All political activists believe the other party is far more ruthless than their own party (and, probably, believe that the other factions within their party are far more ruthless than their own faction). Thus Republicans have been certain that Democrats were going to bully the "patch" portion of the health care bill through the Senate, having Joe Biden overrule the Senate parliamentarian and backing it up with majority support for precedents that let Democrats do whatever they like.
There still could be some of this (although I still doubt it), but at least in one case, if news reports are correct, Democrats are following the lead of the parliamentarian, not overruling him. As Ezra Klein and others are reporting, the option of forcing the Senate to patch first is dead, a victim of the Senate parliamentarian. Now, I thought that it was a bad idea in the first place, and I think the backup plan of passing the Senate bill via a self-executing rule is also a bad idea, but it's pretty clearly, from all the reporting, a bad idea that the House wanted. And one that that they're not going to go through with because the Senate parliamentarian said no.
On the backup plan being a foolish idea, see Jonathan Cohn here, Ezra Klein here, or me here. I don't think it's important, but it is foolish. I do agree with Cohn that this is probably a bad idea driven by skittish Members of the caucus, not by Nancy Pelosi; she's probably just doing what she needs to do to get the votes.
At this point, House Dems don't trust the Senate Dems to do things - both for reasons of intent (the f*cking ConservaDems) and for reasons of procedure - the Senate is now a place where one Senator can and does shut things down at will, with little penalty.
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