On the heels of Saturday's vote, Pelosi is back home pushing the legislation forward, even as questions arise about whether the entire package will pass and how much it will accomplish.
It was a very friendly crowd at the federal building and when asked about a provision in the bill that has split in her party over the provision to ban abortion coverage, Nancy Pelosi called it a temporary distraction.
"Beware of any of these kinds of issues because the fact is they want to take your attention away," said Pelosi.
Pelosi said heated protests focusing on inflammatory issues are keeping Americans from hearing what the legislation will do for them.
However, on KGO Radio Tuesday morning, the president of the Committee for Economic Development -- an independent, non-profit, non-partisan, public policy organization -- told Ron Owens that the bills in the House and the Senate would bankrupt the country.
"The system right now rewards volume it rewards people for doing more services more tests more medication," says Charles Kolb, the president of Committee for Economic Development.
That said Kolb is a recipe for rising costs.
"We want a system in this country that rewards value and actually focuses on the health of the patient," said Kolb.
Pelosi's answer was "I completely agree. The fee for service is an obstacle to getting everything that we want." But she added there are provisions in the bill that will move towards rewarding quality instead of quantity. "Well, community health centers are a big example of not having fee for service."
Pelosi pointed to Dr. Ricardo Alvarez, M.D., medical director of San Francisco's Mission Neighborhood Health Center, who says his health center does focus on outcomes.
"I'd like to tell you that we do it purely because we have absolute clarity in the rationality of our interventions," said Alvarez.
Still, the truth is community health centers have fewer resources which has forced limits on what they can offer, but he says in other countries' doctors order fewer tests, health care costs less, and yet the patients aren't less healthy.
"You know we don't need to do, we don't need to be that aggressive the evidence isn't that compelling," said Alvarez.
Pelosi says there are provisions in the bill that will bend the system towards quality of care rather than quantity and it is also not the end all for healthcare reform.
"Don't get the idea that in passing this bill, we're taking a key and locking the capitol, and never passing another bill," said Pelosi.
At the free market advocacy group, the Pacific Research Center, the director of health care studies told ABC7 Americans don't want government deciding on what tests and what procedures will be available.
Supporters of the bill say it will be doctors, not the government bureaucrats making those decisions and letting the insurance companies decide what we've got now.