For weeks, moderate and conservative Democrats have been winning concessions and Thursday the progressives let everyone know they have had enough.
In one corner, are the so-called "blue dog" Democrats from more conservative districts, and in the other are progressive Democrats led by lawmakers from the Bay Area.
Just outside the capitol Thursday morning, Santa Rosa's Lynn Woolsey and Oakland's Barbara Lee led a group of 53 lawmakers vowing to vote against health care if they do not get what they want.
"The cornerstone of comprehensive health care reform is a robust public health plan option, similar to Medicare," Lee said.
In the past two weeks 52 blue dog Democrats have been trying to weaken support for a publicly funded alternative to private insurance companies, saying they will not vote for a Medicare-like plan.
As a result, compromises have been proposed in order to get the bill out of committee.
Now it is the progressives' turn.
"And we can compromise no more, absolutely," Woolsey said.
ABC7 political analyst Bruce Cain calls it entirely predictable.
"I mean, given that all the concessions have been in one direction for the last couple of days it was just a matter of time before the progressive caucus weighed in," Cain said.
Cain says strategically, progressives had to speak out in order to exert some leverage for what they want.
Thursday morning, Speaker of the House Nancy Pelosi played down the division.
"We are all part of the same party and we will have a bill that will come to the floor and when it does it will pass," Pelosi said.
Pelosi herself favors a public option, but on the Senate side the public option is in trouble.
So far the White House is not leaning on either side. White House spokesperson Robert Gibbs was asked would the president accept a compromise.
"I don't want to get ahead of the policy people doing said evaluation," Gibbs responded.
"From the point of view of the White House, the important thing is not to have it stall out with ridged positions right now," Cain said.
He believes it is better for the president to keep the ball moving and get the bill out of committee and then deal with it.
"The White House can weigh in at that point and say, 'this is what I think a public option has to have in order for it to be acceptable to me,'" Cain said.
Cain says the next month is a critical period for the president and democratic lawmakers. They have to sell the plan to voters and bring the party together over healthcare reform.