But another Blue Dog, Jim Cooper of Tennessee, says the group believes the uninsured will benefit because other provisions would change the insurance system.

Representative JIM COPPER (Democrat, Tennessee): The chief impetus of this whole effort is to help the uninsured. It's unquestionably true in politics that powerful interests have probably a disproportionate voice, but we're doing double back flips to help the uninsured.

OVERBY: And many insurance donors don't want the bill to die. Analyst Ethan Siegel is with the Washington Exchange, a firm that monitors Capitol Hill for institutional investors.

Mr. ETHAN HILL (Analyst, Washington Exchange): I think the influence is there. But it isn't necessarily on all parts to kill the bill. It's to make the bill more livable for the private sector.

OVERBY: At least those private sector elements that lobby and make campaign contributions. National Republicans have targeted many of the Blue Dogs for defeat. But many of them may not be all that vulnerable. Fifteen of the 52 Blue Dogs haven't had a tough race since at least 2002. That includes Mike Ross. Julian Zelizer is a historian at Princeton University.

Professor JULIAN ZELIZER (Princeton University): Ideally, some people think incumbency should allow members of Congress to act more like independent leaders. But it doesn't actually work that way very often.

OVERBY: Instead, he says, most entrenched incumbents listen carefully to the most likely voters back home and to the most reliable contributors in D.C.

Peter Overby, NPR News, Washington.

INSKEEP: We're glad you're with us this morning on this public radio station and when you are checking news throughout the day at npr.org you can see which states and districts have the highest percentage of uninsured residents.

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