• That has prompted progressive Democrats to consider trying to block a vote on the bill, The Hill's Peter Alexander reported Friday.

Where it stands: The White House has already criticized Pelosi's bill, and pushback from the left obviously wouldn't help its chances.

• The Senate's bill is really the one to watch, but it has much less support from leadership.
• In short, a lot of frayed alliances — between Pelosi and the left, Pelosi and Trump, pharma critics and McConnell — would need to un-fray in order for anything to happen here. And the clock is running out.

Go deeper:

• The state of prescription drug spending
• The drug-pricing deal that got away
• Health care spending grew at a faster rate in 2018

By the numbers: Altogether, the U.S. spent $3.6 trillion last year on health care.

• We spend far more than any other wealthy country, and we are no healthier for it.

Be smart: We don't spend so much because we go to the doctor more than people in other countries. It's because we pay much higher prices for the same services — for MRIs or a knee replacement or new drugs — and those costs keep going up.

Our actual health isn't great, either.

• Americans' life expectancy has been declining for three straight years — the first time that's happened in decades.
• That's largely a product of the opioid crisis, which has proven difficult to arrest, in part, because the U.S. spends its money on treating physical illnesses, rather than on prevention or mental-health treatment.

These colliding crises are why health care is so dominant in the 2020 debate — and why it will stay that way.

Go deeper:

• Democrats' divide on Medicare for All
• The drug-pricing deal that got away
• Health care profits are soaring
• The urban-rural health care divide is growing
• The return of the ACA wars

What they're saying:

• Sanders hasn't changed at all. He has tweaked the details of what his plan covers, but still makes the same forceful case for a national plan with no copays, deductibles, premiums or coverage limitations — paid for by tax increases.
• Sen. Elizabeth Warren still backs Sanders' version of the national health plan, but has said she would pursue a public option first, then a full-scale single-payer program later.
• Pete Buttigieg has long supported a public option, not Medicare for All, though his criticism of single-payer has gotten more aggressive as he (and Warren) have climbed in the polls.
• Joe Biden also has a clear position on Medicare for All: He's against it. He, too, prefers a public option. "The party's not there. The party's not there at all," he told "Axios on HBO."

Why it matters: This is the defining debate of the Democratic primary — and it's a fight that Sanders and Biden, at least, are eager to have.

Yes, but: The powerful health care industry, particularly hospitals, opposes a public option almost as fiercely as it opposes single-payer, and would fight it just as hard in Congress, with just as much help from Republicans.

• Democrats are divided over what to fight for, but it would be a fight no matter what.

Go deeper:

• Special report: The coming health care collision
• Health care profits are soaring
• The urban-rural health care divide is growing