WASHINGTON — Health care reform's fragile chances took a turn for the worse Monday as pro-abortion-rights lawmakers led by Rep. Diana DeGette vowed to kill the bill if an anti-abortion amendment isn't stripped from the final version.
The drama played out for most of the day on cable television as pro- abortion-rights Democrats who were outmaneuvered over the weekend suddenly went on the offensive.
DeGette, D-Colo., vowed to send a letter to House Speaker Nancy Pelosi this week with at least 40 signatures of lawmakers promising to vote against the bill — enough to kill the bill once it emerges from conference — if the language restricting federally subsidized insurance policies from covering abortion remained intact.
But anti-abortion Democrats showed Saturday that they can muster at least the same number of votes, as 64 Democrats, including Rep. John Salazar, D-Manassa, voted in favor of the amendment. And reformers now face the prospect that one of the most emotional policy issues of the last quarter-century could kill the biggest domestic initiative of Barack Obama's presidency.
Appearing on a midday news segment on MSNBC and then again on a talk show hosted by liberal champion Rachel Maddow, DeGette said the anti-abortion amendment represented "the broadest restriction on a woman's reproductive health in my lifetime."
"There is a line we are going to draw, and this is the line," she said. "I don't think this bill, which is designed to expand health care, should be used as a tool by the religious right to get further restrictions on something that is legal."
It was a dramatic comedown for Democrats from the celebrations that marked the weekend passage of the bill in the House, suddenly placing abortion alongside the controversial public insurance option as a major hurdle that could derail months of negotiations and dealmaking aimed at passing health reform by Christmas.
Analysts say the last-minute deal to allow a vote on the anti- abortion amendment — authored by Michigan Democrat Bart Stupak — caught pro-abortion-rights forces by surprise and it was unclear how much of Monday's counteroffensive was simply an effort to regain leverage to strike a compromise.
But the amendment has also unleashed political forces that make the final outcome of the fight hard to predict.
Catholic bishops, who have largely been supportive of health reform, lobbied hard for inclusion of the abortion restrictions, helping to hold anti-abortion Democrats together and force a deal.
Maddow said over the weekend that the amendment's inclusion has angered millions of progressive women and could lead them to withdraw support for Democrats in next year's midterm elections.
"I'm not convinced it's just a bluff," said Julian Zelizer, an expert on Congress at Princeton University. "There are a lot of groups who are very angry and see it as something beyond the boundaries of compromise."
Pro-abortion-rights lawmakers had negotiated for months to avoid what happened Saturday.
After it became clear that anti-abortion Democrats had the votes to stop the health-reform bill's passage, Pelosi agreed to allow the amendment, which passed with overwhelming Republican support.
Before the vote, Pelosi held an emotional meeting with the leaders of the 190-member Pro Choice Caucus. She conceded that without the anti-abortion Democrats, there weren't enough votes to pass the bill, which was eventually approved by a 220-215 margin.
DeGette said reports that the meeting devolved into a shouting match were overblown, but some members did leave in tears.
"They were upset about the idea of having to debate this amendment that would so far restrict a woman's reproductive rights. But they wanted the bill to pass," DeGette said.
Later on Monday, Pelosi said that while she is against the anti-abortion language, the amendment was necessary.
Pelosi said the anti-abortion language "would have been in the bill one way or another," so bill-backers thought it would be better to include it as amendment than as a provision that could jeopardize the entire measure. She spoke during a visit to Seattle's Swedish Medical Center.
Now that the bill has passed the House with the abortion restrictions in place, analysts said it was difficult to see a way that a compromise could be struck that would satisfy both sides.
Pelosi said she and other backers of the bill will continue searching for common ground.
But moderate Democrats are unlikely to backtrack on a issue that now has such a high profile and on which they have momentum. Although the restrictions are not in the Senate version of the bill, moderate Democrats in that chamber have vowed to add them.
But progressives have also raised the stakes, casting the debate in the high-pitched tones of one of the country's most enduring and explosive policy debates — access to abortion for poor and lower-middle-class women.
Data show that 87 percent of employer health-insurance policies now cover abortion, and critics argue that companies will drastically curtail that coverage under the amendment because they will want to compete for subsidized policies that health reform will make available to millions of Americans.
Meanwhile, a 2003 study by the Guttmacher Institute found that in fact only about 13 percent of abortions are paid for by private insurance companies and that in all, three-quarters of women who have the procedure pay for the abortions themselves, at least partly to retain anonymity.
The Associated Press contributed to this report.
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