Sen. Ben Nelson’s amendment to severely limit abortion access through health insurance exchanges and the public option was tabled on the Senate floor this afternoon, making good on speculation and hope that the Senate would be more hostile to abortion restrictions that the House, which passed a similar amendment, was. Tabling the amendment kills it, and was, as Robert Pear noted in the New York Times, the riskier move, since 51 votes were required to table it, and only 41 were to defeat it in an up-or-down vote. If Nelson refuses to support the Senate legislation, Sen. Harry Reid may have to court Sen. Olympia Snowe or Sen. Susan Collins, who are pro-choice but public option-hesitant, to join Dems in favor of his healthcare bill instead.



During floor debate, anti-choice senators were at pains to insist that the Nelson amendment did not create any new barriers to abortion (Sen. George Voinovich, how is lack of funding not a barrier?) and that the existing compromise on abortion funding in healthcare reform–in which insurance companies in the exchange would be required to use money from premiums and co-pays to pay for abortion coverage–was merely an accounting "gimmick" (Sen. Mike Enzi, tell that to any non-profit that both provides services and lobbies). The highlight of the floor debate over Nelson’s amendment was an impassioned speech by Sen. Barbara Mikulski yesterday, who quipped in response to arguments that women could simply buy a rider that offers abortion coverage, "Why not have men buy an abortion rider for the women they get pregnant?"



The tide on the Stupak (House version) and Nelson amendments seemed to turn last Wednesday, when a national pro-choice lobby day brought hundreds of citizen lobbyists, marshaled by a huge coalition of groups that included Planned Parenthood and NARAL Pro-Choice America but also dozens of smaller reproductive justice groups headquartered around the country, to Capitol Hill. At the packed rally that kicked off the day, the usual suspects–Rep. Jerry Nadler, Rep. Diana DeGette, Sen. Barbara Boxer, and newer faces Reps. Donna Edwards and Judy Chu–issued full-throated disavowals of Stupak–DeGette called Stupak "the devil’s bargain." Interestingly, a couple of reps got in a little Hyde-bashing to boot: "Stupak is not simply an extension of current law," said DeGette, "and believe me, I don’t like current law." (Nadler called Hyde "obnoxious.") The Hyde amendment, which bans Medicaid funding for abortion except in narrow cases of rape, incest, and life endangerment, came in for less criticism, and even some support, in the floor debate today, with senators reaffirming that Hyde was not up for debate today and Sen. Chris Dodd saying that Hyde has "served us well." (Tell that to the tens of thousands of poor women and teens who are forced to carry pregnancies to term because they can’t afford abortion, Sen. Dodd.)



Now that the Senate bill is all but certain not to include Stupak-like language, what will happen when the bills are conferenced? Would any House members who voted for Stupak pull their support this time around? Stephanie Poggi, executive director of the National Network of Abortion Funds, has met with representatives who consider themselves pro-choice who did not fully understand Stupak before voting on it. "There was too much focus on the leadership without educating members" about what the amendment meant, Poggi says. After the vote, Poggi said, pro-choice voices had stepped up the level of education. At Wednesday’s rally, Nadler noted that House conferees are pro-choice.



Meanwhile, there’s been good news, not only not-bad news, in the Senate for women’s health, too. Last week, the Senate passed the Mikulski amendment, which requires all health insurance plans to cover women’s preventive healthcare and screenings with no copay, by a sizable margin. This is a big deal: earlier this fall, Sharon Lerner noted here at that both the House and the Senate bills failed to specify comprehensive coverage for women’s healthcare services. "None of the bills emerging from the House and Senate require insurers to cover all the elements of a standard gynecological ‘well visit,’" Lerner wrote, "leaving essential care such as pelvic exams, domestic violence screening, counseling about sexually transmitted diseases, and, perhaps most startlingly, the provision of birth control off the list of basic benefits all insurers must cover." (As Sen. Jan Schakowsky said at the rally, "If women’s bodies were the standard for healthcare, how different our world would be.") Mikulski had proposed her amendment to the Senate HELP Committee’s version of the bill, which at the time passed by one vote. But it was dropped off the version of the bill Reid presented to the full Senate. Mikulski’s amendment will likely even provide coverage for contraception. PPFA’s Tait Sye told RH Reality Check’s Amie Newman that the Mikulski amendment "allows Health Resources and Services Administration (HRSA) to recommend what should be covered, so HRSA can/could recommend birth control be covered."