Facing a wall of Republican opposition, Democrats have said they may resort to a rarely used procedural tactic, known as reconciliation, to win approval on purely partisan votes.
President Barack Obama, who hosted a White House summit last week that produced no sign of bipartisan compromise, is to announce this week how he would like Democrats to proceed on a top legislative priority.
Our members, everyone of them, wants healthcare reform, House of Representatives Speaker Nancy Pelosi, a Democrat, told ABC's This Week program.
Everybody wants affordable healthcare for all Americans, Pelosi said. They know that this will take courage.
Surveys show Americans oppose the sweeping legislation pushed by Democrats during the past year. But polls also find that most Americans favor reform and believe costs need to be reduced and coverage expanded.
Republican Senator Lamar Alexander warned Democrats to expect voter backlash in November's congressional elections if they try to use reconciliation, which would enable them to win passage in the 100-member Senate with 51 votes rather than the 60 required to clear Republican roadblocks.
It would be a political kamikaze mission for the Democratic Party if they jam this through after the American people have been saying, 'Look, we're trying to tell you in every way we know how, in elections, in surveys, in town hall meetings, we don't want this bill,' Alexander told This Week.
We'd really like to get a bipartisan bill, said Senator Robert Menendez, chairman of the Democratic Senate campaign committee.
In the absence of that, the American people ... have said in the polls that they want to see (us) move forward on healthcare reform, Menendez told Fox News Sunday.
I believe we will pass healthcare reform this spring, he said.
Democrats in the Senate and House approved healthcare bills last year that would reshape the $2.5 trillion industry by cutting costs, regulating insurers and expanding coverage to tens of millions of Americans.
But efforts to merge the different measures and send a final version to Obama collapsed in January after Democrats lost their crucial 60th Senate vote in a special election in Massachusetts.
Obama has since offered specific ideas of his own that House and Senate Democrats will seek to fold into a somewhat revised bill that could win House and Senate passage, clearing the way for the president to sign it into law.
Democrats had hoped to avoid using reconciliation, but many now see it as the last viable means for passing an overhaul of healthcare.
Under this method, the House would approve the Senate-passed bill. Then changes to the Senate bill sought by the House would be passed through reconciliation.
Many of those provisions, such as changes to a tax on high-cost insurance plans and additional federal subsidies to make coverage more affordable, were incorporated in a proposal released by Obama last week.
House passage, however, is not assured. The House narrowly approved its healthcare bill last year, but a number of House Democrats have raised concerns about the Senate version, including its less restrictive language on abortion.
Pelosi said Senate Democratic leader Harry Reid will seek to determine what provisions can carry the Senate on a simple majority vote. They are to meet on Tuesday.
Each provision would be subject to parliamentary challenges to determine whether they meet the requirement that they be budget-related -- meaning changes to areas like federal funding for abortion would not be possible through the process.
House Democratic Leader Steny Hoyer, appearing on CBS' Face the Nation on Sunday, made it clear his party wants to move quickly.
I would think that within the next couple of weeks we're going to have a specific proposal and start counting votes to see whether or not those proposals could pass either the House or the Senate, Hoyer said.
When we start counting, the votes will be there, Representative Debbie Wasserman Schultz, a member of the Democratic leadership, told NBC's Meet the Press.
Earlier on the program, Nancy-Ann DeParle, director of the White House Office of Health Reform, said she also believes we will have the votes in Congress.
One Republican said he believes Pelosi doesn't yet have enough Democratic votes for passage in the House, but that she may get them.
I would not count her out because she is very good at muscling votes, Republican Representative Paul Ryan told Fox News Sunday. Ryan said she is very good at making deals.