Democratic leaders in Congress have begun the tenuous process of reconciling the House and Senate health care reform bills, though delivering a final bill before the president’s State of the Union address in mid-January could prove overly optimistic.

In a White House meeting this week, President Obama and Democratic leaders discussed possibly forgoing the traditional House-Senate conference committee to minimize opportunities for Republicans to slow the approval process. Under the strategy discussed, the House would pass the Senate bill amended with compromise provisions and then send the bill back to the Senate for one final vote.

House Speaker Nancy Pelosi (D-CA) is expected to face resistance to this approach from the liberal members of her caucus, who pushed for certain provisions that are unlikely to win approval in the Senate. The bill that the Senate passed on Dec. 24 requires most Americans to have health insurance but has no public option or Medicare buy-in. Pelosi was already suggesting on Tuesday that there are other ways to hold insurance companies accountable besides through a public option.

“We will have what we need to hold the insurance companies accountable,” Pelosi said at a Jan. 5 press conference. “I contend that whatever we have coming out of this bill will hold them accountable and they’ll be crying out for a public option.”

Click here to see a non-partisan comparison of the two bills.