Another round of negotiations on the Hill. There are a lot of hurdles blocking reform — here are the 5 biggest – and this week all eyes will be on the House to see if Speaker Pelosi can produce a bill before adjourning Aug. 1. She has said she’d be willing to keep the House in an extra week to see it done but such a move would require agreement on a bill, which is still forthcoming even after House Energy & Commerce Chairman Henry Waxman said last week that he would skip the committee mark up and move the bill directly to the floor. Waxman, and Pelosi, are stumbling over leery Blue Dogs. The bloc of 52 conservative Dems is balking at cuts to Medicare reimbursements, is nervous about the MedPAC panel agreement and still has a list of eight other grievances yet to be addressed. Pelosi may want to find herself a Cesar Millan if she has any hope of seeing this done this week.