"We will pass healthcare reform," Pelosi said confidently to reporters after meeting this morning with the president.
But there are still twists and turns that Democratic leadership and proponents of the bill could face this evening.
Just last night, Democratic leadership gave up on efforts to work out a compromise between Democrats who support abortion rights, those who do not and the U.S. Conference of Catholic Bishops. The original abortion language required that the exchange have at least one plan that covered abortion and one that did not. It would have required all insurance companies in the exchange to put federal funds and private premiums in separate accounts to make sure abortions were only paid for with private funds. Opponents of abortion rights called that simply a line on the ledger.
Between Democrats and Republicans in the House who are opponents of abortion rights, the Stupak amendment could very well pass tonight. The speaker put 190 members of the Pro-Choice Caucus in the awkward position of wanting a health care reform bill, but not wanting to support that abortion language either.
The big question now is will Democrats who are supporters of abortion rights hold their noses?
Rep. Janet Schakowsky (D-Ill.), a supporter of allowing abortions to be covered in the exchange, said she will vote for the bill despite the Stupak amendment. But she is making it clear to Democratic leadership that she will not be so forgiving in the next round. She says if the bill comes out of conference with the Stupak language still in the bill, she will vote no. Other members of the Caucus indicated they would do the same, but some could still peel off if the Stupak amendment passes.
Another big question? What will be in the Republican's Motion to Recommit? The motion is usually the minority's one shot to either kill the bill or amend it. And in this House, where Democrats outnumber Republicans 258 to 177, the motions, otherwise known as MTRs, usually fail.
Republicans will get two opportunities to change the bill. They will get one hour of debate on a Republican substitute, which is expected to fail, and then their usual MTR. GOP aides say no one will see the language until it is introduced on the floor, but there is buzz from members of the Congressional Hispanic Caucus that Republicans might put language in the MTR that would bar illegal immigrants from purchasing health insurance in the new health insurance exchange -- even if, as the bill currently reads, they pay for coverage with their own money and are not eligible for any federal subsidies.
Rep. Luis Gutierrez (D-Ill.) fears that language might attract enough Democratic support for it to actually pass. He says 20 members of the Congressional Hispanic Caucus would vote against the final bill if Republicans succeed in making immigration language more restrictive. Most, if not all, of those members are votes that leadership is counting on to pass the bill.
Rep. Charlie Gonzalez (D-Texas) indicated he would not vote for the final bill if any more immigration language is added. He said it's "bad policy and counter-productive." He said the exchange should be able to provide coverage to anyone who can pay for it.
About two-dozen Democrats, a mix of freshman, fiscal conservatives and even 3 committee chairman, have said they will not vote for the bill. Add Gutierrez's 20 to that two-dozen and the legislation fails.
Of course, it's also possible that Republicans will include language on immigration and other measures, like medical liability reform, that might help Democrats explain their vote against the measure.
If Pelosi succeeds in keeping her caucus together tonight to pass health care reform, despite the different and conflicting factions in her caucus, there will be plenty of talk from proponents about history being made. But it's important to remember though that this is still far from Mr. Obama's desk.
The Senate is struggling just to put together its bill and get the sixty votes needed to bring it to the floor and to prevent a filibuster. Then, the two Houses will have to work out differences and pass bills all over again.