House Speaker Nancy Pelosi warned insurance companies that healthcare reform could cost the industry dearly through new fees, fewer regulatory protections, and fresh competition from the federal government. The admonition came in response to the insurance's lobby's aggressive campaign to block reform legislation from advancing. Pelosi added that the House may adopt a Senate provision that would assess a flat fee on insurance companies that is expected to generate about $40 billion over 10 years as a way to pay for its reform bill.