U.S. President Barack Obama says he thinks his country is "on the cusp of making health-care reform a reality."

Obama spoke at the White House on Saturday, not long after Senate Democratic leaders secured the support of Nebraska's Ben Nelson to provide the 60th and deciding vote for health-care legislation.

The president said that "it now appears the American people will have the vote they deserve" on the issue. He called Saturday's development a major step forward in extending coverage to the uninsured and saving money for businesses and the government in the long term.

Obama also said that overhauling the nation's health-care system will save lives. At its core, the legislation would create a new insurance exchange where consumers could shop for affordable coverage that complied with new federal guidelines.

Most Americans would be required to purchase insurance, with federal subsidies available to help defray the cost for lower- and middle-income individuals and families.

In a concession to Nelson and other moderates, the bill lacks a government-run insurance option of the type that House Democrats inserted into theirs.

Outnumbered Republicans unleashed a new series of attacks against the legislation and vowed to delay its passage as long as possible. The next — and most critical — test vote was set for about 1 a.m. ET Monday.

Individual states would be permitted to ban insurance coverage of abortions in policies sold in the exchange, except in cases of rape, incest or when the life of the mother is in jeopardy. In states where such coverage is permitted, consumers must notify their insurance company they want it, and pay for it separately.

In place of a government-run insurance option, the estimated 30 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress.

Those plans would be privately owned, but operated on a non-profit basis, as many Blue Cross Blue Shield plans are now. Insurance companies would be barred immediately from denying coverage to children because of a pre-existing health condition.

The prohibition on denial of coverage for adults would not take effect in the Senate bill until 2014, a disappointment for consumer advocates.