05/22/2010 05:12 am ET | Updated May 25, 2011

Health Care Is Pelosi's Victory

The House's passage Sunday night of a reform package will inevitably be seen as President Barack Obama's biggest achievement, whether he goes on to serve two distinguished terms or is voted out in 2012. Given the magnitude of the legislation and how long it has eluded the grasp of all of Obama's modern predecessors, this distinction is certainly merited.

That said, the ratification of health care is an even more impressive victory for House Speaker Nancy Pelosi. Faced with an endless litany of institutional roadblocks, false starts, ego-centric Members, and plain political pressures, Pelosi was able to wrangle together just enough votes to push reform to the finish line. It is Pelosi who deserves the most credit for seeing health care through.

The stakes implicit in the end game of health care were politically momentous for House Democrats: after publicly grousing and debating it for over a year, failure to pass anything would have potentially cost their party control of Congress. To be sure, health care reform has become less and less popular as the process has lurched along, but if there is one thing more unattractive to voters than unpopular initiatives, it is looking weak.

Had the House not been able to tackle health care once and for all, majority Democrats would have looked completely and utterly impotent and not deserving of full control of the government.

In other words, Pelosi faced enormous consequences for failure. Like professional sports, politics is always a zero-sum game where winning the only thing that matters and losing is absolutely unacceptable; but this was more acute with the health care vote than ever before. Pelosi had to deliver a majority not just for her party and her President, but even for herself, as defeat could have hastened the end of her speakership.

Even disregarding these considerations, Pelosi faced other immense obstacles, including:

• Sharply competing viewpoints in her own caucus between dominant progressives and recalcitrant pro-life Democrats who composed a crucial bloc of votes;

• A deeply heterogeneous Democratic caucus: regionally, ethnically, politically, ideologically;

• Little help from a rudderless White House operation which could never seem to plot a course towards passage and stick to it;

• A Senate seemingly incapable of substantive movement, seeding anger in distrust in Pelosi's own body;

• An unprecedented united opposition and anti-reform outside lobbying effort; and

• The typical electoral considerations on the mind of every Member in an election year, exacerbated by national resistance to Democratic reform and the shocking victory of Scott Brown.

Faced with these issues and others -- did I mention the Eric Massa distraction? -- Pelosi achieved the only thing that mattered: a majority. Despite the strong negative feelings many have for the Speaker, it is hard to envision anyone else achieving such a difficult success.

For some time, the dislike Pelosi has engendered has been wrong-headed. Pushing aside partisan differences, Pelosi has long been an excellent legislative tactician and proven vote-getter. In the back room, few are better at getting to 218 votes. This is often ignored by those who focus on Pelosi as the spokeswoman and face of the national Democratic Party, a role she inherited after the Democrats retook Congress in 2006.

Admittedly, Pelosi was poorly suited to that position, as she can easily come across as shrill and disingenuous, but with Obama's election, she was able to retreat into the hallways and hideaways of Capitol Hill and focus on doing what she does best.

And indeed, a comprehensive Sunday article in the New York Times notes that after Scott Brown won, it was Pelosi who convinced President Obama and her former deputy, White House Chief of Staff Rahm Emanuel that pushing the full bill was the best course of action, scoffing at their desire to scale back the health care effort. Pelosi was convinced she could get the votes, pragmatically telling the President: "We'll never have a better majority in your presidency in numbers than we've got right now." And Pelosi eagerly took on the duty of lobbying all of the tough Democratic votes herself.

Unlike Obama, Pelosi correctly understood that the only way reform was going to pass was if the House could clear the Senate bill, and that cutting efforts back or starting over was destined to fail.

Pelosi's success Sunday is the best evidence of her effectiveness, but really, she has proven herself time and again, such as by passing the stimulus, a cap-and-trade bill, and an even more liberal health care bill than the current one, all in 2009. She has done her job in delivering legislation pleasing to her party's base; consequently, any failures should be assigned more to the President and the Senate.

Given the House's passage of what was seen in mid-January as impossible, Pelosi has surpassed Sen. Chuck Schumer and even Emanuel himself as the Democrats' sharpest political mind.

As a policy achievement, Congress's passage of wide health care reform may be unmatched and it will be a win for which President Obama gets the current and historical lion's share of credit -- or blame, depending on your partisan affiliation. Nonetheless, as a political achievement, its titanic success belongs to Speaker Pelosi first. While she has won other tough votes before, the vote Sunday was the hardest she will ever face. Under virtually insoluble circumstances which would have fatally stymied others, she spearheaded the effort to attain a majority and got it.

Love her or hate her, Pelosi's work was pretty darn impressive.