Senator Charles Schumer (D-NY) (L) smiles with Chairman Patrick Leahy (D-VT) (C) after the Judiciary Committee voted to send the U.S. Supreme Court nomination of Judge Sonia Sotomayor to the full senate for confirmation during a business meeting on Capitol Hill in Washington, July 28, 2009. REUTERS/Jonathan Ernst

Senate Democratic leaders are close to securing enough votes to advance a sweeping healthcare reform backed by President Barack Obama, a top Senate Democrat said on Sunday, adding that it likely would include a national health plan that would allow states the option of dropping out.

Senator Charles Schumer, a member of the Senate Democratic leadership team, said he is pushing a compromise that would create a new national health insurance plan and allow states to opt out. The proposed public plan would compete on a level playing field with other insurers, he said.

Senate Majority Leader Harry Reid is expected to produce a bill on Monday that will be sent to the Congressional Budget Office for an official cost estimate, an aide said.

Reid and other Democratic leaders have been talking with liberals, who want a strong public plan, and moderates who lean toward a less expansive government program and more state-level options.

They are testing the waters to see which version would win the 60 votes needed to advance controversial legislation in the 100-member chamber and hope to produce a bill this week that would then go to the Senate for debate.

I think we're very close to getting the 60 votes we need to move forward, Schumer said in a NBC Meet the Press interview. My guess is that the public option level playing field with the state opt-out will be in the bill.

Senator Ben Nelson, a moderate Democrat, told CNN's State of the Union that he has not decided how he will vote. He said he favors more state control on healthcare issues and would prefer allowing states to opt in on any proposed new government plan.

I think the states can make decisions on their own about their own citizens, he said.

Obama had hoped to win bipartisan support for his plan to overhaul the $2.5 trillion U.S. healthcare system to rein in soaring costs and expand coverage to most of the 46 million uninsured people in the United States.

Republicans strongly oppose the public plan as well as other parts of the massive undertaking. The only Republican to indicate some support, Senator Olympia Snowe, insists that it not include a public plan. She supports a trigger that would put in place a new government plan only if proposed insurance market reforms fail to expand affordable medical coverage.


Democrats argue the public plan is needed to inject more competition in the market but the insurance industry strongly opposes it saying it would compete unfairly and eventually leader to a government-run healthcare system.

Republicans also are concerned about the cost of proposed new subsidies for health premiums at a time of eye-popping deficits, which reached a record $1.4 trillion this year.

We know there is nervousness among Democrats over this increasing view that Congress is acting like a teenager with their parents' credit card, not worried about who's going to have to pay the bill, Senate Republican Leader Mitch McConnell said on ABC's This Week with George Stephanopoulos.

The Senate bill's roughly $900 billion 10-year cost would be covered by spending cuts in the Medicare health program for the elderly, a tax on high-cost health plans and a special fee on insurers, drug companies and medical device makers. 

Democrats in the House of Representatives strongly oppose the tax on high-cost insurance plans and their legislation would pay for the overhaul mostly through a surtax on the very wealthy. House Democratic leaders also are looking at the health industry fees that are included in the Senate bill.

The House bill is expected to include a government plan but have yet to settle on which version. House Speaker Nancy Pelosi on Friday reiterated her support for a strong public option that would use Medicare payments as the basis to reimburse doctors in the new government health plan.

They are considering two other options based on negotiated reimbursement rates. The negotiated rates are favored by moderates and Democrats from rural areas worried the lower Medicare rates would hurt small hospitals.

There is no philosophical difference between a robust public option and negotiated rates. It's just a difference of money, Pelosi said at a news conference on Friday.