House Speaker Nancy Pelosi told reporters today (Jan. 21) that she does not “see the votes” in her chamber of Congress to pass the Senate’s comprehensive health reform bill without changes.

Nancy Pelosi

Pelosi, according to the Washington Post, said House Democrats were opposed to several provisions in the Senate’s bill, including one that grants Nebraska a lone Medicaid exemption and a tax plan for “Cadillac” health plans.

“There are certain things the members simply cannot support,” she said, according to the report.

The Post reports that moderate Democrats have raised doubts about forging ahead with health care reform without bipartisan support, while liberals are rejecting the Senate bill as not going far enough.

The struggle comes after Scott Brown’s Jan. 19 victory in a Massachusetts special election to fill the Senate seat of the late Edward Kennedy. That victory eliminated a filibuster-proof Senate and has been seen by many as a statement by the American public on health care reform efforts in Washington, D.C.

Meanwhile, President Barack Obama told ABC News on Jan. 20, that rather than reconcile their differences, the House and the Senate may want to start over on comprehensive health reform by enacting smaller changes, such as insurance reform and cost containment.

White House Press Secretary Robert Gibbs said the Obama Administration is “working through the best way forward as the president continues his commitment to get health care reform done.”