Rep. G.K. Butterfield (D-N.C.) got Chairmen Henry Waxman, Charlie Rangel and George Miller to sign a copy of the House health care bill. The fourth signature belongs to Energy and Commerce Chairman John D. Dingell, whose family has been introducing national health care bills since 1943. | Photo by Jonathan Allen Bishops back abortion compromise

House leaders have won the backing of the nation’s Catholic bishops for a last-minute abortion compromise, a critical boost that could give the health reform bill enough momentum – and enough votes – for passage as early as Saturday.

As they awaited President Barack Obama's visit before noon, House Democrats held out hopes they could rally the 218 votes to pass a sweeping $1.2 trillion health reform bill, even if it took until late Saturday night.


But they clearly weren't there yet. During the day's first round of votes to corral support for the bill, Majority Leader Steny Hoyer made a rare appearance in the Speaker's Lobby, just off the House floor, to look for colleagues. He told a group of reporters, "I'm always gun-shy...At this moment, I'm counting."

Abortion flared up as a last-minute obstacle to passage, as anti-abortion members pressed for – and won – a vote on an amendment barring insurance companies that participate in the exchange from covering abortions.

That prompted the letter of support for the compromise from the United States Conference of Catholic Bishops.

"Passing this amendment allows the House to meet our criteria of preserving the existing protections against abortion funding in the new legislation," the bishops wrote in a letter to individual members. "Most importantly, it will ensure that no government funds will be used for abortion or health plans which include abortion."

It’s another bitter pill for liberal Democrats but party leaders are gambling that the amendment will be just the breakthrough they need to secure a majority. And in fact, most Democratic advocates of abortion rights appear likely to swallow hard and vote for a health care overhaul anyway.

“I don't believe any of us believe we can hold up what we've been fighting for ... and that's health care," said Rep. Louise Slaughter (D-N.Y.).

Asked whether her allies in the pro-choice movement would support the bill with the Stupak language, Speaker Nancy Pelosi offered a one-word answer: "Yes."

At least 23 Democrats have come out against the bill, giving Pelosi a buffer of 17 votes to work with. But there could easily be another 20 Democrats in the "lean no" category, not to mention the broad universe of undecided lawmakers. So Pelosi and her team essentially need every undecided vote and four or five "lean no’s." That's a difficult dynamic for any party at any time, but the election results and unemployment rates that just eclipsed 10 percent don't help.

So Democrats are bringing in their closer – Obama – at 11:30 a.m. Saturday to try to push the undecideds into the yes column. House leaders are hoping few rank-and-file House members have the conviction to say "no" to their party’s president.

And Obama’s morning visit makes it likely that the vote will come today because Democratic leaders wouldn’t bring in the president, unless they were ready to vote and felt confident they could win passage. It would be an embarrassment to the president if House members defied him after such a personal appeal.

House leaders decided on about six hours of debate, meaning a vote could come as early as 6 p.m.. But a variety of other votes are expected to be scheduled – so the House whips can do their nose-counting – and that could push a vote into well into the night.

Pelosi and other House leaders appeared confident of a Saturday vote – but had some nervous moments on Friday as a steady stream of members declared themselves firm “no’s.” Among the 23 “nos,” all but three are from members who represent districts won by John McCain. Of the three no votes from districts that Barack Obama carried, two of them are from districts that Obama narrowly carried with 52 percent - -and both were Republican-held districts that just flipped to Dems in 2008.

Then there is Artur Davis of Alabama, who is from a 74 percent Obama district. But he is running statewide for governor in a McCain state.

But if the House passes health reform Saturday night, it will be the deal on abortion language that will have been the final impetus. Leaders reluctantly made the decision after working for days to broker a truce that would garner a blessing from the Conference of Catholic Bishops. But the church, according to members and aides, wouldn't accept a compromise crafted by Indiana Rep. Brad Ellsworth that would have established a body to make sure private insurance companies don't use federal funds to pay for abortions.

In the end, the Rules Committee decided to give Michigan Rep. Bart Stupak a floor vote on his amendment to prohibit private insurers from using federal funds to pay for abortion or allowing companies that participate in the exchange from offering coverage through those plans. Given the strength of the anti-abortion vote in the House, the amendment should pass when it comes to the floor and will therefore become part of the broader bill.

Liberals fought hard to prevent Stupak from adding this language, and members of the Rules Committee expressed an obvious unease with the move during debate late Friday night.

Chris Frates and Jonathan Allen contributed to this story.