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 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.”