Blue Dog Democrats in the House and moderate red-state Senators thought they had won some moderation in the ObamaCare bill over the last few weeks, especially after Democrats got a very loud earful from their constituents during the August recess.  Today, however, Nancy Pelosi tossed the moderates aside in her press conference.  She insisted that the House would produce a bill that includes a public option without a trigger, and with a wealth surtax to pay for it:

House Speaker Nancy Pelosi on Thursday shot down a healthcare compromise that has been viewed as the best chance for getting a bipartisan bill through the Senate.

Pelosi (D-Calif.) rejected the idea of a “trigger” for a public option. That means that the government-run health care plan would be a fallback option, enacted only if other reforms didn’t make healthcare more accessible. …

“I don’t even want to talk about a trigger,” Pelosi said at her weekly press conference. She said the “attitude” of her fellow Democrats is that “a trigger is an excuse for not doing anything.”

Not only did she refuse to consider the trigger, she also will insist on Medicare rates for the public option plan.  That has hit serious opposition, as providers have begun avoiding Medicare patients because of  the low compensation rates and red-tape issues in the system.  Blue Dogs had previously thought they had a deal to offer better compensation rates, at least for a few years, as a pot-sweetener to get providers on board.

This vastly complicates the ability of Congress to pass a bill.  Clearly, a public option and a wealth surtax will not make it through the Senate.  In fact, Pelosi’s hard-line attitude will make it even more difficult for Max Baucus to attempt to woo red-state Democrats, let alone Republicans, into a compromise.  Even before it gets to the Senate, though, this bill has a good chance of failing in the House with Pelosi’s demands.  Democrats may talk big about astroturfing, but the Blue Dogs know well that the reaction in the districts was genuine — and will mean a shortened career for those who support Pelosi’s idea of health-care reform.

Basically, in drawing this line in the sand, Pelosi has said “happy trails” to moderates.  She wants to push through a radical agenda, and she thinks that her progressive caucus will be enough to make it happen.  Pelosi may find out that she just marginalized herself as a party leader — and if she doesn’t realize that soon, she may wind up marginalizing her entire caucus in the midterm elections.