The Senate on Tuesday rejected a bid by anti-abortion lawmakers to put strict limits on federal abortion funding in the Democrats' health care overhaul bill, setting up a congressional showdown over the issue in the weeks ahead.
Fifty Democrats, two independents and Republicans Susan Collins and Olympia Snowe of Maine voted against the restrictions. Thirty-eight Republicans and seven Democrats voted for the tougher rules. Sen. Robert Byrd, D-W.Va., didn't vote.
The vote came as the Senate plodded through a ninth day of debating the $848 billion, 10-year plan to revamp the nation's health care system.
Behind closed doors, Democrats moved closer to a compromise on crafting a plan that would serve as an alternative to private insurance coverage. Democratic leaders want a "public option," or government-run program, but moderates have been cool to the idea.
The public option, approved by the House of Representatives last month, has been one of the two key controversies dogging the health care effort.
The other is abortion. Because of Tuesday's vote, the Senate health care bill continues to allow health plans the option of covering elective abortions. If abortions are covered, the plan must establish separate accounts with private funds to pay for them.
Abortion rights proponents agree that the health legislation should follow current law, which bars federal funds from being used for abortion except in cases of rape, incest or danger to the woman's life. But they also say that if a woman wants to spend her own money on abortion services she should be allowed to do so.
The restricted language remains in the House bill, and if the Senate passes its version of health care, which it hopes to do before the end of this year, the two chambers would have to find a compromise.
That won't be easy, because discord over abortion nearly derailed the House bill; it survived only after the more restrictive abortion language was added.
But abortion rights advocates have strong allies in the Democratic Party, and Senate abortion rights backers were adamant they would not accept the House plan in their legislation.
"I believe we deal with this sensitive topic in a sensitive way," said Sen. Barbara Mikulski, D-Md. "I believe what we have done is found the sensible center, and it leaves the decision in the hands of the patients and doctors, not politicians or insurance companies."
Anti-abortion senators thought the truly sensitive approach was to be more restrictive.
"Most Americans, even some who support abortions, do not want taxpayer money to be used for abortions," said Sen. Ben Nelson, D-Neb., chief sponsor of the amendment. "We should not break with precedent on this bill."
The lobbying has been fierce. NARAL Pro-Choice America this week has been running television ads in areas represented by lawmakers considered swing votes, notably in Raleigh, N.C., Michigan's Upper Peninsula, Maine, Virginia and parts of Minnesota and Wisconsin.
It's also set up phone banks in 20 states where callers are advised to push a button and be connected directly with their lawmakers' offices.
Anti-abortion interests have been just as adamant, and got a boost from the U.S. Conference of Catholic Bishops. In a letter to senators Monday, the bishops said that if the restrictions are not adopted, "the current legislation should be opposed."
With the major abortion vote out of the way, Democratic leaders continued to push for some accord on alternatives to private insurance.
Liberals, as well as President Barack Obama and congressional Democratic leaders, have eagerly sought a public option, but because three or four Democratic moderates have balked, Senate Democrats have been locked in private talks for about a week seeking a compromise.
Under the most widely discussed plan, Medicare, the government's program for seniors, and Medicaid, which helps pay bills for the poor, would be expanded.
In addition, people near retirement age, perhaps those 55 to 65, could qualify for Medicare, which now covers people over 65 and some people with disabilities.
Also under consideration is a plan that would have the federal government, or Office of Personnel Management, oversee new health insurance plans that would be available around the country and perhaps negotiate premiums or payments to doctors, hospitals and other providers.
Nonprofit groups or insurers would run the plans; the federal government would not.
The political dilemma involves whether liberals, notably those in the House of Representatives, would agree to vote for that kind of plan, given the House vote last month favoring a public option.
ON THE WEB
U.S. Conference of Catholic Bishops' letter on abortion
Congressional Budget Office analysis of Senate Democrats' health care bill
Text of Senate Democratic health care bill
Congressional Budget Office analysis of House health bill
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