Whatever the difficulties, she predicted legislation would pass that will transform the nation's health care system, extending coverage to millions who lack it while slowing the growth in costs generally. "It is really historic. It's transformation. It's momentous," she told reporters at a news conference.
For now, it was also messy.
Two House committees approved their portions of the bill on party-line votes in marathon sessions, one shortly after midnight, the other after an all-night session than ran 20 hours.
Republicans sought unsuccessfully in both the Ways and Means Committee and the Education and Labor panel to strip out key portions of the bill, including a new tax on the wealthy and a requirement for the government to sell insurance in competition with private companies.
That left one more panel, the Energy and Commerce Committee, to take action, and there, renegade Democrats were seeking greater cost cutting as well as other changes before providing the votes necessary to send the legislation to the floor for a vote by the full House.
The White House stepped in, as well.
One day after the director of the non-partisan Congressional Budget Office said the legislation did little or nothing to slow the rate of increase in costs, the Obama administration responded by calling for additional steps to ensure the bill "rewards quality, restrains unnecessary costs and provides better care to more Americans."
Legislation is already pending in the Senate to reduce the control individual lawmakers and Congress as a whole has over setting the rates doctors and other providers are paid under Medicare. In a letter to Democratic leaders, White House Budget Director Peter Orszag forwarded an alternative proposal that he said would accomplish the same goal.
"We're very proud of the savings (already in the legislation)" the speaker told reporters, although she added, "Of course, we want more."
Obama asked Congress months ago to approve legislation helping millions of uninsured Americans receive health care, as well as hold down the growth of spending in medicine.
Any legislation that emerges is expected to require insurance companies to issue policies to anyone who seeks coverage, without turning them down or charging higher premiums on the basis of pre-existing medical conditions.
To spread insurance more widely, both the House bill and companion proposals in the Senate would rely on hundreds of billions of dollars in federal subsidies to assist lower income families. The House bill also calls for the government to sell insurance in competition with private industry, a provision that Republicans in particular oppose strongly.
While Pelosi has long said the House will vote on legislation by the time lawmakers leave on vacation at the end of July, she hedged for the first time at the news conference.
"We have to see what the Senate will do," she said, before suggesting that changing the bill to produce more savings might require additional time.
For now, she emphasized, "we are on our schedule to bring up legislation before the break and we continue to be on that schedule."
She spoke not long after six senators, three Democrats, one independent and two Republicans, announced their opposition to "timelines which prevent us from achieving the best result."
"... We believe that taking additional time to achieve a bipartisan result is critical," they said in a letter to the Senate leaders of both parties.
The letter was signed by Democratic Sens. Ben Nelson of Nebraska; Ron Wyden of Oregon and Mary Landrieu of Louisiana; as well as Maine Republican Sens. Susan Collins and Olympia Snowe and independent Sen. Joe Lieberman of Connecticut.
Snowe has been deeply involved in talks in recent days aimed at drafting bipartisan legislation.
Those talks have been led by Sen. Max Baucus, D-Mont., the chairman of the Senate Finance Committee, but they recessed on Thursday for the weekend without any indication that an agreement is at hand.
Reid, like Pelosi, has said he wants legislation on the Senate floor before lawmakers go home for the summer.
So, too, Obama, who told Baucus at the White House recently he wanted a bill by the end of the week - a deadline that went unmet.
