Pelosi doesn’t have votes to pass health bill

House Speaker Nancy Pelosi said Thursday that she doesn’t have the votes to pass the Senate’s health reform bill as some rank-and-file Democrats signaled support for a scaled-down measure - one that deletes parts of both bills or breaks them into pieces, such as insurance industry reforms and Medicaid expansion.

The comment marks a serious setback in efforts to pass President Obama’s top legislative priority now that Democrats are one vote shy of enough to overcome a Republican filibuster in the Senate.

Senate Democrats were hoping that the House would merely pass its bill to prevent the Senate from having to take another vote. While both chambers have passed health bills, the two pieces of legislation have to be merged before moving to the president’s desk.

“In its present form without any changes, I don’t think it’s possible to pass the Senate bill in the House,” Mrs. Pelosi told reporters shortly after a meeting of House Democrats. “I don’t see the votes for it at this time.”

The surprise election of Massachusetts state Sen. Scott Brown to former Sen. Edward M. Kennedy’s Senate seat has left Hill Democrats shaken and without a clear path forward on health reform.

Mrs. Pelosi left open the possibility that the House could pass the Senate’s bill along with another bill to serve as a “patch” to fix what the House doesn’t like in the Senate’s plan. But she called that plan “problematic.”

Senate Majority Leader Harry Reid has refused to put a timetable on moving forward with the legislation.

Several Democrats say the results of the Massachusetts election convinced them that Congress needs to focus on jobs and the economy to win back independents and disenfranchised Democrats.

“I would like to finish this health care debate and move on to energy, jobs, help for small business,” said Sen. Mary L. Landrieu, Louisiana Democrat. “The longer the health care debate goes on, I think it is more difficult.”

Proponents of scaling back the bill say it might be more popular.

“Was [the bill] too ambitious for an anxious public? There is some evidence the answer is yes,” said Rep. Gerald E. Connolly, Virginia Democrat.

House Democrats say there are too many negatives in the Senate legislation. Mrs. Pelosi specifically pointed to a provision that would send Nebraska’s Medicaid expansion tab to the federal government and a tax on high-cost, so-called “Cadillac” insurance plans.

Rep. Raul M. Grijalva, Arizona Democrat and co-chairman of the Congressional Progressive Caucus, said passing the Senate bill and a fix is impractical because there are too many repairs to make in a timely manner.

The Senate bill, “is a recipe for disaster down the line,” he said. “There are too many elements of this bill that make no sense for me to cast my vote in favor.”

He wants to pass the financial parts of the health bill through reconciliation in the Senate - a complicated procedural move that only needs 51 votes - and a second bill with popular insurance industry reforms through the traditional method. It’s a sentiment that’s been echoed by many of his liberal Democratic colleagues. He argues that the insurance reforms could get at least one Republican backer to help it move through the Senate.

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