The latest Democratic plan for health reform calls for the House to pass the Senate bill in exchange for the promise of a supplementary compromise bill that, through the use of the budget reconciliation process, would only require 51 votes. But House Speaker Nancy Pelosi stressed on Thursday that the eventual additions and changes are going to have to be considerable.
"We're not talking about minor tweaks," Pelosi told reporters at her weekly press conference. "Our bills are about 75 percent the same, perhaps 80. The President optimistically says 90, and maybe he knows something I don't know about what's going to happen in the Senate. But there are some areas where we're not the same, and we have to find a way to move forward."
Some of those areas, Pelosi said, are "very important." Key insurance reforms -- an end to rescission and discrimination based on preexisting conditions, for example -- require basic enforcement provisions to prevent the health industry from simply passing the costs of reform onto consumers, she said.
"I would not say they're minor tweaks," Pelosi said. "No, it's more serious than that." Congress needs to "move quickly," she said, though she did not offer a timeframe for passage.