Kim Strassel, in the Wall Street Journal, explains why even the decision to employ the reconciliation “nuclear option,” throwing the rules of the Senate out the window, does not actually guarantee that democrats can pass the health care bill. The focus of drama now moves over to the House.

The Summit Show was designed by Democrats for Democrats, to give Mr. Obama an all-day stage to inspire and exhort his party to charge once more into the health fray. It’s about “altering the political atmospherics,” admitted one senior Democrat. Yet for all the talk of “jump-start,” there’s little to suggest the ugly politics of passage have changed.

The day after Mr. Brown’s victory broke the majority’s power, Democrats turned to New Strategy, Version 37, Part 12. It is now House Speaker Nancy Pelosi’s job to pass the Senate’s Christmas Eve bill. It is Senate Majority Leader Harry Reid’s job to pass retroactive “fixes” to that legislation through an unsightly “reconciliation” process that requires only 51 Senate votes.

The strategy is somewhat bully for Mr. Reid, who can afford to lose eight of his own members. It’s meaningless for Mrs. Pelosi. If the speaker had the votes post-Brown to pass the Senate bill, we’d be living under ObamaCare. She didn’t have them then, and yesterday’s summit was a sideshow to the problems she has getting them now.

A few numbers: Mrs. Pelosi passed her health-care bill in early November, with three votes to spare. The one Republican yes has since bailed. On the Democratic side, one vote has left Congress, one has died, and one retires this week. A smaller Congress means Mrs. Pelosi only needs 216 votes. If all were equal to November, she’s at 216.

Only it isn’t November. It’s nearly March, and the speaker is being asked to pass a bill vastly different from her own, in the wake of a crushing electoral defeat and in light of dire public-opinion polls.

Mrs. Pelosi has at least 11 Democrats with big problems with the Senate’s flimsy language on publicly funded abortions. This is the same crew that nearly derailed her first bill, and whose threats at the time were serious enough to cause Mrs. Pelosi to throw over her liberals in favor of pro-life demands.

For many, this is a moral issue that can’t be changed with Cornhusker kickbacks or “atmospherics.” Rep. Bart Stupak, the Michigan Democrat who spearheaded the pro-life fight, has already declared the Senate bill “unacceptable.” And the Conference of Catholic Bishops has no intention of now giving these pro-life Democrats an out.

Another reality is Mrs. Pelosi’s many announced retirements. The conventional wisdom holds that some Blue Dogs who voted no the first time—say, Tennessee’s John Tanner—might now be willing to stick it to their constituents as their last act in Congress. Maybe.

Mrs. Pelosi is surely more worried about retiring members who voted yes and are convinced that vote hastened their departure. Arkansas Rep. Marion Berry used his retirement announcement to rip the White House for pushing Blue Dogs into an electoral abyss. House Democrats leaving to run for the Senate—including Indiana’s Brad Ellsworth or New Hampshire’s Paul Hodes—might be more interested in, say, winning those races than clinging to their prior yes votes.

Speaking of Indiana, Mr. Reid’s decision to go reconciliation adds to Mrs. Pelosi’s problems. If retiring Sen. Evan Bayh votes no on reconciliation, is Mr. Ellsworth—running for Mr. Bayh’s seat—going to vote yes? Democratic senators will claim to vote against reconciliation on technical grounds, but the public will view it as the disownment of the president’s agenda. The pressure on House Democrats from states with senators who vote no will be incalculable.

Don’t forget, too, the House members who have seen their district polls disintegrate since their first yes. No doubt they appreciated the president’s spirit yesterday. Yet unless the summit drives a 30-point shift in public opinion, they retain good reason to not repeat their mistake.

The trillion-dollar question is how many votes Mrs. Pelosi had in reserve the first time. Yet here, too, March is no November. These members are now on record in opposition. They have benefited back home from those no votes. Why flip now?

Mrs. Pelosi has been effective at marshalling votes, and nobody should write her off. Yet it says plenty that she is demanding that Mr. Reid go first. Something big must change for her to move her members. Mr. Reid knows even reconciliation is no sure thing and is demanding that Mrs. Pelosi be the one to go first.

The next few days will provide a better sense as to whether the sight of 40 Washington pols summiting over CBO estimates is a game changer. Don’t count on it. Talk is easy. Politics is hard.