Nov. 7 (Bloomberg) -- Democratic leaders are struggling to bridge divisions over abortion that could threaten the health- care legislation, even as lawmakers debate the bill.

House leaders will allow a vote on a provision to restrict abortion funding that’s backed by 40 Democrats, in exchange for their support for the larger bill. That deal angered Democrats who support abortion rights and say the amendment would create even greater restrictions on the practice than in current law.

The amendment will come up for a vote today and will likely pass with support from Republicans, lawmakers said. If it does, Democrats who back abortion rights say they may not vote for the health bill. With margins for final passage of the bill close, lawmakers acknowledge the fight threatens the success of the legislation.

“This is an issue that emerged, with the potential of bringing down the bill, pretty much at the last minute,” said Representative Janice Schakowsky, an Illinois Democrat who supports access to abortion. If the additional restrictions make it into the final version of the bill, Schakowsky said in an interview, “many of us couldn’t support it.”

Still, Schakowsky expressed the dilemma that she and like- minded lawmakers faced, saying she would be disappointed “to have gotten to this point and have this issue threaten to bring the bill down.”

She said the caucus of House lawmakers who support access to abortion had 190 members, including Republicans. Democrats need 218 votes from among their 258 members to pass the bill, which is opposed by all Republicans.

Pain and Fury

The abortion issue has caused “pain as well as fury” for House Speaker Nancy Pelosi, as well as members, Schakowsky said. Pelosi, who favors abortion rights, is a Catholic and has met frequently with the U.S. Conference of Catholic Bishops, which has pushed for greater limits on abortion access.

President Barack Obama referred only indirectly to the issue when he met with House Democrats today, lawmakers said. He told assembled Democrats he recognized how difficult the debate was, but that he had confidence the caucus could come together, said Representative Robert Andrews of New Jersey.

Obama, members of his Cabinet and House leaders spent the last few days trying to rally votes for the bill, the president’s highest domestic priority. All Republicans are opposed, criticizing the 10-year plan’s $1.05 trillion price tag and its creation of a government-run program to compete with private insurers such as Hartford, Connecticut-based Aetna Inc.

Government Plan

The legislation, which would cover 36 million uninsured people, would represent the biggest changes to U.S. health care since the 1965 creation of the Medicare program for the elderly.

It would require all Americans to get insurance, set up insurance-purchasing exchanges online for people who don’t have employer-provided benefits, and provide subsidies to help people obtain coverage.

The abortion controversy centers on the health exchanges, where small-business employees and individuals would be able to choose coverage sold by private insurers and the government- backed option.

Anti-abortion Democrats, along with many Republicans, are concerned that low-income Americans could use government subsidies to terminate pregnancies. Representative Bart Stupak, a Michigan Democrat, proposed the amendment that House leaders agreed to put up for a vote.

Funding Restrictions

It would bar the government option from providing abortion services and prohibit participants from using exchange subsidies to purchase abortion services from private insurers. Women could use their own funds to purchase abortion coverage from a private insurer on the exchange.

California Democrat Mike Thompson predicted the abortion amendment would pass. Thompson said its adoption wouldn’t threaten the legislation because lawmakers who favor abortion rights won’t defect and vote against the full measure.

“People know we need to get it,” Thompson said. “There is enough in this bill that any one of us could point to that we don’t like,” Thompson said.

House Education and Labor Committee Chairman George Miller, who led one of three committees that passed health legislation, called Stupak’s provision “a very tough amendment.”

“I think it’s wrong,” said the California Democrat.

Rounding Up Votes

Colorado Democrat Diana DeGette said she was “trying to get the votes to kill it right now.” DeGette said she needed fewer than a dozen more votes to prevail. She declined to say whether she would vote for the health legislation if Stupak’s amendment were adopted.

Stupak, who predicts his amendment will pass, was concerned that current federal restrictions on abortion weren’t adequate. The 1976 Hyde Amendment prevents federal funds from being used to cover abortions except in cases of rape, incest or danger to a woman’s life.

Democratic leaders argue that the House health legislation wouldn’t change existing law on abortion. Stupak and others were concerned that the Hyde Amendment has to be renewed annually and wanted abortion restrictions in the bill to be independent of the provision.

The issue is fraught for conservative Democrats, especially freshmen who won in traditionally Republican districts.

Make-or-Break Issue

Representative Marcy Kaptur, an Ohio Democrat who wants to see greater restrictions on abortion in the bill, said several members were undecided and were waiting to see whether Stupak’s amendment would be adopted.

A few lawmakers who oppose abortion aren’t sure if the amendment will be enough to sway them, Kaptur said. “For some, this is a make-or-break issue,” Kaptur said. “I believe there are a large number who will vote for our amendment and it will pass,” she said of the Stupak provision. Kaptur said she would only back the bill if it does.

House Republican Leader John Boehner accused Democrats of playing a “shell game” with Stupak’s amendment to pass the legislation. He demanded a commitment that it would remain in the legislation after a House-Senate conference.

“We have no guarantee when it comes back from conference that language stopping taxpayer-funded abortion will be in the bill,” Boehner said.

“Have you ever got a guarantee” like that “since you got here?” Ways and Means Chairman Charles Rangel responded. “No.”

To contact the reporters on this story: James Rowley in Washington at jarowley@bloomberg.net; Nicole Gaouette in Washington at ngaouette@bloomberg.net

Last Updated: November 7, 2009 18:29 EST