WASHINGTON - The Senate killed a Republican effort yesterday to let employers and health insurance companies deny coverage for contraceptives and other items they object to on religious or moral grounds.
The vote was 51-48.
In effect, the Senate upheld President Obama’s birth control policy, which guarantees that women have access to insurance coverage for contraceptives at no charge, through an employer’s health plan or directly from an insurance company.
Senator Patty Murray, Democrat of Washington, said the vote showed “the Senate will not allow women’s health care choices to be taken away from them.’’
The vote followed four days of impassioned debate in which senators weighed the competing claims of religious freedom and women’s reproductive rights.
Republicans said the administration was forcing religious institutions to violate tenets of their faith by providing access to contraceptives.
“The president is trampling on religious freedom,’’ said Senator Mike Johanns, Republican of Nebraska.
Democrats, defending the new health care law, said the Republican proposal went far beyond contraception and would allow employers to deny coverage for other items and services to which they objected.
“This amendment opens up Pandora’s box - its overly broad and vague exceptions could allow children to be denied immunizations, companies to object to mental health services, health plans to deny HIV screenings, and the rejection of maternity care for single mothers,’’ Senator John Kerry of Massachusetts said in a floor speech before the vote. “That is just not good legislating. It’s dangerous.’’
Senator Barbara A. Mikulski, Democrat of Maryland, said Republicans were attacking women’s health care as part of “a systematic war against women.’’
Senator Roy Blunt, Republican of Missouri, offered the proposal as an amendment to a highway bill. Under the proposal, health insurance plans and employers could refuse to provide or pay for coverage of “specific items or services’’ if the coverage would be “contrary to the religious beliefs or moral convictions of the sponsor, issuer, or other entity offering the plan.’’
Senator Scott Brown of Massachusetts was one of several cosponsors. Brown has called the issue “one of our most fundamental rights as a people - the freedom of religion,’’ adding: “No one should be forced by government to do something that violates the teachings of their faith.’’
His main Democratic rival for the Senate, Elizabeth Warren, has echoed Democrats’ criticism of the measure, calling it an attack on health care and, in Warren’s words, “an assault on every family in Massachusetts.’’
Kathleen Sebelius, the secretary of health and human services, urged the Senate to reject the proposal.
“The Obama administration believes decisions about medical care should be made by a woman and her doctor, not a woman and her boss,’’ Sebelius said.
Speaker John A. Boehner said yesterday that House Republicans also wanted to protect religious employers who object to the requirement for contraceptive coverage. “It’s important for us to win this issue,’’ he said.
Boehner did not offer any details about a legislative path forward but hinted that it would differ from the one tried by Senate Republicans.
Senator Olympia J. Snowe of Maine, who said this week that she would not run for reelection, was the only Republican voting with Democrats to uphold the president’s birth control policy.
Kerry called the amendment an example of polarizing partisanship that prompted Snowe to not seek reelection in the fall.
“I think our friend from Maine, Senator Snowe, spoke for many of us this week when she talked about ‘my way or the highway’ approaches to partisan politics that have made it harder and harder for people to work with each other and get things done,’’ Kerry said. “I would never speak for her but given her diagnosis of what’s wrong with the Senate today, the amendment we’re debating seems to be exhibit A.’’
Snowe is a moderate Republican and three-term senator, and she criticized the fractious politics on the Hill in her surprise decision this week to leave Congress. She called the Blunt amendment too broad.
Her Maine GOP colleague, Susan M. Collins, a longtime backer of family planning programs, voted for the amendment.
“I do this with - with a lot of conflict because I think the amendment does have its flaws,’’ she said, adding that she hopes “the Senate will begin to address the many important pressing issues facing our nation and stop engaging in what is clearly an election-year ploy.’’
Politicians from both sides of the aisle joined with Collins in protesting that an issue affecting millions of Americans was being used for political gain.
The challenge to the president’s policy was supported by 45 Republicans and three Democrats: Senators Bob Casey of Pennsylvania, Joe Manchin III of West Virginia, and Ben Nelson of Nebraska; Casey and Manchin are up for reelection this year, and Nelson is retiring.
Senator Jeanne Shaheen, Democrat of New Hampshire, said the proposal could affect all Americans, not just women.
“The Blunt amendment would allow employers to deny virtually any preventive or essential health service based on a religious or moral objection,’’ Shaheen said. “An employer could deny coverage of HIV/AIDS screenings, prenatal care for single mothers, mammograms, vaccinations for children, or even screenings for diabetes based on a moral objection to a perceived unhealthy lifestyle.’’
Blunt, a former president of Southwest Baptist University in Bolivar, Mo., said: “This amendment does not mention any procedure of any kind. The word ‘contraception’ is not in there because it’s not about a specific procedure. It’s about a faith principle that the First Amendment guarantees.’’
The 2010 health care law requires most insurers to cover preventive services without copayments or deductibles. Under the Obama policy, these services include all contraceptive drugs and devices approved by the Food and Drug Administration, as well as sterilization procedures.
Churches and other houses of worship would be exempt. In February, after protests from the Roman Catholic Church and others, Obama announced what he described as an accommodation for church-affiliated schools, universities, hospitals, and charities. They would not have to provide or pay for contraceptive coverage, but their female employees could obtain such coverage directly from the employers’ insurance companies at no cost.
Republicans called this an accounting gimmick and said that religious employers would eventually bear the cost, in higher premiums.
Senator Barbara Boxer, Democrat of California, disagreed.
“When insurers provide birth control, they save money,’’ she said. “It’s not only life-saving; it is cost-saving.’’