At issue is a measure sponsored by Sen. Roy Blunt of Missouri that would allow employers and insurers to opt out of provisions in Obama's health care law to which they object on religious or moral grounds. That includes the recently rewritten requirement that insurers cover the cost of birth control, even for religiously affiliated employers whose faith forbids contraception.
Republicans cast the debate as not about contraception or women but instead the First Amendment's guarantee of religious freedom.
"This is an issue that's greater than any short term political gain. It gets right at the heart at who we are as a people," Senate Republican Leader Mitch McConnell said from the floor just before the vote Thursday. "This isn't about one particular religion, it's about the rights of Americans of any religion."
Democrats say the debate is about eroding access to contraception and, more broadly, women's health care rights. There is no more important constituency to Obama's re-election hopes than women and independents.
"This proposal isn't limited to contraception nor is it limited to any preventive service. Any employer could restrict access to any service they say they object to," said Secretary of Health and Human Resources Secretary Kathleen Sebelius. "The Obama administration believes that decisions about medical care should be made by a woman and her doctor, not a woman and her boss.
For both parties, the debate and Thursday's expected vote were efforts to rouse their staunchest supporters.
Late Wednesday, a slate of Republican centrists appeared uncertain how they would vote on the measure.
"It's much broader than I could support," Sen. Olympia Snowe, R-Maine, said on MSNBC just after announcing she was dropping her re-election bid. "I think we should focus on the issue of contraceptives and whether or not it should be included in a health insurance plan and what requirements there should be."
Some Republicans worried privately that the focus on contraception risks losing track of the top concern among voters this year: the economy.
Under pressure from Catholic bishops and others, Obama last month rewrote the policy slightly to shift the cost of birth control from employers to their insurers. Republicans called that an accounting trick.
A majority of Americans support the use of contraceptives. The public is generally in favor of requiring birth control coverage for employees of religiously affiliated employers, according to a CBS News/New York Times poll Feb. 8-13. The survey found that 61 percent favor the mandate, while 31 percent oppose it. Even Catholics, whose church strongly opposed the recent government mandate, support the requirement at about the same rate as all Americans.
