(NBC NEWS) -- Senate leaders need all 58 Democrats, two Independents, and maybe even a Republican or two to pass health reform.
But there's big disagreement on whether to offer Government insurance.
Senator Jack Reed of Rhode Island said, "Sixty-percent of the American public want a public option," while Senator Joe Lieberman of Connecticut said, "If the public option plan is in there, as a matter of conscience, I will not allow this bill to come to a final vote."
Democrats may let states "opt out."
The other big issue is how to pay for reform.
Governor Haley Barbour of Mississippi said, "States like Mississippi and Pennsylvania are going to be forced to raise our taxes, because part of the cost of this is being dumped on us."
The House plan taxes the rich and medical devices while penalizing Americans who don't buy insurance and employers who don't offer it.
This week, the Congressional Budget Office reports tallies the cost of the Senate plan.
President Obama is urging quick action.
"Take the baton and bring this effort to the finish line on behalf of the American people," said Obama.
He wants it done by the end of the year.
