Did Nancy Pelosi Just Kill Health Care Reform?

Esquire just published a cursory profile of Speaker of the House Nancy Pelosi, remarking she "is all about the execution of her job." So how did we end up dropping health care reform off to the realm of "maybe later?"

Tom Chiraella summarizes Pelosi's somewhat thankless position as the person tasked to move legislation across the floor:

It's got to suck, shepherding through a decent career's worth of legislation in the first eleven months of your Speakership under a Democratic president, with your majority, pinning the needle at 218 - that simple majority of the House - again and again, outworking every member of your own party on every major agenda item sent your way, by every measure out-succeeding the president himself, only to watch your approval rating drag the barroom floor like Dick Cheney's knuckles. To paste together a cantankerous majority time and again, with the urgent and overloud drumbeat of anxious White House aides throbbing in your ears, only to get picked at because you tend to stammer and mechanically chop the air with the side of your hand during the weekly press conferences.

However, in the case of health care reform, Pelosi may have jabbed the final nail in the column by admitting that the numbers just aren't there In a press conference earlier today, she explained "There Aren't Enough Votes To Pass The Senate Bill:"

"In every meeting that we have had, there would be nothing to give me any thought that that bill could pass right now the way that it is," she said. "There isn't a market right now for proceeding with the full bill unless some big changes are made."

While Pelosi notes that most people are on-board with some kind of reform, "major changes" would need to be made for it to move forward, and Congress is no longer working to present a bill to the President before the State of the Union, scheduled for January 29.

The Washington Post has a little more detail on the irreconcilable differences in the current version of the bill:

The only way to keep the Senate bill alive, Pelosi said, would be for senators to initiate a package of fixes that would address House concerns about the bill. In particular, Pelosi described her members as vehemently opposed to a provision that benefits only Nebraska's Medicaid system. Also problematic are the level of federal subsidies the Senate would offer to uninsured individuals and its new excise tax on high-value policies, which could hit union households. [...]

Congressional leaders also are considering starting from scratch on a new bill, an undertaking that many Democrats fear could consume months of effort as they brace for a tough 2010 election battle.

Many Representatives have rushed to say that health care reform is not off the table, and the bill is still active for an entire year. But looking ahead to 2010, Nancy Pelosi and her fragile Democratic coalition will have a lot more to fight through.

Nancy Pelosi Doesn't Care if You Like Her [Esquire]
Pelosi: There Aren't Enough Votes To Pass The Senate Bill [TPM]
Pelosi says House cannot pass Senate's health-care bill without changes [Washington Post]