https://mobile.nytimes.com/2009/12/14/health/policy
Thanks to Lieberman, Single Payer was taken out of the Senate version and when Senate version went to the House, it was clear that we didn't have the votes to put it back in - and even if we did, putting it back in would guarantee the bill a quick death on the House floor.
A truly effective Speaker knows her Caucus, understands the other party's caucus and count votes and knows exactly what can and cannot get passed.
And, very important, unless it advances a very specific strategic goal, she doesn't put things "on the table" or on the floor that she knows will never pass.
Pelosi had to crack heads, take names and kick ass in order to get the ACA passed as it was. She knew it wasn't perfect but the most important thing was to get a bill with everything we could get in it passed and signed into law - and then work to improve it over time. Even our most valued and historic pieces of legislation - the Social Security Act, Civil Rights Act, etc. - didn't start out as they exist now but were amended and improved incrementally.
Thank God that Nancy had enough sense, experience and backbone to stand up to the "Single Payer or bust" crowd and got the ACA passed into law. Too bad that too many of that crowd, ignorant of the process and pissed off because they didn't get the entire loaf at the first bake sale, threw a temper tantrum, turned on Obama and Pelosi in 2010 and turned over Congress and a majority of statehouses to the Republicans, guaranteeing that, instead of tweaking and upgrading ACA, we would spend the next seven years fighting to hang on to it.
So, yes - Nancy Pelosi. Is the very EPITOME of strong, independent leadership.
But yes, let's blame her for something Joe Lieberman and the Senate Dems did ...