By GREG HITT and JANET ADAMY

WASHINGTON -- The Senate is marching toward a Christmas Eve vote on the biggest health-care legislation since the passage of Medicare 45 years ago, and its version is likely to form the template for the final bill that President Barack Obama hopes to sign next month.

The White House and Senate leaders expressed confidence Sunday that they have the 60 votes in the Senate needed to overcome Republican opposition and pass a bill estimated to cost $871 billion over a decade.

A flurry of deal-making amid a December snowstorm locked in the final elements of the Senate bill and won the support of the last holdout, Nebraska Sen. Ben Nelson. He won a tightening of rules to ensure no federal money allocated under the sweeping bill is used to fund abortions, and got more money for his state in the Medicaid program.

Democratic leaders also threw in $10 billion in spending on community health centers, a nod toward liberals, and dropped a proposed tax on elective cosmetic surgery after the American Medical Association strongly objected. In its place, the bill now has a 10% tax on indoor tanning services.

The agreements set the stage for a pivotal vote early Monday on the first of three motions to close off debate on the bill. Senate Majority Leader Harry Reid (D., Nev.) said he believes he has the backing of all 58 Senate Democrats as well as the two independents who sit with the majority. If he is correct, the last obstacle would be hashing out differences with the House.

All Republicans are expected to oppose the measure, setting up a pure party-line vote on an issue that is expected to define battle lines for the 2010 midterm elections.

"There is a will to get this done," David Axelrod, a senior adviser to President Obama, said Sunday on CNN's "State of the Union." "People understand we're on the doorstep of doing something really historic."

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