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Conventional wisdom among Republicans and Democrats is that health care is likely to pass in the House this weekend, but deciding which votes bring it across the finish line is a tough task for Speaker Nancy Pelosi. The bill is likely to pass by the barest margins and a number of Democrats in conservative districts, like Jason Altmire (D-PA) and Bill Owens (D-NY), could face a backlash in the midterm elections for lending their support to the legislation. Now Democratic leaders must decide which representatives are permitted to vote against the bill and which ones will face an all-out pressure campaign. “Every vote around here is a heavy lift,” Pelosi told reporters Thursday.