WASHINGTON (AP) — House Democratic leader Nancy Pelosi bruised some longtime liberal allies when she worked with Speaker John Boehner to craft a rare bipartisan accord on Medicare. But lawmakers say it will enhance her stature as a dealmaker, and may help her party avoid being sidelined by majority Republicans over the next two years.

Pelosi and her fellow Democrats disappointed friends in the abortion-rights lobby by backing a bill to avoid future cuts in Medicare physician payments. As Thursday's 392-37 House vote suggests, the bill was a compromise, with appeal to both parties.

Democrats boasted it would extend the Children's Health Insurance Program for two years, and increase federal matching rates for states. But it also would reinforce abortion restrictions at community health centers, a GOP priority that abortion-rights groups strongly oppose.

For that reason, many Senate Democrats, including their leader, Harry Reid of Nevada, called the bill unacceptable earlier this month. By then, however, Pelosi was deep into negotiations with Boehner, an Ohio Republican.

The standoff was politically strange: Pelosi, the 15-term liberal hero and unquestioned defender of abortion rights, seemed less adamant about the topic than did Reid, who came to Washington 31 years ago as an abortion opponent. Reid announced Friday he will not seek re-election next year.

President Barack Obama further weakened Reid's position Wednesday, when he called the bill a good bipartisan agreement. Lawmakers said Senate passage seems probable though timing was uncertain.

Pelosi's allies defended her trade-off. They say she inflicted a nonfatal wound to one constituency in exchange for proving that Boehner can — and sometimes must — turn to Democrats for crucial votes he can't get from his hard-right, "hell no" caucus of conservative purists.

The outcome should show that Boehner is "willing to work with Democrats rather than try to placate the tea party base," said Democratic Rep. Adam Schiff of California. Democrats dislike the bill's abortion restrictions, he said, "but unfortunately it's been part of the necessary give and take" in spending bills for years.

Several Democrats said the abortion restrictions are disappointing but not deal-killers for liberal groups such as Planned Parenthood and NARAL.

"Long-term, that's not a wedge between these various groups," said Rep. John Larson, D-Conn. He said Pelosi and Rep. Diana DiGette of Colorado, both well-known supporters of abortion access, defused the issue this month by patiently explaining, in closed Democratic caucus meetings, that the Medicare bill's language would change current law only slightly.

Lawmakers warn that the new bipartisan dynamic could be short-lived, especially when Congress confronts tougher issues such as raising the debt ceiling. For now, however, the Pelosi-Boehner cooperation lessens the tea party's influence and gives House Democrats hope for a bigger voice in tax policy and trade, among other things.

House members and aides say bipartisan staff talks, from a few months ago, revealed that both parties wanted a better solution to the annual problem of deep cuts scheduled for Medicare payments to doctors. At Boehner's request, he and Pelosi met in her office for 11 minutes on March 4. Staffers soon began working out details.

"The door opened and I decided to walk into it," Boehner would later say.

Meanwhile, abortion-rights groups increasingly were warning of Republican plans to chip away at abortion access at local, state and federal levels, in ways small and large. On March 18, Democratic Sen. Dianne Feinstein of California gave an impassioned floor speech, citing those concerns and vigorously defending abortion rights.

Her speech seemed to mark a Senate Democratic "line in the sand," said Jim Manley, a former Reid aide who follows Congress closely.

But any hope of a coordinated House-Senate campaign ran counter to Pelosi's plans to work with Republicans on the Medicare bill to make her outnumbered House Democrats more relevant.

Those efforts, of course, threatened to anger staunch House conservatives who generally abhor any compromise with Democrats. Some realized, however, the Pelosi-Boehner talks also were creating tension between House and Senate Democrats.

The talks "did irritate me," said GOP Rep. Matt Salmon of Arizona. "But later, when we found out that by cutting a deal earlier, Pelosi basically headed Harry Reid off at the pass, I thought maybe it wasn't a bad strategy after all."

Democrats reject such suggestions, saying it's not unusual for senators and House members to disagree and then resolve their differences. Obama's endorsement Wednesday further eroded Senate resistance.

"With both the Speaker and the Democratic leader working together in the House to put something together, that means something," Feinstein told reporters. "We have to take what we can get."

Pelosi, a major force in making Obama's health overhaul the law in 2010, said House and Senate Democrats basically agree on abortion rights and women's health care, despite complaints by some groups.

"I understand the concerns that people have about it," Pelosi told reporters Thursday. But she called Thursday's measure a "really a good bipartisan bill."

Rep. Jim McGovern, D-Mass., said Reid's opposition surprised him, but "hopefully, it was a mild temper tantrum and we move on."

Obama hailed the House vote. "I want to give John Boehner and Nancy Pelosi credit," he said. "They did good work today."

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Associated Press writers Alan Fram and Jim Kuhnhenn contributed to this report.