on from Flex Plan Services that it uses when reviewing any application for a temporary waiver," Richard Sorian, assistant secretary for public affairs at the Department of Health and Human Services, said on the blog, adding that waivers are granted for businesses that prove they need them to avoid "a large increase in premiums or a significant decrease in access to coverage."  Pelosi, though, was among the most vocal champions of the health care law as she and other Democrats helped shepherd it through Congress in 2009 and 2010.  Nevada, the state represented by Pelosi's then-counterpart on the other side of Capitol Hill, Senate Majority Leader Harry Reid, also just received a partial exemption from a provision in the law requiring companies to spend at least 80 percent of premium money on medical care and related expenses. HHS will allow Nevada to keep that rate at 75 percent in 2011, out of concern that major insurers could otherwise withdraw.  The waivers in Pelosi's district pertained to a different requirement in the health care law dealing with annual benefit limits. The latest set brings the total number of such exemptions since the law's implementation to 1,372 nationwide. More than 3 million people are enrolled in plans affected by these waivers.  On the list of San Francisco businesses with a reprieve were The Stinking Rose, an Italian restaurant; TRU Spa, a day spa in the city; and the upscale Hotel Nikko. Daily Caller first reported on the exemptions in Pelosi's district.  Steve Larsen, director of the administration's Center for Consumer Information and Insurance Oversight, said in a statement that the waivers were deemed vital to workers in the service sector. "These temporary waivers are necessary to help ensure that the waiters, dishwashers, maids, home health aides, and other hardworking people can keep the health coverage they have, while we transition to 2014, when they will have access to affordable coverage in a competitive marketplace," he said.  But the latest list quickly raised questions among Republicans. Rep. Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee, said in a statement that the waivers are a "tacit admission that the health care law is fundamentally flawed."  "Despite the president's promise, it appears that just because you like your health care plan does not mean that the administration will allow you to keep it," Upton said.  Newly seated Nevada Sen. Dean Heller also said the Nevada waiver exposes the l