The health-care reform debate is heading out of the halls of Congress this month and into the schoolhouses, city halls and community centers of Iowa.

Like the rest of Congress, Iowa lawmakers are fanning out across the state over the August recess. And they're likely to get an earful from energized grassroots networks aimed at squeezing in final face-to-face arguments before Congress goes back to vote in the fall.

It's a high stakes month, says U.S. Sen. Chuck Grassley,

R-Iowa, the top Republican on the Senate Finance Committee. He's been part of talks to put together a bipartisan reform proposal.

"I think it can make it or break it," Grassley said Monday. "If there is a continuation of the trend that set in a couple months ago, that people don't like ObamaCare, it's going to do one of two things: Bring it to a halt or change it to a more incremental approach."

Recent polls have said support for President Obama's handling of the health care issue is slipping, but that some of his ideas still are popular, such as a publicly run insurance option.

Grassley, who has been involved in reform talks with five other senators on the Senate Finance Committee, is likely to be the focus of much of the grassroots efforts.

Amy Logsdon, an official with a coalition backing many of Obama's health care principles, said members who are Grassley constituents plan to let him know "the status quo is hurting us."

"We're going to be showing the depth and breadth of support for real reform," said Logsdon, political director for the Iowa Citizen Action Network, lead partner in Iowa for Health Care for America Now.

At the other end of the spectrum, a conservative group that criticized Grassley two weeks ago over his role in the health care negotiations has notified its members they, too, should make their voices heard.

"Democrats are leaning on him. Conservatives should, too," said Tim Albrecht, spokesman for the American Future Fund, a group based in Des Moines that's opposing the president's health care ideas.

Congress' failure to get health care bills passed by the summer recess has focused a great deal of attention on the 31 days of August.

Thus far, there appear to be no grand advertising strategies planned for the state.

Instead, much of the attention in Iowa will zero in on the constituent meetings that lawmakers will hold throughout the month.

"It's a very important month," said Andy Warren, state director for the Iowa affiliate of the National Federation of Independent Businesses.

The overarching issues dominating the national health care debate, such as cost and whether there should be a government-run insurance option to compete with private insurers, are likely to generate a lot of heat at these meetings.

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But backers of reform say they plan to focus, too, on parts of the legislation that are unique to the state.

Jeff Giertz, a spokesman for U.S. Rep. Bruce Braley, said the Waterloo Democrat plans to talk about a deal he and others struck with the House leadership to change the way the Medicare system reimburses hospitals and doctors.

Rural states, particularly Iowa, have complained for years about being shortchanged.

"The Medicare payment reform piece is a big part of the bill. It will save a lot of money," Giertz said.

Iowa lawmakers say they are open to persuasion at their town hall meetings, even though some have been steeped in the details of a complex issue for weeks.

"I think my town meetings do have an impact on me," Grassley said. He said that his meetings going back to last year have drawn considerably more people.

Braley, who sits on the Energy and Commerce Committee, which passed a bill last Friday, also is interested in learning from constituents, his office says.

"The goal of our August is to get feedback and see how the bill can be improved," Giertz said.

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