The victory of the Affordable Care Act is sometimes attributed as much to her as to the President, but the fact is, the Republicans now hold their biggest majority since Harry Truman was President back in 1946, and when the final results come trickling in, it could break records going back to the thirties. the possibility of retaking the House in '16 is now in serious jeopardy. She would also be 76 by 2016. (Steny Hoyer even older) There's also a perception problem that isn't going to change. Some people come to be perceived almost as a negative caricature by a huge part of the population, whether rightly, e.g Sarah Palin; or wrongly i.e Pelosi. That narrative, that caricature is stuck and it's a shame, but it's the reality. Harry Reid needs to stay, to protect Nevada in 2016, but it's probably time for some new blood in the Democratic House leadership; and that's not necessarily a bad thing.