WASHINGTON — As a school nurse long ago, Rep. Lois Capps worked with children of the uninsured, getting eyeglasses for them with help from the local Lions Club.

Capps, who represents coastal sections of San Luis Obispo County and the city of San Luis Obispo, is one of the most liberal members of the U.S. House. She is a longtime advocate of universal health care. And she said she’s thrilled to be a member of a Congress that’s on the verge of passing a historic overhaul of the nation’s health care system, legislation that she says was first proposed by Teddy Roosevelt and that “means everything to me.”

In a high-stakes battle, she’s also threatening to vote against the bill because one issue is even more important to her: abortion.

At 71, Capps’ name has suddenly become synonymous with defending abortion rights on Capitol Hill, and she’s engaged in one of the biggest fights of her nearly 12-year congressional career.

Capps, of Santa Barbara, is one of 40 lawmakers threatening to derail the legislation if a House-Senate conference committee does not remove language that would restrict access to abortions.

The issue is stirring up plenty of passion in Washington, much to the satisfaction of Capps, who whipped up hundreds of backers when they flooded Capitol Hill for a day of lobbying last week.

“The stakes are now really high and the advocates are going to make all of the difference in the world,” said Capps, attending a standing-room-only abortion rights rally and standing in front of a bright orange-and-white sign that said, “Abortion Is Health Care.” She drew loud applause when she announced: “I am one who cannot even envision voting for health care reform that takes us back on women’s rights.”

Watching Capps at the abortion rights rally, Jingyi Zhang, 25, of San Mateo, called her “a good leader” and said she was happy that California was playing a prominent role in trying to protect abortion rights.

“I feel like California and New York should be the leaders because they tend to be perceived as the most forward-thinking of the states,” she said.

‘Wake-up call’

Capps said abortion-rights backers got “a huge wake-up call” last month when the House voted to include abortion-limiting language in its health care bill by accepting an amendment offered by Michigan Democratic Rep. Bart Stupak.

Backers of abortion rights have a new mantra, “Stop Stupak,” and they much prefer the competing “Capps amendment,” which would not add any more restrictions to abortion coverage.

Capps may not be well-known nationally, but her amendment is quickly gaining fame in the nation’s abortion debate.

“She will probably be known forever as the author of the Capps amendment,” said Cecile Richards, president of the Planned Parenthood Federation of America. While Capps has become a darling of pro-choice groups, anti-abortion groups are working hard against her amendment.

“Americans, women included, reject the radical feminist vision of an abortion for every home, at government expense,” said Marjorie Dannenfelser, president of the Susan B. Anthony List, which opposes abortion rights. If the Stupak amendment is removed, she said, the vote on final passage of the health care bill will be “the most significant pro-life vote” of the year, adding: “This will be a career-affecting vote.”

At the same time, the U.S. Conference of Catholic Bishops is backing the Stupak amendment, saying that without it millions of insurance purchasers would be forced to pay an “abortion surcharge” because they’d be required to pay for abortion coverage.

The House Energy and Commerce Committee approved the Capps amendment earlier this year. Under the amendment, the government could not mandate or prohibit coverage for abortion services for plans in the health insurance exchange, and it would ensure that patients have access to at least one plan that covers abortion services and one that does not. In addition, the amendment would retain and expand existing conscience protections for health care providers who refuse to provide abortions because of their personal beliefs, and it would clarify that public funding may not be used for abortion services except in cases of rape, incest and to protect the life of the woman.

Many abortion-rights backers said the committee work was intended to be a compromise between opponents and proponents of abortion rights and to ward off a divisive fight over abortion when the bill went before the full House.

“We thought that was pretty much something that had been taken care of,” said Sacramento Democratic Rep. Doris Matsui, a member of the committee.

But when the bill came to the full House, a majority voted to scrap the Capps amendment at the last minute in favor of Stupak’s plan, which opponents say would result in the biggest rollback of abortion protections in a generation. Under Stupak’s amendment, consumers who get government subsidies to buy insurance in the exchange could not buy a plan that covers abortions, except in cases of rape, incest or to protect the life of the women.

“My goal has always been to ensure that the voices of the majority of Americans who oppose federal funding for abortion were heard in this important debate,” Stupak said.

Devil’s bargain?

Democratic Rep. Diana DeGette of Colorado, the co-chair of the Congressional Pro-Life Caucus, said abortion-rights opponents are “hijacking” the health care debate and that “they took hostages and demanded a ransom.” But she said backers of abortion rights will not trade away those rights to get a health care bill passed.

“That is a devil’s bargain, and it’s a bargain that we will not make,” DeGette said.

California Democratic Sen. Barbara Boxer, who’s part of a team of women leading the abortion fight in the Senate, said abortion-rights backers will defeat the Stupak amendment, but she said it’s a fight that they had hoped to avoid.

“We didn’t ask for it,” she said. “We didn’t look for it. But now that we’re in it, we will win it.”

Boxer called Capps “a smart and sharp” leader and said that supporters of the Stupak amendment are trying “to chip away and tear away” the abortion rights guaranteed by the Roe v. Wade Supreme Court case. And she noted that no other medical services are being singled out for non-coverage under the health care bill.

“They’re picking on women,” Boxer said. “And the women of America are just simply not going to stand for it.”

Part of history

Capps said that working on reproductive health and sex education was a big part of her job as a school nurse. She spent 10 years working on a program that helped pregnant teens, so she says the issues are “very close to me.” And she said all she’s trying to do is bring “a common-ground approach to the big issue of abortion.”

She predicted that she won’t have to carry through on her threat to vote against the health care bill, saying abortion issues will be resolved and that a bill ultimately will land on the president’s desk.

Capps brushed off any talk of her notoriety in the debate, saying she is happy to be part of “a very important chapter in our country, in the history of our democracy.”

“I want this to be about access to health care,” she said. “I want my grandkids to remember that there was a time when some of their friends didn’t have an opportunity to go to get a checkup at the doctor, and now they do. And that’s the legacy that I’ll be happiest to have.”