House Speaker Nancy Pelosi on the Health Care Bill

Diane Sawyer talks with Nancy Pelosi about the biggest victory of her career.

March 22, 2010— -- Following is a transcript of Diane Sawyer's interview this afternoon with Speaker of the House Nancy Pelosi. The interview took place following Sunday night's passage of the health care reform bill.

DIANE SAWYER: Have you been asleep tonight? Last night?

NANCY PELOSI: (LAUGH) A little bit. Not enough -- on top of all of the -- excitement, I had the joy of having my little grandchildren with me at the -- apartment. And so -- I didn't want to miss any time with them early this morning.

DIANE SAWYER: So, this was (unintelligible) President Obama called you, the two of you talked in here last night. What did you say to each other? What was the -- what were the words you used?

NANCY PELOSI: I have to think back on that. But -- it was pretty exciting for both of us. Many presidents since Teddy Roosevelt have tried to pass health care reform for Americans. And many Speakers of the House have tried to do it, as well. And -- last night, we had that level of success. I told him -- that I was certain that it would not have happened without his vision, without his commitment, his unwavering commitment -- to making comprehensive health care -- health insurance reform the law of the land. Not only by his eloquence, but also by his -- speaking to Members to convince them that we were here to get this done. And not just have the House a bill and see what happens after that.

DIANE SAWYER: What was the moment in the last 48 hours you were most worried?

NANCY PELOSI: I've always believed that we would pass the legislation.

DIANE SAWYER: Never a waver? Never a doubt? Never a second?

NANCY PELOSI: No. I always believed in my -- my Members, in my colleagues. They know -- they've come here as public servants. And they know that this was an historic opportunity. And some of them had to take more time to -- see what -- what it meant for their districts and the rest. We have a very diverse caucus. And -- that's the beauty of it. And -- and --


NANCY PELOSI: --and its strength.

DIANE SAWYER: And the moment you knew you had it, the moment you knew for certain you had it?

NANCY PELOSI: Well, I always believed we would. But -- I knew by the time we went to the floor -- that we were ready. And that we would make history. And we would make progress for the American People. And we would hold insurance companies accountable.

DIANE SAWYER: Did you allow yourself a moment of --


DIANE SAWYER: A moment to commemorate it? Anything personal you did?

NANCY PELOSI: Well, I prayed over it at church on Sunday morning. And thought about how fortunate I was to be in this position. And actually how fortunate each of my colleagues was -- each of them were to be in this position. So, it was -- we feel very blessed. Our colleague John Lewis said it better than anyone. He said, "We may not have chosen the time, but the time has chosen us." And we are here now to be -- along with the Congresses that -- enacted Social Security, Medicare, Civil Rights Act, health care for all Americans. All of that on a par.

DIANE SAWYER: But as you know, the Republicans have been saying -- you had 65 Republicans votes weigh in on Medicare. You had 77 Republican votes on Social Security. Those were bipartisan bills. And the Republicans were out in force already this morning, Senator McCain said, "Here it comes. We're going to waste no time. We're going to fight this every step of the way, including in the Senate."

NANCY PELOSI: Just a little -- I've been doing some research on Medicare. And people who were involved in that legislation had sent me some of the records, some of the voting sheets and the rest, at the time. The fact is, is that this is more inside baseball. But the fact is the crucial vote on Medicare was a vote -- a motion to recommit. That is the vote right before the final vote. And that was the vote that would have gutted the essence of Medicare from the bill. And maybe a dozen or just a few more Republicans voted against the motion. So, this idea of what happened on final passage is not quite the story. What happened on the critical moment, the motion to recommit for us is where the Republicans can put forth their proposal. They did -- at -- at Medicare and most of them voted against Medicare on that vote. Similar last night -- on their motion to recommit, which is our biggest dread. Is what would the motion to recommit be and how can it take down this bill? We were successful in defeating it. But let the history books show that -- all that bipartisanship around Medicare -- it -- it emerged after the really decisive vote.

Nancy Pelosi on the Health Care Bill

DIANE SAWYER: As you know, there was such vitriol around the capital. And also inside the room last night. We heard people saying, "This is Nancy Pelosi's one-party rule." We heard -- on the floor of the House, we heard Boehner -- we heard the Minority Leader Boehner say, "Shame on you. Shame."

NANCY PELOSI: Well, you know, some people will do anything for the insurance companies. And -- I think a good deal of -- there's some obvious feeling in the country -- that they are opposed to what the government -- increased government role in health insurance, in regulating the insurance companies. And some of that is legitimate. Some of it has been hijacked by the insurance companies, because they love the turf they've been on. The American People have been on the turf of the insurance company. Last night, the leverage changed. Now the insurance company will be on -- on -- the side of the --

DIANE SAWYER: Do you think (unintelligible) the Minority Leader's motive?


DIANE SAWYER: Was that John --


DIANE SAWYER: His entire motive?

NANCY PELOSI: Well, I think his motive is that there will not be an expansion of health care for all Americans with a government involvement in regulating the insurance companies. But you have to ask him about his mot -- I really don't question people's motivation. I just comment on their actions. And what President Obama has done in all of this, with his summit a few weeks ago, is to make the -- that distinction. Main difference between the Democrats and the Republicans is we want to regulate the insurance companies, the Republicans do not. We want to end discrimin -- denial of -- of coverage on the basis of preexisting conditions. We want to stop them from -- cutting off coverage because a person's become sick or rescinding coverage as they're on their way to the operating room. We want to have -- being a woman not be a preexisting medical condition. That and many other of these concerns -- are what the insurance companies want to maintain. We want to change that. And that's the main difference between the Democrats and the Republicans.

DIANE SAWYER: The two big challenges imminently, first one, what if the Senate comes back and -- and alters the Medicare adjustments that you've made? Medicare cuts that you have made and certain provisions of it? And they have said they're going to do that. Will you -- will the House vote again?

NANCY PELOSI: Well, let's say --

DIANE SAWYER: Will you win (?) it?

NANCY PELOSI: One of the reasons we did not want that infamous motion to recommit to prevail is it would have gutted the bill. But it would have also upset -- the agreement that we had that this bill will phase $1.3 trillion for the taxpayer. That it will insure 32 million Americans. And that it will hold the insurance companies accountable. So, I believe that whatever the Senate sends us -- that will -- however they pass this bill, I don't see how they get 60 votes to change any of those things. But -- again -- we're confident as we go forward that we're ready to take the vote. Confident that they would pass the vote.

DIANE SAWYER: Another challenge ahead. Thirty-four states now are looking at provisions or in the State of Virginia, Wednesday, the Governor's going to sign it, saying that it is unconstitutional to --

NANCY PELOSI: Right, again.

DIANE SAWYER: --to have a fine for not getting insurance. That the Federal Government cannot impose that on the States.

NANCY PELOSI: Well, we feel confident about what is in the bill. And we know that there is, again, a philosophical difference. The same people who opposed Medicare, because it was an increased government roll in health care in America are opposing this. And this is quite different. This is very private sector oriented. Medicare is private sector, this is more private sector oriented. So, those same people who do not believe in a government role will -- come forward. But we believe that what is in our bill -- is the right path to go. That we're confident about it. And you always get -- those who want to stop the bill to take this course of action.

DIANE SAWYER: Not worried about constitutional challenges?

NANCY PELOSI: No. We feel -- obviously, that's something that we -- look into as we're putting the bill together. But it -- that is also why -- we're very -- we're very precise in our language. So the intent of Congress is clear. And that is why -- the statements and comments and executive orders, whatever, of the President on how the bill will be implemented are very important. But it always is the case. The Congress legislates -- the White House -- the Executive Branch enforces, and the -- the Supreme -- the Judiciary interprets. We feel very confident about our legislation.

Nancy Pelosi on the Health Care Bill

DIANE SAWYER: One more question about cost. As you know, there's great anxiety in the country about the potential cost of this bill. And somebody -- a critic labeled it fiscal Frankenstein. We went back and looked at a 1967 projected the cost by 1990 of Medicare was $12 billion. What really happened is it was $107 billion. Which is more than eight times what they projected it would cost. What guarantee is there to the American people that this won't similarly balloon out of control?

NANCY PELOSI: Well, I'm so pleased that you're asking me about cost, because the cost of -- health care in America, both in delivery of service and insurance to families is unsustainable. It's unsustainable to family budgets. It's unsustainable to federal budgets. And one of the important things that we had to do from the standpoint of the federal government was we -- to cut those kinds of expenses in Medicare. Waste, fraud, and abuse that have contributed to the rising cost of Medicare. There is no cut in this bill to benefits for seniors or any of -- ri -- rising of -- raising of premiums in the legislation. So, to -- to be clear, that's why A.A.R.P. has said we have made this solvent for today's seniors and future generations by the necessary cuts in waste, fraud, and abuse. The upward spiral of -- rising medical cost can drive our country bankrupt unless we take this action now. The -- the simple fact is this. This legislation will save the taxpayer $1.3 trillion over the life of the bill, and the ten years after.

DIANE SAWYER: But they didn't think Medicare --

NANCY PELOSI: That is why we had to do the --

DIANE SAWYER: --would balloon out of control, and it did.

NANCY PELOSI: But we're talking about a different -- we're addressing some of the ballooning controls of Medicare and taking those down. But that is why -- the -- those that oppose the bill go out and say -- use fear tactics for seniors and say that -- they're going to cut your Medicare. No, we're not going to cut their Medicare. We're going to cut waste, fraud, abuse and excessive payments to the insurance companies, which have contributed to the ballooning costs in Medicare. We'll be spending a good deal of time on this, because we have to dispel the misrepresentations that are out there. So, the cost to a family and an individual, the cost to a business, small businesses having their insurance policies increase, the costs to our federal budget -- family budget, federal budget require that we pass this legislation with those savings for individuals, for businesses, for the federal budget. And for our economy to be much more competitive, because we don't have this anvil of cost around our businesses. They can compete internationally much better. And individuals are free. Now, they can start a business, they could change jobs, they could be self-employed without worrying about not having health insurance, because it is now affordable, accessible, and with reforms of the insurance companies -- that make it better for them.

DIANE SAWYER: A couple of questions about what it took to get this done. We read today that you blocked the incremental approach that some in the White House were proposing. In fact, calling it kiddie care. And said -- saying, "Let's go for it. Let's go for it." And in fact -- I think it was -- it was Congresswoman Eschew (PH) who said, "You put the steel into the President's spine."

NANCY PELOSI: Now, that's good to hear. I mean, mi -- with all due respect. (LAUGH) With all due respect to Congresswoman Eschew, and she's like a sister to me -- the President has been unwavering in his commitment to comprehensive health care reform. Unwavering. And that's one of the reasons that he could be so persuasive with Members. Because they saw his commitment, his vision, his knowledge of these issues, his strategy to get it done, and get it -- get it -- not only passed -- but make it work for the American People.

DIANE SAWYER: But I know you say you knew you would do it. You believed you would do it. At the end of the day, how hard was it, looking back, how hard?

NANCY PELOSI: Well, as Speaker, let me say this, every bill is a heavy lift. It's all very difficult. Because we have a very diverse caucus. You strive for bipartisanship -- when you can -- when you find your common ground, that's great. If you don't find your common ground, you have to stand your ground. And in addition to that, you want bipartisanship, but you cannot let the lack of bipartisanship stand in the way of making this change that is important to the American People. So, every bill that I take up here is, again, a heavy lift. By and large -- I mean, on this substant -- big bills. This bill was almost easier for me, for two reasons. One, everybody was in it. You know, some bills -- you're -- it's supposed to look easy, but it's really hard. This one, everybody knew it was difficult. There was a tremendous amount of interest in it. And I loved doing it. Universal access to health care for all Americans. Saving $1.2 trillion for the American People. 32 million people insured. Children, young adults, seniors, women, small businesses, our economy all bene -- benefiting from it. It was fun every day.

Nancy Pelosi on the Health Care Bill

DIANE SAWYER: Did you say to yourself this morning, "This was historic. This is the morning after the night we made history"?

NANCY PELOSI: I did. But I've been saying that for awhile, because I've been thinking, "I know -- for some reason this does not succeed, I will take that responsibility. But if it -- but if it passes, there will be many, many people responsible." And the President of the United States first among them, but my leadership team, Steny Hoyer (PH), Jim Cyland (PH), the whole leadership team. The Members, each individual one, was such a bonding around their duty to public service and to make this happen.

DIANE SAWYER: Pretty amazing things being said. The Economist said that you are arguably the most powerful woman in American history. A Brown University professor has said you are certainly the most powerful Speaker in 100 years.

NANCY PELOSI: That sounds good. (LAUGH) I don't -- I don't take it personally, except I take it as a compliment for all women. Because as the first woman Speaker, I certainly wanted to demonstrate that we could get a job done that has eluded others for -- for a century. But -- it -- it's -- it's exciting, because again -- my sisters here in the Congress, this was a big issue for us, because women know as caregivers, as mothers and the rest, how important this is.

DIANE SAWYER: And when the Republicans say they can run against you in November and this will be their ticket to win.

NANCY PELOSI: They've been saying that -- they said it in '06. They said it in '08. And we believe that when we can clear the fog of the misrepresentations that have been made about this legislation, largely instigated by the insurance companies to keep them reaping obscene benefits -- profits at the expense of the American People -- that -- we will -- we will do justice behind it.

DIANE SAWYER: And when you say, "I'll take the hits. Let 'em come at me." You mean it?

NANCY PELOSI: I'm in the arena. You become Speaker of the House, you're in the arena. You are the target. And -- you have to -- shall we say -- almost enjoy that.

DIANE SAWYER: One question. What do you think your dad and your mom would have said about this moment?

NANCY PELOSI: Well, my brother called me, my brother Tommy, he was Mayor of Baltimore, too. Thomas D'Alessandro. And he -- he was just so thrilled at what Mommy and Daddy would think about this. Of course, I believe that they do know. That they do know. But it's not only them, it's all of the people -- all the people who -- supported my colleagues here. All the people who pinned their hopes on the instinct for public service that so many of us had here. That we would be able to find a way to work together, to find comm -- our own common ground to move this forward. Realizing it wouldn't be easy. And realizing that -- as that -- that we had to get the job done. I -- I saw one article that said it took some luck. And -- certainly luck is useful, but I believe you make your own luck through hard work and through prayer. And you have to be ready -- when luck comes your way.

Nancy Pelosi on the Health Care Bill

DIANE SAWYER: Did your dad have -- a phrase a (unintelligible) that meant the most to you when he'd say it to you? Or your mom?

NANCY PELOSI: Well -- the only thing that comes to my mind right now is, "Make sure you have the votes." (LAUGH)

DIANE SAWYER: Not so sentimental. But nonetheless. (LAUGH)

NANCY PELOSI: (unintelligible) we're very pragmatic. When it comes right down to it. You may have a great vision, you may have the best idea, but you have got to -- you must have the votes.

DIANE SAWYER: Make sure you have them. Speaker Pelosi, thank you.

NANCY PELOSI: Thank you, my pleasure. Thank you.

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