The Democrats' battle plan is called reconciliation. It is a parliamentary maneuver that could allow the Senate and the House to agree on the particulars and pass the health care bill without Republican support.
The reconciliation rule was adopted in 1974 under the Nixon administration. It allows the Senate to pass budget items with just a 51 vote majority rather than the 60 votes, usually required to end debate.
"The bill that ended welfare as we know it, so to speak and ended AFDC as an entitlement was passed through reconciliation," says UC Berkeley professor Eric Schickler.
A leading authority on the Senate rule tells ABC7 over the years Republicans have used it to great effect.
"President Bush's two major tax cuts passed through reconciliation, 2001 and 2003," says Schickler.
The first president to use it was Ronald Reagan. Former Speaker of the House Newt Gingrich, R-Georgia, used it to pass portions of his Contract With America.
However, now Democratic leaders hope to use it. Here is the strategy: the Senate has already passed a version of the health care bill. If Pelosi can get the House to pass the same version, then the president will sign it and it will be law.
She needs 217 votes to make it happen, but Democrats in the House do not like some of the Senate's provisions, so Pelosi and the president and Harry Reid, D-Nevada, will craft a second much smaller bill to amend the Senate version and they will attempt to pass that fix though the Senate with just 51 votes under reconciliation.
"I'd say it's pretty close to 50/50 as to whether they can do it. Maybe slightly less than 50/50 because they are just so many things that could go wrong," says Schickler.
"In order to really pull these votes together, I think there is going to be some really serious arm twisting going on," says ABC7's political analyst Bruce Cain.
Cain in Washington D.C. says there is very little being said about this on Capitol Hill because this kind of arm twisting you do not do in public.
"I imagine they're going to have to present to the blue dogs, the wavering centrists, the following choice: you can take an unpopular vote and get money or you can buck us on this and you're not going to get money," says Cain.
The money professor Cain is talking about is the mother's milk of politics -- large campaign contributions. The party can give those large campaign contributions to the candidates it supports and it is a very powerful weapon.
ABC7 called Pelosi's office on Friday to ask how close she is to the 217 votes. The statement came back: "We are focused on policy right now, then later we will focus on the votes."