Washington (CNN) - The Senate health care bill has too many unpopular provisions to win approval from the House at this time, House Speaker Nancy Pelosi said Thursday.
Pelosi's comment to reporters appeared to dash the chances that Democrats will take the easiest route for passing a health care bill - having the House approve the Senate version unchanged.
"I don't think it's possible to pass the Senate bill in the House," Pelosi said. "I don't see the votes for it at this time."
She insisted that all options remain open, but also signaled possible agreement with President Barack Obama's comment Wednesday that scaling back the legislation estimated to cost almost $1 trillion over 10 years might be the preferred option.
Congressional Democrats have been reconsidering their strategy after a Republican victory in Tuesday's special Senate election in Massachusetts, which stripped Senate Democrats of the 60-seat super-majority needed to overcome a GOP filibuster.
Scott Brown's win in one of the most progressive states in the nation raised already-high anxiety levels among Democrats looking ahead to midterm elections.
Administration officials and top congressional Democrats are reviewing a diminished range of options to pass a health care bill and salvage victory on Obama's top domestic priority. The White House and Democratic leaders were trying to merge separate versions of health care bills passed by the House and Senate when Brown's election changed the political landscape.
Obama called Democratic leaders including Pelosi, Senate Majority Leader Harry Reid and House Majority Leader Steny Hoyer on Thursday to discuss options for progress, White House spokesman Bill Burton confirmed.
Pelosi, a California Democrat, said the Senate bill has "certain things that (House) members just cannot support." She cited a provision worked in by Nebraska Sen. Ben Nelson that exempts his state from paying increased Medicaid expenses, and a 40 percent excise tax on insurance companies that provide the most expensive health insurance coverage.
According to Pelosi, two options for the House are to pass the Senate bill with changes and send the measure back to the Senate, or to focus on particular segments of the bill considered non-controversial.
"We have to get a bill passed. We know that," Pelosi said, later adding: "I don't think anybody disagrees with 'let's pass the popular part of the bill.'"
However, she noted that "some of that popular part of the bill is the engine that drives some of the rest of it."
Both Pelosi and White House Press Secretary Robert Gibbs said Democrats would take time to assess their options in the wake of Brown's election in Massachusetts.
"The president believes it's the right thing to do, to let the dust settle, and give those on Capitol Hill some time to search for the best path forward," Gibbs said Thursday.
"We are not in a big rush: pause, reflect upon what our possibilities are, see what the support is in the caucus," Pelosi said. "We have to always go where we can build consensus."
On Wednesday, Obama said in interview with ABC News that he "would advise that we try to move quickly to coalesce around those elements of the package that people agree on."
"We know that we need insurance reform, that the health insurance companies are taking advantage of people," Obama said. "We know that we have to have some form of cost containment because if we don't, then our budgets are going to blow up."
Several rank-and-file Democrats said the less controversial provisions also include barring discrimination by insurers based on pre-existing conditions and closing the Medicare "doughnut hole" to bring down prescription drug costs.
"There are great concerns about the health insurance system and the kind of power that the insurance people have over people to deny care, to raise rates and so on," White House strategist David Axelrod told CNN Wednesday. Obama is "not going to walk away from that," Axelrod said.
Republicans have been unanimous in opposing the health care bill, and House Minority Leader John Boehner of Ohio said Thursday that the existing measures should be scrapped.
"Our goal is to stop this monstrosity and we're working with our members so that we don't find ourselves in a position where they're able to pick off a few of our members and to get this bill passed," Boehner said. "We need to stop, scrap the bill and start over. And start over in a bipartisan way."
Pelosi, however, questioned whether any common ground exists to work with Republicans on the issue.
"They have made it clear they are not for health care reform," she said. "We are, and so to the extent we can find common ground between those two differences remains to be seen."
Pelosi insisted that the health care bill was not the reason for the Democratic loss in the Massachusetts Senate election, saying the main issue on the minds of voters was the nation's 10 percent unemployment rate.
"The jobs issues has permeated every major initiative that we have," Pelosi said, later adding that "perhaps we haven't been clear enough about the focus and purpose, or the connection" between Democratic priorities such as health care reform and the nation's overall economic health.
Rep. Janice Schakowsky, D-Illinois, said Thursday that Democrats must adopt a stronger populist tone to clarify how health care reform is in the interest of the middle class.
"There is enormous support for doing health care, but the feeling is, the message - how this is going to help the American people - has been clouded by the insurance industry and by the Republicans," Schakowsky said. "We've got to be able to go out there and show people we are on their side and fighting for them. People in Massachusetts weren't seeing Democrats on their side, fighting for them. And we've got to do better. We have to have a populist, strong posture."
Another option raised Wednesday by a key labor union would be a two-step process for passing a health care bill.
"The House should pass the Senate's health insurance reform bill - with an agreement that it will be fixed, fixed right, and fixed right away through a parallel process," said Andy Stern, head of the Service Employees International Union. However, some House Democrats indicated they lacked confidence the Senate would make the necessary adjustments in the future.
A further option is to revisit the idea of trying to push health care through the Senate with only 51 votes - a simple majority.
To do that, Democrats would have to use a process known as reconciliation, which is limited to legislation affecting the budget and therefore could only apply to parts of the health care package.
Rep. Lynn Woolsey, the California Democrat who chairs the Progressive Caucus of liberal House members, outlined a plan in which the House would approve a health care package negotiated by the White House that combines the bills previously passed by the House and Senate.
According to Woolsey, the Senate would then pass as much of the package as it could under reconciliation procedures, needing only 51 votes. In addition, the Senate also would pass an accompanying measure - under normal procedure which would require 60 votes to overcome a filibuster - with as much of the rest of the House-passed version as possible. The House would then have to approve the Senate measures to send them to Obama's desk.
Senate Finance Committee Chairman Max Baucus, D-Montana, told CNN Wednesday that he thinks reconciliation will be necessary to pass a health care bill in the chamber. However, multiple Democratic aides - and some representatives - warned that using the reconciliation process would take time and possibly evoke criticism of relying on a procedural trick to pass a bill.
"It looks too partisan," said Rep. Gerry Connolly, a freshman Democrat from Virginia, while Democratic Rep. Earl Pomeroy of North Dakota likened the move to "legislative trickery."
In addition, many Democrats are eager to put the health care debate behind them and move on to economic issues, such as job creation, as soon as possible in this election year.
"If there's anybody in this building that doesn't tell you they're more worried about (the November) elections today, you should absolutely slap them," Sen. Claire McCaskill, a Missouri Democrat, said Wednesday. "That's what this place thrives on."
–CNN's Ted Barrett, Dana Bash, Evan Glass, Suzanne Malveaux, Alan Silverleib, Deirdre Walsh and Tom Cohen contributed to this report
(Updated at 7:00 p.m. EST)