Updated

Rep. Mike Ross (D-AR) says that President Obama and skeptical, conservative Democrats in the House have reached what he called a “small breakthrough” on one of ten contentious issues that threatens to torpedo a major health care reform bill.

Ross says Mr. Obama and seven members of the fiscally-conscious “Blue Dog” Coalition agreed in principle to create what he called an “Independent Medicare Advisory Council. The Arkansas Democrat believes the council  could help defray health costs and achieve better equity in the legislation.

“It’s a big one,” said Ross.

Ross says the council would be comprised of public and private citizens. But he conceded that it would take “a number of amendments” to retrench the health care bill now stalled in the House.

The idea could meet a cool reception in the Senate where key Republican senators would prefer Congressional oversight of Medicare spending.

Ross pointed to former Sen. Ted Stevens (R-AK) as what he called the “poster-child” for helping adjust Medicare payments to rural areas. Ross says Stevens secured a 35 percent Medicare increase for Alaska just before he left the Senate early this year.

Blue Dog Democrats have blocked the House Democratic leadership from securing enough votes to approve the bill. Concerns about the legislation’s cost, proposed tax increases and the speed that Congress was moving the health care package have forced the president and Democratic leaders to court their votes.

Some moderate Democrats are still smarting from their vote last month on a controversial climate and energy bill. Republicans are trying to target vulnerable lawmakers who voted for what House Speaker Nancy Pelosi (D-CA) describes as her “flagship issue.”

Rep. Jason Altmire (D-PA) is one Blue Dog who didn’t support the climate legislation. He says the vote on the so-called “cap and trade” bill could impact potential support for health care reform.

“If you’re a member who voted for cap and trade and had a bad experience back home, you’re probably not looking forward to a bad vote on a health care bill that’s not going to go anywhere in the Senate,” Altmire said.

House leaders planned to vote on the health legislation next week just before the August Congressional recess. But House Majority Whip Jim Clyburn (D-SC), the man charged with finding the votes for the measure, appeared open to taking the bill off a fast track.

“If we can do it next week without consensus or wait a week and do it with consensus, I’d rather wait a week,” Clyburn said.

Ross said he was pleased that House leaders were listening.

“We don’t need to box ourselves in with an artificial deadline,” he said.