Senate Minority Leader Harry Reid Harry Mason ReidGraham signals support for confirming a Supreme Court nominee this year Trump signals he will move to replace Ginsburg 'without delay' Senate Republicans signal openness to working with Biden MORE (D-Nev.) stands as the biggest hurdle to a rare bipartisan deal on Medicare backed by Speaker John Boehner John Andrew BoehnerLongtime House parliamentarian to step down Five things we learned from this year's primaries Bad blood between Pelosi, Meadows complicates coronavirus talks MORE (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.).

The political maneuvering is even more unusual because it is splitting

Pelosi and the House Pro-Choice Caucus from Planned Parenthood.

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The abortion-rights advocacy group on Tuesday slammed the deal, which would repeal a formula used to pay physicians under Medicare. It argued the legislation would also extend the reach of the Hyde Amendment, which restricts the use of federal funds for abortions.

“I don’t know the last time that expansion of Hyde Amendment has been supported by the Pro-Choice Caucus,” one aide to a women’s health group said.

Pelosi on Tuesday sharply disputed that point, arguing the legislation, would do nothing to further restrict abortion rights.

“I said to my colleagues this morning, I would leave Congress before I voted for the codification of the Hyde language,” Pelosi told reporters Tuesday. “That’s not what this bill does.”

Senate Democrats are withholding support despite the enthusiastic statements from Pelosi, who said she was “very proud” of the measure.

Speaking a few hours later, Reid gave it the cold shoulder.

“I personally am going to wait until we see it having passed the House before we start speculating what we need to do with it, if anything,” Reid told a pack of reporters.

Senate Democrats began raising concerns about the deal as details first emerged last week.

Their objections include the fact that the package would only extend the Children’s Health Insurance Program (CHIP) for two years instead of four.

But it is abortion and a two-year extension of federal funding under ObamaCare for community health centers that appear to be the biggest sticking points.

In the past, an executive order has applied the Hyde Amendment’s restrictions on federal funding for abortions to community health center funding.

Some advocates of abortion rights say that the new package would be a break from the status quo because it would include the Hyde Amendment provisions in mandatory spending for the health centers.

While Pelosi was able to secure additional language making clear that the Hyde Amendment restriction expires when the funding does, the groups still fear setting a precedent.

Planned Parenthood in a statement blasted the bill and said it “extends barriers to abortion coverage.”

Supporters of the bill say it makes no change to current policy, pointing out that community health centers were already subject to the Hyde Amendment and that the restriction expires when the funding does.

Just before Pelosi’s public comments on Tuesday, Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), the co-chairwomen of the House Pro-Choice Caucus, released a statement arguing that the bill’s language “does not further restrict women’s access to abortion.”

Reid declined to say whether he had concerns about the abortion language, adding that “there’s been a lot done” to change the bill in recent days.

Asked about CHIP, Reid said he believes “four years of CHIP is the right thing to do,” but declined to say if it would force him to oppose the rare bipartisan deal.

House leaders say they have the votes to pass the long-awaited reform package, with a vote likely scheduled for Thursday. It is a high priority not only for Pelosi but for Boehner John Andrew BoehnerLongtime House parliamentarian to step down Five things we learned from this year's primaries Bad blood between Pelosi, Meadows complicates coronavirus talks MORE, who touted it as a serious step toward entitlement reform.

For years, Congress has approved short-term patches, known as “doc fixes,” to prevent a cut in the payments to physicians under Medicare’s sustainable growth rate (SGR) formula.

Some House Republicans are questioning whether Reid will let the measure move forward. It is likely to need votes from both parties in the Senate to become law.

“Historically, he has been the difficulty,” said the bill’s lead sponsor, Rep. Michael Burgess Michael Clifton BurgessIgnore the misinformation: The FDA will ensure the safety of any COVID-19 vaccine House goes postal for one day GOP lawmaker calls asymptomatic testing crucial after CDC revises guidance MORE (R-Texas), who has spent 12 years fighting to repeal the SGR.

While Boehner and Pelosi will both earn victories for sealing the deal, Senate Democrats could see little incentive to compromise in a chamber where they are constantly sparring with GOP leaders.

“After putting up with [Senate Majority Leader Mitch] McConnell’s scorched earth-obstructionism for so long, a lot of Senate Democrats would likely be very uneasy compromising,” one Senate aide said, specifically pointing to CHIP funding.

The emerging deal has made a surprisingly fast rise through the House. Even though only about one-third of the bill’s costs would be offset, few members from either party have voiced opposition.

Efforts to eliminate the SGR have always been bipartisan, but lawmakers have been divided about how to make up the costs. Last year’s effort to repeal the bill ended with a last-minute decision by Boehner to suspend rules and hold a voice vote to pass Congress’s 17th temporary “patch.”

Timing is an increasingly big problem. Congress must pass legislation on the fix before March 31 to avert an automatic 21 percent cut in payments to doctors.

Some senators, including Majority Whip John Cornyn John CornynCalls grow for Biden to expand election map in final sprint Bipartisan praise pours in after Ginsburg's death Chamber of Commerce endorses McSally for reelection MORE (R-Texas), have said Congress could use a short-term bill to temporarily avert the cuts while pursuing repeal. But Burgess and other members of the House GOP Doctor’s Caucus have stressed that each day past the deadline weakens the mandate to make the deal.

“The backup plan is chaotic,” Burgess said Monday. “My goal is to get this done.”

House Democrats are holding out hopes that the Senate will help deliver a victory on the SGR, particularly because the deadline coincides with a scheduled two-week recess that starts Monday.

“Remember that nobody smells jet fuel quicker than a United States senator,” a senior Democratic aide said.