Democrats may have to abandon their effort for comprehensive healthcare legislation in favor of a piecemeal approach, Sen. Ben Nelson (D-Neb.) said Friday.

Nelson, a centrist Democrat whose vote is critical to the fate of healthcare reform in the Senate, said that while he's inclined to support a majority-vote maneuver to pass a bill, he's unsure Senate Democrats will be able to do so.

"I don't know if we can get a comprehensive bill through," Nelson said during an interview on KLIN radio in Nebraska. "Honestly, I just don't know."

"We may be forced to doing healthcare -- to use my analogy -- by making a pie a piece at a time, which is typically not the preferred way to handle legislation," the senator added. "But this is so big, and has so many moving parts and has so many supporters and detractors, that maybe that's the only thing you can do. Grab a piece of it here, grab a piece of it there and try to put together as much of it as you can."


Nelson's remarks come as House and Senate leaders appear prepared to use the budget reconciliation process to move forward on their health reform bill. That process would allow the Senate to pass key elements of a package with only a simple majority of votes, sidestepping the 60-vote threshold needed to end a filibuster, as well as the opposition of 41 Republicans and some centrist Democrats.

The Nebraska senator reiterated his support for using that process if he believes the underlying bill is good.

"We'll have to see what the final package is," he said, cautioning that he hopes the process wouldn't have to be used.

Republicans have derided the tactic as extreme and partisan, and claim it has never been used to overhaul such a large section of the economy.

Nelson deflected that criticism, pointing to how the process was used to pass President George W. Bush's $1.35 trillion tax cuts, legislation which Nelson supported at the time.

"As far as I'm concerned, reconciliation is the least preferred way to do something. But I must say, at times, it's become necessary," he said. "And I supported reconciliation during the Bush years when Democrats were obstructing the Bush tax cuts."