House Speaker Nancy Pelosi urged her colleagues to back a major overhaul of U.S. health care even if it threatens their political careers, a call to arms that underscores the issue's massive role in this election year.
Lawmakers sometimes must enact policies that, even if unpopular at the moment, will help the public, Pelosi said in an interview being broadcast Sunday the ABC News program "This Week."
"We're not here just to self-perpetuate our service in Congress," she said. "We're here to do the job for the American people."
It took courage for Congress to pass Social Security and Medicare, which eventually became highly popular, she said, "and many of the same forces that were at work decades ago are at work again against this bill."
It's unclear whether Pelosi's remarks will embolden or chill dozens of moderate House Democrats who face withering criticisms of the health care proposal in visits with constituents and in national polls. Republican lawmaker unanimously oppose the health care proposals, and many GOP strategists believe voters will turn against Democrats in the November elections.
Pelosi, from San Francisco, is more liberal than scores of her Democratic colleagues. But she generally walks a careful line between urging them to back left-of-center policies and giving them a green light to buck party leaders to improve their re-election hopes.
Her comments to ABC, in the interview released Sunday, seemed to acknowledge the widely held view that Democrats will lose House seats this fall -- maybe a lot. They now control the chamber 255 to 178, with two vacancies. Pelosi stopped well short of suggesting Democrats could lose their majority, but she called on members of her party to make a bold move on health care with no prospects of GOP help.
"Time is up," she said. "We really have to go forth."
Her comments somewhat echoed those of President Obama, who said at the end of last week's bipartisan health care summit that Congress should act on the issue and let voters render their verdicts. "That's what elections are for," he said.
The White House says Obama, perhaps on Wednesday, will announce a "way forward" on health care. He, Pelosi, and Senate Democratic leaders have left little doubt that they hope to pass a Democratic-crafted bill under "budget reconciliation" rules that would bar Republican filibusters in the Senate. It's unclear whether Pelosi can muster the needed votes in the House.
White House officials say they will redouble efforts to remind voters that the Senate passed an Obama-backed health care bill in December, with a super majority of 60 votes. The new plan calls for the House to pass that bill and send it to Obama's desk, and then use Senate budget reconciliation rules to make several changes demanded by House Democrats.
Following a Republican victory in Massachusetts last month, Democrats now control 59 of the Senate's 100 seats, one vote short of the number needed to block GOP filibusters.
Pelosi told CNN that "in a matter of days" Democrats will have specific legislative language on health care to show to the public and to wavering lawmakers. She predicted voters will warm up to the bill once they understand its details.
"When we have a bill," she said, "you can bake the pie, you can sell the pie. But you have to have a pie to sell."
Obama and Democratic lawmakers say they may add several more Republican ideas to their legislative package, even if it's unlikely to attract a single GOP vote. One idea, by Sen. Tom Coburn, R-Okla., would focus on battling waste and fraud in the medical system.
The main elements of the Democratic plan are known, and opposed by Republicans in Congress. It would insure about 30 million more Americans over 10 years with subsidies for the poor and a new requirement for nearly everyone to carry health insurance.
It would also bar some insurance company practices, such as denying coverage to people with medical problems. And it would establish government-run exchanges to help individuals and small businesses obtain insurance policies, although it would exclude the "public option" that many liberals wanted.