WASHINGTON (CNN) - House Speaker Nancy Pelosi signed off Thursday on a key component of a health care deal reached with conservative Democrats earlier in the week, potentially paving the way for a new consensus among the fractured House majority.
The deal between four fiscally conservative congressmen - part of the so-called "Blue Dog" coalition - and the chamber's Democratic leadership allowed debate to resume Wednesday in the critical House Energy and Commerce Committee.
A full House vote on the health care plan has been delayed until after the August congressional recess in part because the committee's fiscal conservatives had threatened to defeat the bill if several of their concerns were not addressed.
The Energy and Commerce Committee is the last of three committees required to clear the bill before it can be considered by the full House.
Pelosi told Capitol Hill reporters that she is "okay" with language instructing the Health and Human Services secretary to negotiate reimbursement rates for doctors and hospitals under a government-run health care option.
The idea is a key concession to conservatives worried that a public plan would have an unfair advantage over private insurers if it is allowed to tie its hospital and doctor payments to lower Medicare rates.
Conservative opponents of the public option have maintained that a not-for-profit plan would have a competitive advantage over private insurers and eventually would wipe them out.
The provision is "not my preference" but "it meets the test of having an effective public option," Pelosi said.
"I am for the strongest possible public option" to keep private sector "honest" and reach the goal of universal coverage, she added.
Pelosi noted that the provision had also been adopted by the Senate Health, Education, Labor, and Pensions Committee chaired by Massachusetts Sen. Ted Kennedy - a longtime liberal advocate for health care reform.
"I have a comfort level with (Kennedy's) language," Pelosi said. It proves there is "common ground" between the Democrats' conservative and liberal wings.
The agreement with the Blue Dogs, which is projected to lower the cost of the House plan by $100 billion over a decade, would also exempt businesses with payrolls below $500,000 from having to provide health coverage to their workers.
In addition, the agreement calls for the creation of state-run health insurance cooperatives to compete with a public health insurance option and private insurers.
It is not clear if any 52 House Blue Dogs beyond the four who made the agreement will sign on. It also remains unclear if House liberals will agree to the changes.
In a statement issued by the White House on Wednesday, Obama thanked members of the House and Senate, including "some Blue Dogs on the Energy and Commerce Committee," for "working so hard" to reach an agreement.
The Blue Dogs had initially threatened to derail the House bill because of concerns that it cost too much and fails to address systemic problems in the nation's ailing health care industry.
While momentum for reform may have accelerated in the House, prospects have grown more cloudy in the Senate. On Wednesday, two key Senate Republicans negotiating a bipartisan agreement said they now consider a deal out of reach before the Senate goes on its August recess.
The so-called "Gang of Six" negotiators - three Democrats and three Republicans - have been working to reach a compromise in the Senate Finance Committee.