California Democrats Cardoza, Costa uncertain on health care bill

WASHINGTON — San Joaquin Valley Democrats will feel the heat whichever way they vote on the massive health care package now set for House action as early as Saturday.

Unlike Valley Republicans, who aligned themselves early against the ambitious overhaul, Democratic Reps. Dennis Cardoza of Merced and Jim Costa of Fresno are holding their cards close to their chest. Both Democrats are already GOP targets, at least rhetorically, and both said Friday they were still evaluating the nearly 2,000-page bill.

"They could pay a price if the vote is framed as a pro-abortion bill, or an immigrant-rights bill ... or a big government-run operation," said Marc Sandalow, who runs the University of California at Merced's D.C. program. "At the same time, it's a huge risk to be seen as voting against reform."

Cardoza and Costa are among several dozen House members who remained publicly uncommitted Friday, though offering hints of support. With no Republican planning to vote for the bill, House Speaker Nancy Pelosi can lose no more than 40 Democrats and still secure the 218 votes needed for passage.

One bloc of Democratic defections will come from the Blue Dogs, a moderate-to-conservative coalition whose members include both Cardoza and Costa. Many coalition members represent districts carried by Republican presidential candidate John McCain last year.

Cardoza and Costa, by contrast, represent districts where Democrats enjoy a sizable voter registration advantage, and Democrat Barack Obama carried both districts in 2008. Cardoza and Costa voted with a majority of House Democrats well over 90 percent of the time last year.

"I would like to vote for the bill, if they get it right," Costa said late Friday afternoon, adding that it would be "a vote to keep the process going."

Costa explained that his vote could be contingent upon securing federal support for a proposed U.C. Merced medical school, help for hospitals that treat lots of low-income patients and sufficient health coverage for seasonal agricultural workers. Costa said he also is pressing the Obama administration for more help with California water projects.

"I'm waiting for answers," Costa said.

Cardoza, too, stressed Friday that "we're working on a number of issues that are important to the Valley." He said this includes "the crisis" in doctor training, as well as agricultural worker coverage and support for unrelated water projects, as well big-picture priorities like cutting costs.

"We've made some improvements," Cardoza said, "but we're going to have to see some important movement here."

Still, whether out of mischief-making or a real sense of political potential, Republican operatives are poised to strike at both.

"It would be political suicide for either of them to vote for it," said Rep. Devin Nunes, R-Visalia, who called the measure "an atrocity" that would accelerate a bankruptcy in federal medical programs.

The GOP story line is already clear.

A week ago, the National Republican Congressional Committee e-mailed press releases declaring that "Costa caves in to Nancy Pelosi" and "Lap Dog Cardoza caves in to Nancy Pelosi."

The GOP rhetoric, in turn, is tailored to fit the rural Democrats' congressional districts.

Forty-five percent of Central Valley residents disapprove of Pelosi's job performance, a September survey by the Public Policy Institute of California found. This was Pelosi's highest disapproval rating for any California region. Forty-five percent of Valley residents surveyed said they approved of Pelosi, her lowest approval rating for any region. Ten percent were undecided.

The flip side, too, is expressing itself. In recent days, organizations called Health Access California and Health Care for America — Now! have been soliciting contributions for advertisements designed to "keep the pressure on Reps. Costa and Cardoza."

Health Care for America — Now! describes itself as a "national grassroots campaign," backed by groups including the AFL-CIO, the American Nurses Association and the Service Employees International Union, among others.

The other Democratic member of Congress whose district shares portions of San Joaquin County, Rep. Jerry McNerney, D-Pleasanton, could not be reached Friday, but his Web site stresses the importance of "improving our health care system with fiscally responsible reform."