Wary Centrists Posing Challenge in Health Care Vote

Representative Dennis Cardoza, Democrat of California, typifies the speaker’s challenge. The husband of a family practice doctor, he is intimately familiar with the failings of the American health care system. His wife “comes home every night,” he said, “angry and frustrated at insurance companies denying people coverage they have paid for.”

But as a member of the centrist Blue Dog Coalition, Mr. Cardoza is not convinced that Mr. Obama’s bill offers the right prescription. It lacks anti-abortion language he favors, and he does not think it goes far enough in cutting costs. So while he voted for the House version — “with serious reservations,” he said — he is now on the fence.

“I think we can do better,” Mr. Cardoza said of the president’s proposal.

Representative Frank Kratovil Jr., Democrat of Maryland, is also unconvinced. He voted against the House bill on the grounds that it is too big and too costly — a view that some constituents in his Republican-leaning district share. In case he did not get the message, one of them hanged him in effigy this past summer outside his district office on the Eastern Shore of Maryland.

“This system is broken; we have to do something,” Mr. Kratovil said. “But my preference would be to do smaller things.”

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