Washington (CNN) - Senate Majority Leader Harry Reid said Thursday that Congress would pass a health care bill this year, while his counterpart in the House - Speaker Nancy Pelosi - outlined a two-step plan intended to maintain public focus on the issue.
"We're going to do health care reform this year," Reid told reporters, the day after President Barack Obama urged Congress in his State of the Union address to act on what was his top domestic priority in 2009. "The question is, at this stage, procedurally, how do we get where we need to go?"
Democratic hopes to get a bill to Obama's desk by now were derailed by the GOP's upset win in last week's special election to fill Ted Kennedy's Massachusetts Senate seat.
The win stripped Democrats of their 60-vote Senate super-majority and gave Republicans enough votes to block most legislation in the chamber. Democrats, who were in the process of combining previously passed House and Senate bills at the time of the election, have been struggling since to come up with a new legislative strategy.
Pelosi, a California Democrat, said Thursday that Congress "must take whatever time it takes" to pass a bill. She described a two-step process in which the House would likely vote in coming weeks on a series of specific health care provisions that have popular support.
At the same time, Pelosi said, work would continue on finding a way to pass a more comprehensive overhaul later.
Pelosi said the idea was to demonstrate continued momentum for some of the most important aspects of health care reform.
"That doesn't mean that it is a substitute for doing comprehensive" legislation, Pelosi said. "It means we will move on many fronts, any front we can."
Pelosi declined to identify which provisions the House might vote on separately, but said "they can move quickly."
A senior Democratic aide told CNN that leaders were considering votes on a series of bills before Congress is scheduled to take a week-long recess in mid-February. One of the bills could include a measure to repeal the antitrust exemption for insurance companies, a provision included in the House health care bill but left out of the Senate version.
As reported Wednesday by CNN, House Democrats believe that moving forward with some health care reforms that the public favors would demonstrate their resolve to work on a top priority issue during an election year.
However, several Democratic aides acknowledge it was unclear if the Senate also would pass the piecemeal health care measures.
At the same time, House Democratic leaders continue to negotiate several changes to the Senate's health care bill in order to get enough support to pass it in the House.
The bill then would go back to the Senate for a vote in the Senate under rules allowing approval by a simple majority, according to the House Democrats' plan.
"We're not talking about minor tweaks," Pelosi said.
House Democrats object to 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.
The White House has negotiated with labor leaders to modify the tax plan for expensive health policies by exempting many health plans covering union workers until 2017.
Pelosi indicated that some key insurance reforms, such as banning discrimination by insurers against people with pre-existing medical conditions, must be coupled with other major reform provisions.
"Otherwise, you have no leverage with the insurance companies" and they would likely increase rates, Pelosi said.
Republicans continued to criticize Democrats for moving forward with a plan they say the American people have rejected in recent elections.
House Minority Leader John Boehner, R-Ohio, said his party has a better solution to the proposal that Obama and Democratic leaders "are trying to shove down the throats of the American people."
In the Senate, some liberal Democrats have urged Reid to use a legislative tool known as reconciliation, which would allow some components of the health care bill to pass with only 51 votes.
Several progressive activists held a news conference Wednesday urging the Senate to pass a package of changes through the reconciliation process. Under that scenario, the House would then pass both the original Senate bill and the package of changes passed through reconciliation.
Some Democratic sources warn, however, that using reconciliation is complicated and fraught with legislative hurdles, raising questions about whether it could happen even if enough congressional Democrats supported the move.
Other Democrats in tough re-election fights worry voters will see such a move as legislative gimmickry, reinforcing complaints that Democratic control of Washington has been business as usual.
In the State of the Union speech, Obama acknowledged the health care issue has sown political division.
"This is a complex issue, and the longer it was debated, the more skeptical people became," Obama said. "I take my share of the blame for not explaining it more clearly to the American people. And I know that with all the lobbying and horse-trading, this process left most Americans wondering what's in it for them."
On Thursday, Reid, D-Nevada, linked health care reform to helping the U.S. economy recover fully from the recession.
"Health care reform is truly economic reform," he said.
–CNN's Dana Bash, Deirdre Walsh and Tom Cohen contributed to this report
These two dummies just don't get it, we don't want the crappy bill congress has come up with, start over and do it right with no paybacks to the unions and no vote buying this time.
If you don't pass it ,I will not support another Dem in my life..That
would be Bob Casey in Pa. !!!
America should not be the last major society to get Universal Health Care, but we are.
Our House and Senate Representatives are not representing us, or we would have had it decades ago. THEY have Comprehensive health care and WE UNDERWRITE IT! Congress, who gets BILLIONS from special interests represents THEM, against our better interests.
NOT JUST DEMOCRATS, NOT JUST REPUBLICANS, THEY ALL STINK!!!
Stupid Dems can't get anything done without a super majority? Spineless, weak, self-serving ego maniacs.
"Democratic hopes to get a bill to Obama's desk by now were derailed by the GOP's upset win in last week's special election to fill Ted Kennedy's Massachusetts Senate seat."
No, it was the Democrats who held out so they could get nice kickbaks that derailed this legislation... this could have been done a long time ago given the vast majorities the Dems had in both houses. The GOP was powerless to do anything about this getting passed...
pass health care reform but listen to the american people are saying and what they want, otherwise come nov 2010 out the door you go.
Harry & Nancy are two old progressive Hippies who would love nothing more than to tax you to death.
I have to ask, who is the President?
I thought the country elected Obama?
But it appears Harry and Nancy have thier own agenda. What part of, " we do not want it " dont they understand? What part of " we would rather have lower unemployment " dont they understand?
Obama needs to take these two out behind the wood shed and knock some sense into them. Health Care may be important, but NOT this crap Pelosi and Ried are trying to sell. Snake oil is what it is. The majority of the polls say the citizens of this country do NOT want this particular bill. So again, Obama, smack some sense into these two. BE A LEADER. Not just the community organizer many accuse you of being.
What a joke still trying to push a Health Care that doesn't make any.
That's the way, uhh huh, we like it, uhh huh, uhh huh. Just keep trying to do what is best for Americans, and let the slime from the GOP say, "No!" Americans will wake up to the obstructionists.
No matter what approach is used going forward, it should be aired on C-Span. And it should include Republicans in the process so the people can see and hear what the Democrats and Republicans have to say and offer and can see who is cutting deals.
They just don't "get it" and never will. They are so much smarter and know so much better what is good for the American people. Let them keep on beating this government takeover of America's healthcare drum and we'll be rid of a bunch of partisan politicians that put party and SELF ahead of America's best interests.
These 2 idiots couldn't order from a menu. Can you say term limits? Vote tem out.
Maybe Nancy will choke on her dentures.
President Obama had better become "Dr. Immodium" because that is what is necessary to stop the "oral diarrhea" of the lunatic right wing nuts.
I want New York State to get the same Medicare/Medicaid deal as Nebraska.
You bet – full speed ahead!
Well they have alreay bribed Landreu and Nelson...who else are they going to bribe.
Funny thing though, the smart dems want nothing to do with passing this toxic bill.
President Obama still doesn't get it. The problem is not that he did not explain health care more clearly to the American people. The problem is that he is not listening to us. We heard the explanation, we heard about the proposed plan and how it was arrived at, and we don't like it. We don't like the substance, the cost nor the process by which this plan was developed. Quit campaigning against President Bush, start listening to the American voters and keep the promises you made for a bi-partisan, transparent legislative process.
Reid and Pelosi. These were terrible choices if the President and his party wanted bipartisanship. They're both arrogant and not well respected by the public. Too bad....
If anyone out there has seen Dumb and Dumber; this must be the second of the series. All I want to know who is on the front of the mini-bike? Hopefully they will be voted out of office before this abomination takes to law.
Everyone agrees that Health care needs to be addressed. People want affordable Health care. But it's the way this administration has been going about it! It's the way they are approaching certain issues. That's the only problem people have with the reform they are pushing for.
I really think the cost of heath care needs to be addressed first: Everything from pharmacy prices to hospital stays need to be more reasonable. Then go after the insurance companies. This administration acts like they don't care about paying the high prices to the doctors, or the hospitals, or pharmacy. But they are more than willing to pay it out of our pockets, and take to insurance.