WASHINGTON — Senate Democrats said on Saturday that they had clinched an agreement on a far-reaching overhaul of the nation’s health care system, and that they were on track to approve the legislation by Christmas over fierce Republican opposition.
As the Senate convened in a driving snowstorm, Democratic leaders said a breakthrough came when Senator Ben Nelson, Democrat of Nebraska, agreed after 13 hours of negotiations on Friday to back the bill, making him the pivotal 60th vote.
“Change is never easy, but change is what’s necessary in America,” Mr. Nelson said during a morning news conference. “And that’s why I intend to vote,” he said, “for health care reform.”
If Senate Democrats could win passage of their bill, it will need to be reconciled with a version adopted last month by the House, and Mr. Nelson issued a pointed warning that he would vote against the measure if any changes were not to his liking.
Because the Democrats nominally control 60 seats in the Senate — the precise number needed to overcome Republican filibusters — every senator in the Democratic caucus effectively has veto power over the bill. No Republican is willing to support it
The legislation, the most sweeping overhaul of the nation’s health care system in more than a generation, seeks to extend health benefits to more than 30 million uninsured Americans by expanding Medicaid and providing subsidies to help moderate-income people purchase private insurance.
The bill also impose tight new regulations of the health insurance industry, barring insurers from denying coverage based on pre-existing medical conditions and limiting how much extra they can charge for people based on their age.
The majority leader, Harry Reid of Nevada, racing against the clock to complete the bill by his self-imposed holiday deadline, introduced a 338-page package of last-minute amendments, including the key provisions needed to win Mr. Nelson’s support.
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