Senate Majority Leader Harry Reid has announced the Senate healthcare reform bill will include a public health insurance plan that states can choose to opt out of.

Sen. Harry Reid: “As we’ve gone through this process, I’ve concluded — with the support of the White House, Senators Dodd and Baucus — that the best way to move forward is to include a public option with the opt-out provision for states. Under this concept, states will be able to determine whether the public option works well for them and will have the ability to opt out, if they so choose. I believe that a public option can achieve the goal of bringing meaningful reform to our broken system. It will protect consumers, keep insurers honest, and ensure competition. And that’s why we intend to include it in the bill that we submitted — that will be submitted to the Senate.”

The Washington Post reports the opt-out provision was engineered by New York Senator Charles Schumer as a compromise between moderates who want a smaller government role and liberals who prefer a single-payer system. The Democratic leadership must now scramble to secure the sixty votes needed to pass the measure. While details of how states could opt out of the system are unclear, it likely means that millions of Americans may never have a chance to enroll in a government-run health insurance plan because of Republican opposition. A combined total of 154 million people, or 51 percent of the population, live in states where Republicans control the governor’s mansion or the state legislature.