When Democrats held a majority of the seats in the U.S. House of Representatives, and Rep. Nancy Pelosi was the House speaker, she helped pass the Affordable Care Act, also known as Obamacare.

Now, after more than six years in the minority party, she is watching House Republicans move to repeal and replace parts of the law.

She says that although Democrats don't have the votes to stop the GOP legislation alone, they can still show their opposition to it.

"In my office I have a painting of Abraham Lincoln, who said, 'Public sentiment is everything,' " Pelosi told NPR's Robert Siegel. "Regardless of the number of Democrats in the House, the number of people who are affected, 24 million [people] who would lose their care, I'm depending on public opinion. ... The fact is the more we point out the shortcomings of the legislation, the fewer votes [Republicans] will have."

The interview below has been edited for length and clarity.


Interview Highlights

On the shortcomings of the Affordable Care Act

Let's go back to where we were before the Affordable Care Act, because that was a time where [some people] wouldn't even be able to have any insurance. So what was the purpose of the Affordable Care Act? [It was] threefold. One, to lower cost. Two, to improve benefits. And three, to expand access for millions more people. And it's done all three. ...

Look, there hasn't been a bill ever passed of this magnitude, whether it was Social Security, Medicare, Medicaid, voting rights, civil rights bill, that was not revisited. Some of the improvements we [could] have [had] in the Affordable Care Act were there, but the Republicans prevented them from happening. So you can be a self-fulfilling prophecy and say, "I'm gonna make sure this doesn't work now. Now see, it didn't work."

On whether the Democrats could work with President Trump or House Speaker Paul Ryan on health care legislation

We have a responsibility to the American people to find as much common ground as we can. There has to be sincerity, though. ... I don't think he has the faintest idea — the president — about the health care thing.

[But Rep. Paul] Ryan ... is [a] philosophical, right-wing, anti-government [person], and so an act of mercy for him is to reduce the government's role. So we're talking about two different things. They're debating whether it's "Trumpcare" or "Ryancare," but neither of them wants it identified with themselves because it's such a failure in the public mind.

On Trump's knowledge of health care

The more the president might learn about [health care], then he might see where there's a path [to working with Democrats], because to tell you the truth, the Affordable Care Act is a private sector initiative. It contains many Republican ideas.

Understand this about Republicans, and then you'll understand part of what our challenge is here: They always are gearing whatever they do to benefit the high end. This is the biggest transfer of wealth in the history of our country, in terms of hundreds of billions of dollars going into the pockets of the top 1 percent of the people in our country, at the expense of the good health of our middle class and those who aspire to the middle class.

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