Catholic bishops may end up having the final say on health care overhaul as they use their considerable clout with millions of Catholics to get abortion restrictions added the House bill.
Recognizing their power to move votes, top government officials spent last Friday negotiating with the bishops' representatives as final terms of the deal were reached.
"The Catholic Church used their power - their clout, if you will - to influence this issue. They had to. It's a basic teaching of the religion," said Rep. Bart Stupak, D-Mich., a leading pro-life advocate and architect of the health measure's restrictions.
House Speaker Nancy Pelosi, a pro-choice Catholic, got in touch with Washington's former archbishop, Cardinal Theodore E. McCarrick, Friday to discuss the matter.
The conference came after Stupak advised Pelosi of the wisdom of conferring with the bishops' staff if she wanted a deal on the health care bill.
"I said, 'Well, they're here, and they're one of the key groups you want to have on your side, so why don't we just bring them in and work this out," Stupak said.
The final measure, passed by the House Saturday, prohibits federal funding of abortion except in cases of rape, incest or the life of the mother being in danger.
With the baton being passed to the Senate, President Barack Obama finds himself in a tough position.
Pro-life Democrats are standing firm in their refusal support a bill without abortion restrictions while pro-choice advocates are refusing to support legislation that contains them.
Meanwhile, Obama is struggling to find a middle ground that has yet to be identified.
Bruce Oppenheimer, a political science professor at Tennessee's Vanderbilt University told the London Telegraph that moving the process forward may end up taking priority over pleasing pro-choice supporters.
"Your big effort in the short term is to get something out of the Senate and therefore you're willing to trade off on specific provisions as long as you can get a bill through."