Health care reform legislation will be on President Barack Obama's desk by Christmas, Americans will be mandated to buy insurance and those who can't afford coverage will have a public option — or maybe they won't, Sen. Tom Harkin, D-Iowa, told reporters from around the country today.

Four of the five committees that have approved legislation "will have a public option," as an alternative for people who can't afford private coverage, he said during a teleconference organized by Families USA, a health consumers advocacy group based in Washington, D.C. Harkin is one of the strongest supporters of a public health insurance option.

But sensing mounting opposition among Republicans, including continuing stiff resistance to the public option by Utah Sen. Orrin Hatch, Harkin said he would be willing to compromise and include a possible opt-out clause through medical cooperatives group plans organized into pools of insurers, patients and providers at the state level.

"All of the public polls show that a huge majority of the American people want a public option," Harkin said. "That co-op idea seems to be persistent but I have not seen any data on how it can work at all. But if it was a choice, maybe I wouldn't have as much opposition if it was out there as a choice."

Harkin said a simple public option as outlined by Obama — a government plan that would catch those who couldn't find coverage under new and improved private insurance plans — is still by far the most logical and simplest approach.

"It's what we have in our bill," he said, noting that his willingness to discuss compromises should not be interpreted as him backing away from his bill. "I'm willing to listen to any good ideas and I will work closely with the finance committee, but frankly I think we got it right."

Harkin said by his count, there are 52 votes in the Senate, eight short of "the magical 60" required to get the bill approved on the floor.

Hatch has called the public option a Trojan horse that will cause "a mass exodus" from private health insurance coverage because it will invariably be the cheapest option for people to meet mandated coverage under the pending reform proposals.

Harkin said that argument is groundless. "If the insurance industry does in fact design plans that they say they are going to, people won't be driven away form their plans and toward a government option for coverage," he said.

e-mail: jthalman@desnews.com