Democrats may have to settle for health reforms without Republican votes because Republicans want less regulation and less oversight of insurance companies, Kathleen Sebelius says.

The Health and Human Services Secretary told ABC's Matthew Dowd that health care reform has been slowed by attempts to get support from Republicans.

"I think part of the pace of this debate was a real attempt to have a bipartisan approach," said Sebelius. "The House bill had Republican support."

For the Senate bill she insisted, "there were months spent with six senators, three Republicans and three Democrats in a room negotiating, adding ideas to the bill, trying to figure out a strategy to move forward in a bipartisan fashion."

"I think the president would love to have Republican votes," she added. "What he has is lots of Republican ideas: Selling insurance across state lines, making sure that we crack down very aggressively on fraud and abuse moving forward."

"But," she pointed out, "there's a fundamental difference. The Republicans feel strongly that insurance companies should have less regulation than they do now, less consumer protection, less oversight. The president feels strongly that we need to change the rules of the road, that we can no longer have a private health system where insurance companies get to pick and choose, where they can lock people out and price people out. That's really one of the fundamental divides."

Sebelius added that even though there are Republican ideas in the bill, and Democrats are "hopeful" that there will be Republican votes, she's not sure there will be.

Also on Sunday morning, she told NBC's David Gregory the president has called for an up or down vote with no set deadline. Gregory asked if health reform doesn't pass by April if it is realistic that it will ever come back. Sebelius replied, "I think it's realistic because the American people are desperate."

This video is from ABC's This Week, broadcast March 7, 2010.

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