In an on-the-record roundtable with bloggers and journalists this morning, Speaker of the House Nancy Pelosi was extremely confident that health reform will pass and pass quickly:

I have no intention of not passing this bill. I have faith in my members that we’ll be passing this.

If we don’t’ pass the bill, how do you explain that to Americans? There is incredibly urgency in cost and the health and well-being of American, and yet we as Democrats, with two Houses [of Congress] and White House, couldn’t make the historic decision to go forward?

The same forces that are aligned against Medicare are against this bill. This is what what they believe. I’ll give them credit for staying true to their beliefs – they don’t believe in health care for all Americans and a government role in that. The budget that they have [Rep. Paul Ryan's budget] privatizes social security, offers vouchers instead of medicare, and gives block grants to states instead of Medicaid. That is what they believe.

We want to take it to the American people and say, "This is the choice you have. This is their vision, and this is ours." [The Democratic members of the House] are strong enough and courageous enough to take that message out there.

There is a legitimate political debate happening in our country – what role should government have in bringing down health care costs, increasing accessibility and coverage, holding insurance companies accountable. We welcome that debate.

This is the most important initiative most of us in Congress – Congressman Dingell who was here for Medicare notwithstanding – will ever do in our legislative lifetimes.

Throughout the meeting, Pelosi continually referred back to this language, stressing that it’s time to move forward and that the legislation is historic progress. At one point, she said that her "biggest fight" was against doing a small, incrementalist bill instead of addressing the entire system. "We’ve won that argument," she said, "And we can now take the country in a new direction."

Pelosi said she is asking members of the Democratic caucus to think about what is in the bill that they support, not what’s not in the bill that might lead them to oppose. She says the bill does three transformational things, the "triple A" as she puts it:

We’re proud of what’s in there. Affordability for the middle class, access to health care for 31 million Americans, and accountability for insurance companies. The reconciliation package will change the pay-for [the excise tax], increase affordability, and correct the inequities in the states [the Nebraska deal]. The reasons we [in the House] didn’t like Senate bill are corrected in reconciliation bill.

The biggest lever is to prevent insurance company abuses is the ability to prevent them from doing business in the exchange. That’s a really big deal for them. If they raise rates they can be barred from the exchange. If they don’t abide by anti-discrimination rules, they can be barred.

And, between now and implementation, if insurance companies don’t follow the law, they’ll be prevented from participating in the exchange. The Secretary [of Health and Human Services] can establish fines, and the Attorneys General can take action if they’re discriminating. That’s in the legislation.

Of course, we want to pass more. That’s why we passed the insurance industry anti-trust repeal, and we’ll revisit some other issues in the future.

As for how reform will pass, the Speaker stressed that it’s hard to get a vote count before you have a bill. As of today, she is waiting for the final CBO score to release the language, then they can begin counting votes. "Time is important," she said, "every special interest against the bill benefits by delay."

She said there were three options for passing the Senate bill and the reconciliation improvements through the House. The first – having the House and Senate pass the reconciliation bill before the House passes the Senate bill – was ruled out by the Senate parliamentarian. The second option – having the House pass both the Senate bill and a package of reconciliation fixes – is available. And there is a third option, one that the Speaker said she and her members are leaning towards. Under the plan, the House would vote only on the reconciliation bill based on a rule that says once the reconciliation bill passes the House, the Senate bill would be "deemed" passed in the House as well:

We don’t have the votes yet because we don’t have a bill yet. People just haven’t made a commitment because they haven’t seen the bill. The vision and specifics will get us the votes.

There is no easy vote around here, but I have confidence we’ll be fine if we keep eye on the ball and have members be completely familiar with final bill. This is historic.

The Budget Committee is marking up last year’s reconciliation instructions today – a "shell bill" – in preparation for putting in the real reconciliation bill as soon as the CBO scores come out. The Rules Committee will meet shortly thereafter to decide how the bill or bills comes to the floor. By all accounts, the House is still on target for a vote late this week or this weekend, and Speaker Pelosi is confident she’ll have her votes.

(also posted at the NOW! blog)

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