This is a rush transcript from "On the Record," December 1, 2009. This copy may not be in its final form and may be updated.

GRETA VAN SUSTEREN, FOX NEWS HOST: Democratic Senator Ben Nelson is popular. Both sides on Capitol Hill want his vote for the health care bill.

Now Senator Nelson is one of the key swing votes that could make or break that bill in the senate, so what is he going to do? We asked him.


VAN SUSTEREN: Senator, nice to see you, sir.

SEN. BEN NELSON, D - NEB.: Thank you.

VAN SUSTEREN: Senator, what will it take for you to vote on this senate bill? What does the senate have to do to this bill?

NELSON: Well, it has to make -- the Senate will have to make a lot of changes. The public option would have to be changed dramatically or dropped from the bill. The class act, which is the community living assistance program that the CMS actuary said will be financially upside down in a very short period of time, that needs to be out of the bill.

We need to take care of putting the Stupak language into the Senate bill to make certain that no federal dollars are used directly or indirectly to fund abortions. So that plus a whole host of other issues, such as the tax on medical devices, the tax on insurers, that are nothing more than a sales tax on policyholders.

VAN SUSTEREN: Under this current bill as you understand -- and I realize that this is being debated now -- is Medicare going to get cut, and how much?

NELSON: Well, you know, it's an interesting discussion. But if Medicare gets cut -- what happens is Medicare actually reimburses hospitals and doctors less over a 10-year period of time. That's so-called a savings to Medicare because it is money Medicare does not have to pay out, and those are called Medicare cuts, but Medicare itself, in terms of the benefits is not scheduled to be cut for benefits to the Medicare recipients, their insurance.

VAN SUSTEREN: Now, I know that you'll make the decision based on what you think is best for your state. But as a practical matter, I've gone back and looked at the newspapers, your Omaha newspaper and your Lincoln newspaper. Both are very much opposed to it. In fact event he Lincoln newspaper says the cost estimates can't be trusted. And they're both saying that the Senate is playing and fooling around with the numbers?

The polls in your states show basically a split -- 50 percent for, 50 percent not in favor generally. Those numbers are not quite exact, you know what I'm saying.

But in light of the fact that your state seems to have so much problems with the way that the accounting for this bill, how can you ever vote for it?

NELSON: Well, I do not know that I can. Voting for -- the cloture motion and the motion to proceed to get it onto the floor is altogether different than voting for a cloture motion to end debate to get it off of the floor. Each takes 60 votes.

Getting it on to the floor does not automatically mean it gets off the floor, and I have heard such percentages thrown around. Well, once the bill gets on the floor, it almost always gets off of the floor.

This is unique, and I do not think they ought to apply the history of the past to this present situation because this is altogether different.

VAN SUSTEREN: The way the current bill is now -- tell me if I am correct on this -- that the revenue stream is figured out at a 10-year revenue stream? In terms of figuring out...

NELSON: That's correct.

VAN SUSTEREN: The CBO and how much can be collected, but that the service part of it is only six years? The delivery?

NELSON: There is -- I think that is the way it works because the revenue comes out almost immediately, and then the actual effect of the bill does not go into effect for some extended period of time, I think 2014 -- 2013, 2014 -- in that time frame. So there has been a criticism that if you collect the money up front, its benefits don't get really working until later. That is a legitimate point to be made.

As to the...

VAN SUSTEREN: Can you vote for any bill that has that mechanism of collecting revenue for that period of time, and the delivery does not start until later? Is that something that satisfies you?

NELSON: Well, that's -- that wouldn't -- look, I do not like that, but that would be just one of the things that I wouldn't like.

If it has got a robust government-run public option that the states have to opt out, I couldn't vote for. If we do not have the Stupak-type language in the bill, I could not vote for it. If the class act is in it, I would have trouble voting for it. Most likely, that would have to be perfected, if it could be.

But there are other issues, as well. There is an under-reimbursement that will be in place for nursing homes in states like Nebraska that will put an added burden on nursing homes because they'll be under-reimbursed.

There is a plan to take something like $14.6 billions out of current reimbursements for nursing homes over the next 10 years. That creates a problem in Nebraska.

There are so many problems with this. It is very unlikely to see that the senate can solve all these, but the bill is here, there will be amendments offered. I am planning to bring with some others the Stupak- type language to make sure that federal funding -- federal dollars neither directly nor indirectly can be used for funding abortions.

So we will see what we can do. And at the end of that process, I can make my decision as to whether or not it's been corrected enough or I will be that 60th vote or one of those votes to get it off the floor.

At the present time, with the bill as is, was presented, I would not vote to get it off the floor.

VAN SUSTEREN: Am I correct in saying that you and for instance Senator Bayh seemed to look at the whole picture, this whole bill, much differently than those senators who have never been governors? You've been a governor. Senator Bayh has been a governor. Both of you seem to have a little different view of this.

Am I right in that (INAUDIBLE) sort of a different approach to this?

NELSON: I think it does, yes, Greta. I think it gives us a different perspective. If you had to run a state, if you have had to be in the executive branch, you begin to think about the taxes. You begin to think about the expenses and matching. You worry about the CBO numbers. If they are off 10 percent on that $1 trillion, and this is $900 billion, and it's off $90 billion. And that is not pocket change, even in Washington.

So there is a lot of concern that we have about how it is put together. And I think that just probably comes from having sat in the corner office at the state capital, worrying about those things, trying to put budgets together, and making sure at the end of the day, the revenues match the outflow.

VAN SUSTEREN: So there is a big difference in terms of implementing what's done in Washington and voting on what's done in Washington.

NELSON: There certainly is and I worry about that government-run robust public option. The government is now going to be in the insurance business. Back here in Washington, it is easy to say that, and it is easy to cast a vote for that by comparison to trying to implement it. And there is a belief somehow that Washington can do something different than the private sector.

I am not one who believes that that is the case. I do not think that Washington is always wasteful in its spending. There are things that are done quite well around here, but not everything. And, consequently, I think Senator Bayh and I both and some others are really concerned about the numbers and whether it would all add up at the end of the day.

VAN SUSTEREN: Senator, thank you, sir. Good luck, sir.

NELSON: Thank you Greta.


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