Most important, the contents of the Affordable Care Act had been publicly available and publicly debated for months when Pelosi made her remarks in March 2010. The bill, in its original form, was passed by the House of Representatives in October 2009, and in the Senate that December. Although the bill was unusually long (the act runs to 906 pages in the legislative record, with many more pages of regulations) its contents had been subjected to intensive debate and scrutiny in both houses of Congress.
That process was fundamentally different to the secrecy surrounding the Republican-sponsored American Health Care Act, when Pelosi tweeted on 20 June 2017 that "Americans deserve to know what's in the [Republican healthcare] bill." At that time, the architects of the legislation had not published any of its contents. (A draft of the bill was published on 22 June 2017, two days after Pelosi's tweet).
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