The abortion debate heated up in the halls of Capitol Hill - and on the House floor itself.
"It's outrageous," said California Rep. Barbara Lee. "It further places the religious views of some into our public policy."
The controversial amendment introduced by Democrat Bart Stupak and Republican Joe Pitts would bar any new government insurance plan from covering abortions, an extension of a law, its authors say, that has been on the books since the 1970s.
"I'm not writing a new abortion policy," Stupak said. "The Hyde amendment already prohibits federal funding of abortion."
Late last night the amendment passed 240 to 194. And Democrats acknowledged that without it, the health care bill faced defeat.
"I was part of recommending that it come to the floor," House Speaker Nancy Pelosi said.
It was a major concession for pro-choice Democrats, to ensure the success of the overall health care bill and secure the 218 votes needed to win passage. But abortion rights activists say it was a huge step back.
"Right now about 80 to 85 percent of private insurance companies cover abortion care. This means that women without their own money in this country are not going to be allowed to access that care," said Nancy Keenan, president of NARAL Pro-Choice America.
Sixty-four Democrats joined 176 Republicans to vote for the amendment. And anti-abortion activists say that may be a sign.
"It was very exciting last night to see demonstrated that there is bi-partisan pro-life majority in the House and that reflects the pro-life majority in America," said Dr. Charmaine Yoest of the group Americans United For Life Action.
But abortion opponents aren't declaring victory just yet. The bill now goes to the Senate, where ardent defenders of abortion rights are promising to reverse the amendment's impact on the health care bill in its final version.