Sen. David Vitter has been a strident opponent of national Democrats' health care reform efforts in Washington and, in advance of his 2010 re-election, is seen as one of the GOP's most reliable votes on the issue. But, POLITICO reports the senator will have a difficult time deciding how to cast his vote on an amendment pushed by Republicans to strip some $300 million designated for Louisiana from the bill. (The artilce also notes Vitter broke with many in his party last week in voting for a bill guaranteeing preventive screenings for women.)

Last month, Vitter's Senate colleague, Mary Landrieu, inserted language in the health care bill that would provide up to a third of the estimated $900 million shortfall Louisiana is facing in its Medicaid budget. The issue has been a top priority for the Louisiana delegation, but Republicans say the issue is being used to "buy" votes on health care, with some conservatives going so far as to call Landrieu a "prostitute." Louisiana is facing the Medicaid shortfall due a to skewing of per capita income that occurred post Katrina, increasing the state's share of the costs. From POLITICO:

“I’ll have to consider it as it comes up for a vote,” Vitter said of an amendment by Sen. Tom Coburn (R-Okla.) to strip the money from the bill.

Vitter, who has a chilly relationship with Landrieu, told POLITICO that he’s “extremely uncomfortable with it being on this bill — in particular, it is essentially buying support and buying votes on this bill.” On Monday, Landrieu strongly rejected the notion she was bought off, saying that “there was not a quid pro quo for that vote” and that it was the “No. 1 request” of Louisiana Gov. Bobby Jindal, a Republican, to get the additional Medicaid money.
Informed of Vitter’s comments and asked how Vitter should vote, Landrieu said tersely: “Vitter should help his state, is what he should do."

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