In Nancy Pelosi's world, the U.S. Constitution does not matter.
She is getting ready to enact an unconstitutional bill, unconstitutionally.
Pelosi plans, according to news reports, to pass the health care takeover bill through the House without voting on it.
The Senate version of the bill is itself unconstitutional, because it would require Americans to buy a product (which most of them don't want). This never has been done before.
But the Constitution clearly requires a vote on bills.
As stated here a number of times before, Pelosi is hellbent on passing this bill, by whatever means necessary. Reluctant Democrats are being bribed and browbeaten to fall into line even now.
Remember the period 2000-2008 when Democrats constantly were complaining that the president was "shredding the Constitution"?
Ignoring it is better, I suppose.