The fiscally conservative Blue Dog Coalition likely holds the key to enacting a universal health care plan this year, but so far the Democratic bloc feels like it’s being cast aside.

Forty-five Blue Dogs, led by Rep. Mike Ross (Ark.), on Monday warned that they need to be part of the writing of health care legislation in a sharply worded letter to Energy and Commerce Chairman Henry Waxman (D-Calif.), Ways and Means Chairman Charlie Rangel (D-N.Y.) and Education and Labor Chairman George Miller (D-Calif.).

The Blue Dogs pronounced themselves “increasingly troubled— at the lack of involvement in the writing of the massive bill and said their limited role is “especially concerning in light of the collaborative approach taken by our Senate colleagues.—

Ross said they want to be brought in on the front end, not the back.

“I’ve had a sit-down with Chairman Waxman on health care, but we keep hearing rumors that a bill is being written,— he said. “A conversation is nice, but we want to be there when it’s being written.—

Ross made clear that the success of the health care overhaul was at risk. Lawmakers are pressing ahead quickly on a massive reform package with a goal of enacting a bill into law this year. Leaders in both chambers have said they’d like to have a bill on the floor by August.

“We speak with 51 votes, and we expect to be involved in helping draft the legislation. And if we’re not, I see a lot more complications down the road on health care than what the leadership experienced on cap-and-trade,— Ross said in an interview Tuesday.

Ross, who chairs the Blue Dog task force on health care, said the issue is far more complex than a measure to cap carbon emissions, another top Democratic priority this year.

“That’s been derailed for two weeks largely because leadership said, Here’s the bill,’— Ross said. “We don’t want that to happen with health care.—

On Tuesday, the Blue Dogs issued a set of principles for health care reform that touched on several key issues but not on whether a public insurance option should be included. Ross said the omission was intentional, adding that the Blue Dogs are “willing to be open-minded and consider those types of options, but we want to be involved.—

The Blue Dogs’ grousing comes in the context of the last major health care reform effort, which collapsed in 1994. Then-first lady Hillary Rodham Clinton led a largely secretive health care task force that split Democrats into warring factions.

“This is not something that should pass with 218 votes,— a Blue Dog aide said. “It’s something that should pass by a large bipartisan margin on the House floor.—

The Blue Dog request for more input got a nod from a key ally, House Majority Leader Steny Hoyer (D-Md.), in a press conference Tuesday. Hoyer has already been trying to coordinate the issue with committee chairmen while looking out for the concerns of Blue Dogs and other Caucus groups.

They “want to be included in the formulation of the legislation,— Hoyer said. “I think that’s a reasonable request. I think they will be. … I think the committee chairs want to do so as well.—

A Democratic leadership aide said that Hoyer and Speaker Nancy Pelosi (D-Calif.) had already agreed to bring the various Caucus groups to the table before the Blue Dogs penned their letter. “Hoyer and the Speaker are going to have meetings with the chairmen and with the different groups so we can build a consensus,— the aide said.

Waxman, who is rushing to put the finishing touches on a compromise cap-and-trade bill, released a statement saying he would start formally reaching out to different Democratic factions on health care.

“Beginning this week, we are beginning more intensive, formal discussions with different sectors of the Democratic Party, including all caucuses,— Waxman said. “I have been talking informally with members of the Energy & Commerce Committee, and I look forward to working with all members on this important legislation and to benefiting from their input.—

Added Miller spokeswoman Rachel Racusen: “We are continuing to work with all members of our Caucus on health care reform that provides every American with access to quality and affordable health care that meets their needs.—

Jennifer Bendery contributed to this report.