Republicans have been beating the drum over the last several days about reports that moderate Democratic Representatives such as Rep. Stephanie Herseth Sandlin who voted against the House version of health care reform last year might vote in favor of the compromise bill.

If this happens, would it be a surprise? Sure, a small one. But not a big one.

The reason it would be surprising is because Herseth Sandlin is facing a strong reelection challenge in a state where health care reform is quite unpopular. On a matter of politics, voting against it would seem to be the politically safe thing to do.

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But that's about as far as my surprise goes. First, of course, voting against health care reform hasn't bought Herseth Sandlin much respite from nonstop criticism from Republicans. No matter how conservatively she votes the state party and her opponents will find something to criticize. I'm not doubting that a vote in favor of health care reform could be a powerful symbol for voters who haven't yet really tuned into the 2010 election. But I'm not sure how much political benefit she'd actually get from opposing it.

Second, and more importantly, Herseth Sandlin has ALWAYS said she supports health care reform and wants to vote for a bill she likes. Look — there's two types of members of Congress who voted against health care reform. One group, of which Sen. John Thune is a member, view all the Democratic reform proposals as disasters-in-the-making, government takeovers of health care, economically devastating — bills with a few good elements but which are unquestionably wrong. If you think of health care reform bills like that, obviously you'll do everything you can to torpedo it — just as Thune has done.

But a second group includes moderate Democrats who like the goals of health care reform but think the current bills aren't good enough. They don't want to blow up health care reform and start over. They want to make the current bills better. And the only tool they have to achieve that is the threat of withholding their votes. That doesn't mean anything if you're not willing to follow through and vote against a bill that crosses your line in the sand.

From the beginning, Herseth Sandlin has said she has particular objections to parts of health care reform bills.

For example, on Nov. 6, when Herseth Sandlin announced her decision to vote against health care reform in the House, she said she liked the bill being drafted by the Senate Finance Committee (which formed the basis for the final Senate bill) better.

"I think there are more prudent provisions in the Senate bill than the House (bill)," Herseth Sandlin said, though she said the "hadn't endorsed every element of that bill."

The congresswoman said she liked several things better about the Senate bill:

• Its cost-containment/deficit-reduction measures, chiefly the excise tax on high-value health care plans.

"I'm not thrilled about the proposal, but I think it's a necessary dose of medicine we have to take here if we're going to contain costs," she said. "Given some of the alternatives, you can find a way to pay for this within the health care system by addressing the high-value plans that most health economists agree drive up utilization — that drive up costs for everyone else in the system."

• It would have a less-deleterious impact on South Dakota's budget. The Senate Finance Committee expanded Medicaid to 133 percent of poverty, while the House bill expanded it to 150 percent of poverty. A higher limit means more Medicaid patients and more costs for states.

Given her preference for how the Senate Finance Committee bill handled things over how the House bill did it, why is anyone surprised that she's at least considering voting for the compromise bill?

Oh, and that same day, she said this:

"I most certainly expect that it will be improved in conference and I'm optimistic that it will happen and that I will be able to support a conference report."

She may get her wish.