Pelosi, D-Calif., made the comment to reporters after House Democrats held a closed-door meeting at which participants vented frustration with the Senate's massive version of the legislation.
Her concession meant there was little hope for a White House-backed plan to quickly push the Senate-approved health bill through the House, followed by a separate measure making changes sought by House members, such as easing the Senate's tax on higher-cost health plans. Such an approach would be "problematic," she said, though Democrats haven't completely ruled out pursuing it.
"In its present form without any changes I don't think it's possible to pass the Senate bill in the House," Pelosi said, adding, "I don't see the votes for it at this time."
Pelosi also signaled that advancing health legislation through Congress will likely be a lengthy process - despite Democrats' desire for a quick election-year pivot to address jobs and the economy, which polls show are the public's top concern.
"We're not in a big rush" on health care, Pelosi said. "Pause, reflect."
Two days after the stunning special election in Massachusetts - where Republicans captured the Senate seat held for decades by the late Edward Kennedy - many House Democrats said one lesson was that the public wanted a more modest approach to overhauling the health care system. Several said Democrats should refocus the legislation onto popular proposals like barring insurance companies from denying coverage to sick people.
"The mega bills are dead," said Rep. Michael Arcuri, D-N.Y. "If we didn't see what happened Tuesday night, we have blinkers on."
Rep. Jose Serrano, D-N.Y., said that ideally, Democrats would like to address a whole range of problems, including giving more people coverage, helping them pay for it and curbing the growth of medical costs.
"We're obviously finding out we don't have an ideal world, so why not deal with that which we can get done," Serrano said.
By all accounts, Democrats have made no final decision on their options, which included breaking the health legislation into several smaller bills. But with Republican Scott Brown's Massachusetts victory denying Democrats the 60 Senate votes they need to kill Republican delaying tactics, Obama and others were talking about legislation that would attract broad support.
"I would advise that we try to move quickly to coalesce around those elements of the package that people agree on," Obama said Tuesday in an interview with ABC News.
"We know that we need insurance reform, that the health insurance companies are taking advantage of people. 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. And we know that small businesses are going to need help," he said.
In a bid for GOP support, participants suggested other elements that could be added. These included allowing insurance companies to sell policies across state lines, according to Rep. Timothy Walz, D-Minn.
Sen. John McCain rejected the idea of a slimmed-down version of the current legislation. "We are more than happy to sit down and start over," the Arizona Republican said Thursday on CBS' "Early Show." "Not scale back, but start over in a true negotiating process, rather than the Democrats going back to try to pick off one or two Republicans."
Nearly as shaken by the Massachusetts vote were health care provider groups that have supported the Democratic effort, such as drug makers, hospitals and doctors.
While few were making public statements, industry groups that stood to gain millions of newly insured customers were worried that such potential gains were in jeopardy, according to lobbyists speaking on condition of anonymity to describe confidential conversations.
Industry groups also were worried that without a health care bill, some of the savings several of them had agreed to contribute - such as lower Medicare reimbursements - might be used for separate congressional efforts this year to reduce the soaring deficit.
Underscoring their sense that the Massachusetts vote put them atop a political wave, Republicans were e-mailing fundraising solicitations on Wednesday to supporters.
"Democrats nationwide should be on notice: Voters are looking for checks-and-balances, and they are prepared to hold the party in power responsible for their reckless spending and out-of-touch agenda in Washington," wrote Sen. John Cornyn, R-Texas, who heads the Senate GOP's campaign arm.
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Associated Press writers Ricardo Alonso-Zaldivar, Erica Werner and Ann Sanner contributed to this report.
