With the final showdown over health care reform looming, conservative activists Tuesday descended on Capitol Hill to press lawmakers to spike the measure while medical stakeholders worked behind the scenes to protect their interests.

Disgruntled voters who have aligned with the tea party movement gathered in a park across from the Capitol to express their anger that the House may shortly consider a bill they view as a hostile government takeover of the health care system.

Shouting “kill the bill” and waving signs such as “Stop being a Democrat, Start being an American,” the crowd cheered on a parade of Republican lawmakers who at times employed colorful language to denounce the bill.

“I don’t want to make you sick, but I brought an abortion to show you here today,” Rep. Louie Gohmert (R-Texas) said as he held up a copy of the health care bill. Gohmert claimed the measure included three ways in which abortion can be federally funded. “There are a lot of demons around here apparently.”

Democrats have said the Senate version of the bill, which the House will take up, segregates insurance payments so that no money would be used for abortions. The House and Senate are also expected to vote on a reconciliation measure that includes changes to the Senate bill. But that measure can only include budget-related items and is not expected to include any abortion language.

Nevertheless, Rep. Steve King (R-Iowa), who urged the protesters “to rise up” and “storm this city,” alleged the bill would fund both abortions and health care coverage for undocumented immigrants.

“This is about liberty. They are seeking to nationalize your body,” King said.

As activists protested outside, some health care interests were seeking to ensure that the provisions they had successfully fought for in the legislation would not be significantly altered through the reconciliation process.

Officials with the American Association of Homes and Services for the Aging were working Tuesday to fend off any possible changes to a provision that would provide insurance for adults who become disabled and seniors with chronic illnesses. The provision known as the CLASS (Community Living Assistance Services and Supports) Act is included in the Senate bill.

Tonya Speed, a lobbyist for the AAHSA, said the group was “shoring up support” in the House for the Senate bill, including participating in an event on Capitol Hill with Speaker Nancy Pelosi (D-Calif.) on Tuesday afternoon.

[IMGCAP(1)]Other groups, such as the Catholic Health Association, which represents Catholic hospitals, were not only trying to ensure passage of the Senate bill but were also making sure reconciliation included what they said were needed legislative fixes to the bill.

In a letter to House Members, Sister Carol Keehan, president of the Catholic hospital group, said the Senate bill “goes a long way toward meeting the goals of reform,” but she said a corrections bill was needed to address such issues as increasing tax credits for low-income people who buy health insurance and increasing Medicaid’s primary care reimbursement rates.

The letter states that the final health care reform package should provide no federal funding for abortion. However, the Catholic hospital association is not working to defeat the Senate bill, unlike anti-abortion groups that argue the measure contains language that is not restrictive enough regarding federal funding for the procedure. Anti-abortion groups as well as the U.S. Conference of Catholic Bishops had thrown their support behind more restrictive abortion language, authored by Rep. Bart Stupak (D-Mich.), in the House version of the bill.

The bishops put out a statement this week opposing the Senate bill’s abortion language.

Americans United for Life, an anti-abortion group, on Tuesday launched a $350,000 campaign that included running full-page newspaper ads in eight Congressional districts in Ohio, West Virginia, Indiana, Illinois and North Dakota. In addition, the group said it was making phone calls and blasting e-mails and text messages to its activists about the upcoming House vote on the Senate bill.

Other groups were anxiously awaiting the details of the reconciliation measure to see whether their concerns were addressed.

Kathleen Jaeger, president of the Generic Pharmaceutical Association, has been lobbying for changes that would reduce the 12-year minimum time included in the Senate bill that brand-name drug companies have to exclusively develop cutting-edge biologic drugs.

While the generic industry has some key allies, including President Barack Obama and Energy and Commerce Chairman Henry Waxman (D-Calif.), Jaeger said the brand-name drug companies have waged an impressive lobbying campaign to protect their interests.

“This is ‘101′ in the best in lobbying and political influence,” Jaeger said. The Pharmaceutical Researchers and Manufacturers of America, which represents the drug industry, had made a deal with the Senate last year to contribute $80 billion over 10 years in drug subsidies, which the White House has recommended be increased by $10 billion. Drug companies in recent days have been seeking to ensure their interests were maintained in the final bill.

But Jaeger said her group would “continue to pound the pavement and make sure our champions have everything they need.”

After the tea party rally, some in the crowd headed to House office buildings to lobby Democratic Members who have been on the fence on health care. Three men from the Eastern Shore of Maryland were debating whether it was worth stopping by the office of their Congressman, Rep. Frank Kratovil (D), who voted against the House version of the health care bill but who remains undecided.

“I don’t think it matters,” said Don Loveless, a retired government worker from Stevensville. Loveless was accompanied by two realtor friends, Charles Kraus and Jeff Bridegum. They all said they did not vote for Kratovil in 2008 when he was first elected in the Republican-leaning district. But they warned that if Kratovil voted for the health care bill, they would work hard for his defeat, contacting their friends and relatives.

Others in the crowd said the issue was broader than health care. “People want free will. They are telling us what cars to drive, what light bulbs to use,” said Claire Thomas of Arlington, Va.

Marlene Langert of Adelphi, Md., said Obama and the Democrats reminded her of the Bolsheviks in Russia that her parents and grandparents escaped from in the 1920s.

While Langert said she was on Medicare, a government program, she added, “My husband and I paid for it over the years, so it is not really a handout.”