With the politics of abortion continuing to threaten passage of their health care reform overhaul, House Democratic leaders are wrestling with what appear to be three routes for moving forward — and none is particularly easy.

Speaker Nancy Pelosi (D-Calif.) clearly would prefer to find the votes to pass the Senate’s less restrictive abortion language over the objections of the Catholic bishops, Rep. Bart Stupak (D-Mich.) and a clutch of House Democrats who oppose abortion rights.

But that will require Pelosi to offset the votes of Stupak and as many as 10 other Democrats he says stand with him on abortion by flipping other moderates from “no” to “yes” on the overall health care reform package.

Leadership aides are skeptical of Stupak’s count and believe they can hang on to about half the number that the Michigan Democrat says are in his corner.

And getting a handful of folks to switch from “no” to “yes” is certainly far easier to do than flipping a dozen.

But already some Democrats have started pushing to punt the abortion debate with promises that the issue will be subject to future floor votes.

Energy and Commerce Chairman Henry Waxman (D-Calif.) has floated putting off the issue — although to date both sides of the debate have rejected the idea. Under Waxman’s idea, the Senate language would stand for now but be subject to future votes in the years before the insurance exchanges take effect.

The idea isn’t far off from a deal that Stupak and the bishops signed off on last year. Stupak said last year that they had an agreement with Pelosi to add a ban on private insurance offering abortion coverage that would be subject to an annual vote alongside a permanent ban on the public option offering such coverage. That deal was nixed by abortion-rights supporters who demanded a floor vote on Stupak’s restrictive language, and Stupak won easily.

With the public option off the table, an annual vote on abortion coverage by private insurance companies would seem consistent with the earlier deal, according to a Democratic leadership aide.

“If it was good for them then, why can’t it be good for them now?” asked a House leadership aide. “Don’t they want health care?”

A third route involves forcing new abortion language through the Senate, either on a reconciliation bill of fixes or on another bill, but that will require 60 votes to overcome procedural hurdles.

Republicans, hoping to sow doubts among House Democrats about reconciliation’s prospects for passing the Senate, threatened Tuesday to block any efforts to toughen up the Senate abortion language. Specifically, Republican Senators plan to raise a budget point of order, a procedural move objecting to the reconciliation process that requires 60 votes to defeat.

“If there is anyone left in the House who believes Senate Republicans will help carry their water on abortion or anything else so they can vote in favor of the health bill, they are radically misreading our Conference,” a senior Republican Senate aide said Tuesday. “Republicans intend to raise every point of order and will not waive a single one regardless of merit to assist Democrats in passing this $2.5 trillion health care boondoggle.”

Abortion-rights supporters, meanwhile, are vowing to oppose efforts to restrict abortion coverage provided people pay for that portion of the insurance with their own money.

“We are not going to agree to further restrictions on abortion,” said Rep. Diana DeGette (D-Colo.), co-chairwoman of the Pro-Choice Caucus, noting that 40 Members have signed a letter vowing to oppose a health care bill with language akin to the blanket Stupak ban that passed the House.

“If you put abortion restrictions in the bill, that’s the one thing we’ll never fix,” she said, predicting that pressure to vote against abortion rights “will just crush people every year.”

DeGette, who is also a Chief Deputy Whip, said she’s done her own count and believes Democratic leaders can roll Stupak and company.

“I think we have the votes,” she said. “Some of the people I think will vote ‘yes,’ but they don’t want to tell Bart that.”

DeGette also doesn’t like the idea of annual votes on abortion.

“We’re not going to have an annual vote on anything,” she said. Women should be able to choose private insurance that covers abortion in the exchanges just as they can now without exchanges, she said.

“We’re not going to cross our fingers and hope we can fix this later,” she added.

That whip count, meanwhile, is complicated by the uncertainty surrounding what route leadership will take. Rep. James Oberstar (D-Minn.), chairman of the House Transportation and Infrastructure Committee, is one of the higher-profile backers of Stupak’s push and as recently as late last month pledged to oppose any health reform bill that lacked the Stupak language included in the House legislation. But Oberstar spokesman John Schadl on Tuesday signaled some flexibility. He said Oberstar is hopeful “there will be a compromise that he and others will be able to live with. Something’s got to change, but he hasn’t ruled out voting for the Senate bill if it’s an interim step toward a fix.” Schadl added, “Nobody is under the illusion that the House is going to pass the Senate bill as is. The question is will it meet the threshold that allows him to move forward — Jim is pretty confident that’s going to happen.”

So, apparently, is Stupak. His office noted that he met last week with Waxman and House Majority Leader Steny Hoyer (D-Md.) and expects further discussions this week. He “remains optimistic that language can be worked out,” a Stupak spokesman said.

Democratic leaders acknowledge they don’t yet have a solution in hand.

House Majority Whip James Clyburn (D-S.C.) said on MSNBC on Tuesday he was confident that Stupak and other Democrats would ultimately vote for the health care bill, but he didn’t offer a particular path for success.

And Hoyer on Tuesday morning said he has talked to Stupak about sitting down to discuss the issue. But the House Democratic No. 2 said they have not yet begun discussing substance.

“It is a serious issue that obviously confronts the Congress that has to be resolved in a way consistent, I think, with our opportunity to pass health care for all Americans,” Hoyer said.

David M. Drucker contributed to this report.