WASHINGTON — John Boehner helped start the clock running on a government shutdown. It’s up him to stop it.

The U.S. House speaker’s choice — between keeping the government running and continuing to fight the nation’s three- year-old health-care law — has implications for the 2014 congressional elections and, potentially, his future.

The Ohio Republican has a tough decision to make. He can keep up the fight against Obamacare when the Senate sends back a spending bill in coming days, making a shutdown more likely. Or, he can fund the government with the help of Democratic votes, and risk alienating a band of Republican newcomers who’ve already tried once to oust him as speaker.

“This is coming back and John Boehner is going to have to make the decision again,” said Peter Wehner, head of former President George W. Bush’s Office of Strategic Initiatives. “He’s in a situation where he’s damned if he does and damned if he doesn’t.”

Boehner has five days to choose before a shutdown.

The House probably won’t get back the Senate bill with health-law defunding stripped out until just days before government spending authority runs out on Monday.

Changing the proposal and sending it back to the Senate increases the chance of shutdown. Senate Majority Leader Harry Reid, a Nevada Democrat, said any House amendments at that point would be a “sure-fire way to shut down the government.”

The Office of Management and Budget estimated 30 days of shutdowns in 1995 and 1996 cost more than $1.4 billion, or $2.09 billion in today’s dollars. Democrat Bill Clinton was re-elected president in 1996 in a landslide after the Republican Congress was blamed for closing the government.

Boehner insists he doesn’t want to shut down the government, though his caucus could again try to curb the health-care law with changes to a Senate bill. They’re mulling options such as rolling back a tax on medical devices and lifting an exemption that keeps members of Congress out of Obamacare.

The speaker also could determine that move is too risky, right up against a potential shutdown. Then his option would be to call for a vote to clear the spending bill with the help of Democrats, which would keep the government open and could turn some members of his caucus against him.

He’s been seeking to persuade House Republicans to put off the fight over the health-care law until a debt-ceiling debate in the next few months. So far, he hasn’t succeeded.

Boehner has been pushed into a corner by a vocal minority of House Republicans whose legislative priority is to stop President Barack Obama’s health-care law. They’ve shown no signs of relenting.

“It doesn’t make sense if we take this stand and then next week say we really didn’t mean it,” said Texas Rep. Louis Gohmert, one of 12 Republicans who voted against Boehner’s re-election as speaker in January.

Gohmert and his group are backed by the limited-government tea party movement, which is trying to cripple the law. FreedomWorks, an organization tied to the tea party, is targeting college campuses, telling young adults to not sign up for the government-run insurance exchanges scheduled to roll out on Oct. 1.

Americans for Prosperity, a small-government group funded by billionaire industrialists David and Charles Koch, is spending almost $1 million on TV ads to do the same.

Brent Bozell, head of ForAmerica, a tea party group specializing in social media, warned that “Republicans who fold will find themselves with primary challengers.” The group has claimed responsibility for 50,000 phone calls to the offices of Boehner and other Republicans in support of defunding Obamacare.

“If John Boehner does not hold the line — if he caves — his speakership is over,” Bozell said in an interview. “If he champions this, he reasserts his leadership.”

When asked for a response, Michael Steel, Boehner spokesman, said, “The House has passed a bill to keep the government open and defund Obamacare.”

“The fight, right now, is in the Senate,” he said.

Boehner tried to delay the health-care law fight until a debate over the nation’s $16.7 trillion debt ceiling, which lawmakers still have a few weeks to decide. While Obama has insisted he won’t negotiate over the country’s ability to pay its bills, other Democrats, including Sen. Amy Klobuchar of Minnesota, have said a deal is probable.

House leaders are trying to return to that game plan.

If the House votes this week on leadership’s proposal to suspend the nation’s debt cap for one year and, among other things, delay Obamacare for a year, it could ease pressure on the spending showdown.

“Our goal is to avoid a government shutdown,” Steel said.

Dan Holler, communications director for Heritage Action for America, a limited-government group pushing to defund the health law, said there “wasn’t an appetite among House Republicans” for that approach.

Still, there’s support among tea party Republicans to amend the Senate budget plan. One proposal is to eliminate health-care subsidies for U.S. lawmakers and their staff.

The amendment, by Republican Sen. David Vitter of Louisiana, would overturn an Obama administration decision in August to maintain employer contributions for Congress, worth about $5,000 for individuals and about $10,000 for families.

“That issue has clearly bubbled to the top,” Rep. Steve Southerland of Florida, the 2010 class liaison to House Republican leadership, said in an interview.

Holler suggested Republicans could amend the budget bill to keep some parts of the government running while pushing the fight beyond Monday.

A shutdown would carry political risks for their party, Republican senators including Tennessee’s Bob Corker have warned. The party in 2014 will try to maintain their 33-seat majority in the House and win the majority in the Senate for the first time since 2006.

“If the House doesn’t get what we send over there until Monday, they’re in a pretty tough spot,” Senate Minority Leader Mitch McConnell, a Kentucky Republican, said about House Republicans.

The Democratic Congressional Campaign Committee has created websites, produced videos and issued eight news releases in nine days trying to score political points off the possibility of a shutdown.

Boehner, 63, was an architect of the Republican agenda that helped his party win a House majority in the 1994 election. Just as in that upheaval, the Republican class of 2010 is mostly composed of members who vowed to uphold their campaign principles, making compromise difficult.

Rep. Tom Graves, a Georgia Republican elected in 2010, said the speaker’s willingness to fight over the budget bill was “reminiscent of the young John Boehner.”

“I’m happy to stand right beside him when I see that resolve,” Graves, 43, said in an interview.

It remains to be seen whether that support for Boehner will last the month.

“It’s only as deep as the support is from outside of the Beltway,” said Rep. Thomas Massie, a first-term Kentucky Republican. “That’s really what got us to this step.”

Still, Boehner allowed himself a smile last week, enjoying the applause from fellow Republican lawmakers at a Sept. 20 rally, in a rare moment of unity.

“The American people don’t want the government shut down, and they don’t want Obamacare,” Boehner said.

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