House Speaker Nancy Pelosi is doing everything in her power to get health care reform passed

Gloria Borger
CNN Senior Political Analyst

The story so far: House Speaker Nancy Pelosi does everything in her power to get health care reform passed by keeping her Democratic caucus together.

She keeps liberals by insisting on a public option. She works on fiscal moderates by re-jiggering it. She works on lowering the cost of the package. She pays for it by taxing millionaire couples, appealing to the class-warfare crowd.

And to keep the Catholic bishops (and their moderate allies) on board, she keeps severe restrictions on paying for abortion in the measure. The liberals, of course, threaten to bolt - but it remains in the final package.

This is not legislating; it's whack-a-mole.

The challenge is simply to try and keep your unruly team in line, and maybe pick up a stray vote or two from the opposition. If you succeed, it's not about bipartisanship. It's just salesmanship.

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Democrat House Speaker Nancy Pelosi

Jay Newton-Small
Time

On Saturday morning, about 12 hours before the House of Representatives passed sweeping legislation to expand health care coverage to almost all Americans, President Barack Obama did what he does best: he gave an inspirational speech meant to rally recalcitrant House Democrats. Many in the room credited Obama with swaying the last of the fence sitters. "A few members that were leaning no told me afterward that they'd been moved to vote yes," Representative Rob Andrews, a New Jersey Democrat, told reporters after the meeting.

Obama spoke of doing something greater than yourself. He asked House Dems to join him in "bending the arc of history," a phrase he first invoked in his election-victory speech a year ago before 125,000 people in Chicago's Grant Park. And though there was cheering and chants of "Fired up, ready to go!" this was no easy sell for Obama. The vote came the same week as Democrats lost the Virginia and New Jersey governors' mansions, and a day after the Labor Department reported a 26-year record unemployment rate of 10.2%. Preaching altruism in such a climate to politicians bent on self-preservation is tough. In the end Democrats lost 39 of their own — passing the bill 220-215 with a cushion of just two votes, one of those a Republican in a heavily Democratic Louisiana district.

Democrats on Capitol Hill spent some of the aftermath congratulating themselves on their historic achievement, but they knew as well as anyone that it was far too early to really celebrate. Obama's speech, after all, was strikingly partisan, lambasting the GOP for doing nothing more than "saying no, stopping progress, gumming up the works." That change in tone from his fruitless attempts at outreach 10 months before in the run-up to the stimulus vote made it clear that Democrats are now resigned to going it alone both in the House and the Senate. Majority leader Harry Reid has moved away from the lone Republican still negotiating on health care, Maine's Olympia Snowe, and toward a plan to pass the bill relying solely on Democratic votes, of which he'll need every one in order to overcome the threat of a filibuster by Republicans.

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Editor's Note: While health care reform proposals are still being reconciled on the Senate floor, House of Representatives Speaker Nancy Pelosi unveiled the House plan Thursday at a rally on Capitol Hill in Washington D.C. Read the full contents of the proposed bill.

AC360°

The battle over health care reform reached another milestone Thursday as top House Democrats unveiled sweeping legislation that includes a highly controversial public health insurance option.

The nearly 2,000 page bill - a combination of three different versions passed by House committees - would cost $894 billion over 10 years and extend insurance coverage to 36 million uncovered Americans, according to House Speaker Nancy Pelosi.

It guarantees that 96 percent of Americans have coverage, Pelosi said. The figure is based on an analysis by the nonpartisan Congressional Budget Office.

Among other things, the bill would subsidize insurance for poorer Americans and create health insurance exchanges to make it easier for small groups and individuals to purchase coverage. It would also cap annual out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.

Deirdre Walsh
CNN Congressional Producer

House Democratic leaders are preparing to unveil a health care bill as soon as Thursday that includes a more moderate version of the public option, one that allows doctors to negotiate reimbursement rates with the federal government, several Democratic leadership aides tell CNN.

That’s a blow to Speaker Nancy Pelosi, who has argued for a more “robust” version of a the public option, one that ties reimbursement rates for providers and hospitals to Medicare rates plus a 5% increase. But Pelosi and other Democratic leaders appear to be bowing to the reality that after a week of canvassing rank and file Democrats, her preferred approach does not have enough votes. Instead the more moderate version of a public option, favored by rural and moderate Members, appears to have the most support among House Democrats.

One of these Democratic aides told CNN “the votes aren't there for robust public option, so that means we're looking at the other form of the public option.”

This aide said House Democratic leaders will meet Wednesday afternoon to make final decisions.

House Democratic leaders are planning to unveil their health care bill at a big event on the West Front of the Capitol Thursday morning. However, these sources cautioned the bill is still not final, and the event for Thursday is tentative.

“The overall message is the same as it's been at the beginning. We're committed to a bill with a public option,” one aide told CNN, arguing that the House is still presenting a strong health reform bill.

Democratic leaders expect to get a final cost estimate today from the Congressional Budget Office.

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Majority Leader Steny Hoyer, left, Rep. John Larson and Speaker Nancy Pelosi address the news media Monday.

John Feehery
Special to CNN

The issue was: Should they stay or should they go?

Speaker of the House Nancy Pelosi thought the House should stay and work until Democrats pass health care reform.

Senate Majority Leader Harry Reid thought the Senate should adjourn for the summer break and come back after the senators have a chance to meet with their constituents.

Pelosi lost, and House Democratic leaders now concede there won't be a vote before the traditional August recess.

Both paths came with big risks. Had Pelosi's brigade marched off a cliff, taken a difficult vote on a potentially unpopular bill and faced hordes of angry constituents, she would have faced an unruly and upset Democratic caucus come September.

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Anderson Cooper talks with Senior Political Analyst David Gergen about Speaker Nancy Pelosi and President Obama.

Tanya M. Acker
AC360° Contributor
Attorney

A “hag,” is how one conservative commentator described Speaker Pelosi, as he discussed the current controversy over “what she knew and when she knew it” with respect to the CIA’s interrogation techniques.

Really? A “hag”?

The issue of whether the Speaker is a hypocrite has very little to do with whether the interrogation techniques at issue are illegal – but fine. If you want to go down the road of discussing who may or may not be a hypocrite in Washington I think that people on both sides of the aisle would welcome that debate.

But must we really indulge the sexism and misogyny? Just as many conservatives have found a way to criticize President Obama without resorting to racist and other hateful rhetoric, one certainly can have a debate about the Speaker’s good faith without the silly references to “Botox” and facelifts.

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Program Note: Tune in tonight to hear the latest on why Republicans want an apology or proof from House Speaker Nancy Pelosi on AC360° at 10 p.m. ET.

Watch this clip of House Minority Leader John Boehner speaking to John King on Sunday's State of the Union. Boehner and other top Republicans are demanding an apology from House Speaker Nancy Pelosi or proof to back her claim that the CIA misled Congress about the use of harsh interrogation tactics