Speaker Nancy Pelosi’s (D-Calif.) push for liberal priorities in a health care overhaul met stiff resistance from her moderate wing on Wednesday, with key centrists predicting the measure would face a difficult route to passage if leaders don’t accommodate them.

But with no solid whip count in hand on the most divisive issues — the shape of a public insurance option and the inclusion of a millionaires’ tax to help fund reform — Democrats were struggling with a path forward even as leaders pursued an aggressive timetable for wrapping up work on the bill next week.

“Right now, I don’t believe leadership has the votes to pass [the bill] in its current form,— said Rep. Stephanie Herseth Sandlin (D-S.D.), the whip for the fiscally conservative Blue Dog Coalition. She said members of her group expressed “dismay— earlier this week with the direction of the legislation, particularly a liberal push for a public insurance option pegged to Medicare reimbursement rates. Other moderates — including newer Members and those in the business-friendly New Democrat Coalition — were raising hackles about a surcharge on the wealthy.

The blowback came after Pelosi made clear in a leadership meeting last week that she preferred a liberal approach to both the public insurance option and the levy on the rich.

Democrats will try to find consensus on the public option when they gather this morning for a meeting devoted to the subject. But leaders are fast approaching a decision that will cost them a significant chunk of votes from one end of the Caucus’ ideological spectrum or the other. How many on either side remains unknown.

By Pelosi’s count, about 20 Blue Dogs would line up behind a bill with a strong public insurance option, according to lawmakers and aides who have heard her quote that number. But Herseth Sandlin’s count put that number lower — and she said she communicated the discrepancy to leadership staff Wednesday morning.

Rep. Earl Pomeroy (D-N.D.), another Blue Dog, gave Pelosi just a 50-50 chance of being able to pass a bill on the House floor that tied the public insurance option to Medicare rates.

“There are going to be a lot of Democrats, myself included, who can’t vote for it,— he said.

Although that move would save an estimated $65 billion to $70 billion, Pomeroy said those savings would be extracted from providers in states like his, which have low reimbursement rates under Medicare, and could result in fewer hospitals and other facilities.

[IMGCAP(1)]But liberal leaders said they are happy to have Pelosi in their corner and aren’t talking up compromise on their core issue of a public insurance option tied to Medicare rates.

“What she supports, which is the Progressive [Caucus] plan, the robust public option, is the one that saves money,— said Congressional Progressive Caucus Co-Chairwoman Lynn Woolsey (D-Calif.). “We don’t need to tax employee benefit plans.—

Leaders of that group have been whipping their members to get firm commitments on voting against any bill that does not include what they have termed a “robust— public option. They were set to meet Wednesday evening to compare notes on their whip counts. “It’s going very, very well,— Progressive Caucus Co-Chairman Raúl Grijalva (D-Ariz.) said.

Energy and Commerce Chairman Henry Waxman (D-Calif.) said no decision has been made on what will be included in the final bill, although he acknowledged a desire to get it done quickly to give the Congressional Budget Office time to score it. Waxman wouldn’t venture to say whether the bill would be tied to Medicare rates, but he said a public insurance option would be in the bill.

“It’s hard to believe we would have a trigger because we have such strong support for a public option,— he said. “A trigger is not a public option, it’s the possibility of a public option.—

Meanwhile, freshman Reps. Gerry Connolly (D-Va.) and Jared Polis (D-Colo.) said they have continued to push to shrink or eliminate a surcharge on the wealthy to pay for the bill.

“We met with [Pelosi’s] staff as recently as last night,— Connolly said. He and Polis said they would prefer to raise money by using Senate Finance Chairman Max Baucus’ (D-Mont.) plan to tax insurance companies that offer high-end insurance plans. Baucus’ plan, which calls for a nonprofit health insurance cooperatives rather than a public option, is being marked up by his committee and could head to the Senate floor as early as next week.

Connolly noted the Senate has already said the surcharge is dead on arrival, and President Barack Obama omitted any mention of it when he delivered a joint address to Congress earlier this month. And while Connolly, who used to work as a Capitol Hill staffer, said he understands the desire of leadership to have a negotiating position going into conference, the issue is a difficult one for the party’s majority makers. “For people in competitive and marginal districts, that’s a whole different problem,— he said.

He said freshman and sophomore Democrats have already taken a series of tough votes this Congress, whether they be on the stimulus package or the cap-and-trade bill. “This is not a bunch of weak-kneed, lily-livered, afraid-of-their-own-shadow freshmen,— he said.

Democratic leaders stressed that no final decisions have been made. At least one acknowledged the difficulty of scoping the shifting attitudes among Members. “I can’t quite get a feel yet for where it is we’re going to go,— Democratic Caucus Chairman John Larson (Conn.) said. “Every day unfolds a little different wrinkle and a little bit more momentum one way or the other.—

Fresh evidence of that came Wednesday evening, when Herseth Sandlin said she sensed new movement back toward compromise on the public insurance option. “In my estimation, there is a growing chorus of pragmatism,— she said.