Nov. 9 (Bloomberg) -- More than 40 House Democrats signed a letter to House Speaker Nancy Pelosi vowing to vote against a final health overhaul measure if it includes abortion restrictions contained in legislation approved Nov. 7, said Representative Diana DeGette.

The letter circulating among lawmakers calls “unprecedented and unacceptable” language approved by the chamber that would limit access to the procedure for people who use an insurance-purchasing exchange that would be created in pending U.S. health-care legislation.

“We will not vote for a conference report that contains language that restricts women’s right to choose any further than current law,” says the letter, released by Democratic Representatives Louise Slaughter of New York and DeGette of Colorado. The two lead a caucus of lawmakers who favor abortion rights.

The Democrats’ threat to vote “no” on a final bill places further pressure on House Democratic leaders, who allowed a vote on an amendment with the abortion restrictions after a revolt by anti-abortion Democrats threatened passage of the broader legislation.

A total of 64 Democrats supported the amendment, offered by Representative Bart Stupak, a Michigan Democrat. It passed on a 240-194 vote and poses one of the biggest challenges when party leaders later work to craft a compromise that can push President Barack Obama’s top legislative priority through both chambers.

The broader health-care legislation passed on a 220-215 vote.

Deal Fell Apart

Stupak’s amendment bars the government plan from covering abortions. It also prohibits federal funds from being used to help people purchase private insurance sold on the on-line exchange that covers abortion. Women could use their own money to purchase a separate abortion rider.

After the vote, Stupak said that pro-choice lawmakers rejected a compromise that wouldn’t have been as restrictive. The deal fell apart because “some groups overreached and can’t count” votes, he told reporters early Nov. 8, referring to pro- choice lawmakers and abortion-rights advocates.

In a separate interview, Stupak said he had reached an agreement with the speaker and representatives of the U.S. Conference of Catholic Bishops that would have allowed Congress to revisit the restrictions on private insurance sold in the plan every year. Stupak said that he was “dumbfounded” when Pelosi called him 90 minutes later to say she couldn’t honor the deal.

Compromise Spurned

The speaker urged him instead to offer the compromise as an amendment. Stupak said he refused, saying he wasn’t bound by the broken deal and should be allowed to offer his original amendment.

Stupak said the amendment that the House approved was stronger than the compromise because it contains permanent restrictions on government funding of abortion for any insurance policies sold on the exchange.

The compromise that fell apart would have applied permanently only to the public option instead of every policy in the exchange, Stupak said. The restrictions on the private insurance in the exchange would be subjected to year-to-year review in appropriations legislation, he said.

California Democrat Henry Waxman denied that abortion- rights advocates walked away from the deal, saying the compromise was unacceptable to the Catholic bishops and others.

Cost, Scope

The health-care plan’s $1 trillion price tag over 10 years and its creation of a government-run program to compete with private health insurers represent the biggest changes to health care since the 1965 creation of the Medicare program for the elderly. It would require Americans to get insurance, expand Medicaid, establish insurance-purchasing exchanges for people who don’t have employer-provided benefits, and provide subsidies to help people obtain coverage.

The Senate is still working to find consensus on a measure that may not be considered until the first week in December.

Senate Democratic Leader Harry Reid from Nevada is awaiting independent analysis from the Congressional Budget Office to finish drafting a measure, and he may not get the information until later this week, said his spokesman, Jim Manley.

Asked about the abortion restriction, Maine Republican Susan Collins told reporters that the Senate Finance Committee legislation “did a good job putting up a firewall that would prevent federal funds from going to abortions.”

Collins, who supports abortion rights, has opposed the health-care legislation, arguing it would lead to higher premiums and disincentives for small businesses to hire more workers.

To contact the reporters on this story: Laura Litvan in Washington at llitvan@bloomberg.net; James Rowley in Washington at jarowley@bloomberg.net

Last Updated: November 9, 2009 16:09 EST