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Iowans Closely Watching Sen. Grassley on Health-Care Reform

Grassley drew strong rebukes from Democrats after he seemed to suggest at one town hall that conservatives were justified in worrying that a provision in the House version of the legislation that pays for end-of-life consultations would lead to the federal government playing a role in deciding when to "pull the plug on Grandma." Grassley says he opposes that counseling as written in the House version of the bill, but a spokesman said the senator does not think the House provision would in fact give the government such authority in deciding when and how people die. The House bill allows patients to decide for themselves if they would like such counseling.

Yet even as Grassley hints he may not agree to a compromise with Democrats, he also makes nods in the other direction. Grassley aides noted he had already spoken twice in the recess with Sen. Max Baucus (D-Mont.), chairman of the Finance Committee, who is working closely with him. In front of crowds, Grassley referred to the work of "our committee" and even listed provisions he backed: efforts to increase pay of rural doctors under Medicare and banning insurance companies from using preexisting medical conditions to deny people coverage.

As he travels the state, Grassley constantly notes his opposition to any funding of abortions in the bill, another major Republican fear. He lists his conservative stances on a number of issues this year: He has been a reliable party-line vote in opposing some of Obama's major legislative efforts, such as the economic stimulus bill and the successful nomination of Judge Sonia Sotomayor to the Supreme Court.

"I believe in the Republican Party, I am a Republican, I will always be a Republican; Republican principles are very important to me," Grassley said during one stop.

Even as he confers with Obama, Grassley also aggressively tries to distance himself from the president, who is increasingly unpopular among GOP activists. Grassley suggested Obama and Democratic leaders might leave him "pushed from the table" in the negotiations by pushing a partisan bill, although the president and his team have urged the Gang of Six to keep meeting.

And outside of his town halls, the senator is trying to make peace with his strongest conservative opponents. Grassley met this week with activists from the "tea party" movement in the state, assuring them he would not back a health reform bill that funds abortions or includes a government insurance program. The activists said they had already selected a conservative to run against him in a primary next year if he votes for a health-care bill they don't like.

"He's a very nice man. I really hope he listened," said Ryan Rhodes, the state leader of the Iowa Tea Party, who declined to name the person who would challenge Grassley. "But we will be making sure that we hold him accountable."

A Des Moines Register in April poll showed about two-thirds of Iowans approved of the job Grassley is doing. But that came before his heightened role in the health-care debate.

In an increasingly Democratic state, many Iowans would likely approve of Grassley reaching a compromise with Democrats. But as his base largely opposes reform, Grassley seems content not to declare his final position on health care.

"I've got 16 more town meetings" this month," he said, when asked by reporters what he had learned that he would tell colleagues in Washington after a series of meetings featured Republicans repeatedly making the same critiques of the health-care effort. "So I don't want to draw a conclusion from four."

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