WASHINGTON — Capping a divisive debate, the U.S. Senate voted 51-48 on Thursday to reject a “rights of conscience” amendment by Sen. Roy Blunt, R-Mo., that opponents said would have allowed employers to opt out of providing no-cost coverage for contraceptives or other health care that violates their religious or moral beliefs.

Although his effort fell short, Blunt vowed afterward that “this fight is not over.” He said the battle is likely to move next to the Republican-controlled U.S. House and eventually to federal courts, where lawsuits already have been filed challenging President Barack Obama’s compromise on contraceptive coverage.

“I think eventually, if the legislature doesn’t clarify this and the administration doesn’t change its mind, the courts will” rule on the issue, Blunt told reporters. In a statement, he also decried what he called opponents’ “outlandish and divisive efforts to misinform and frighten Americans” about the amendment.

Liberal Democrats, led by Sens. Barbara Boxer, D-Calif., and Patty Murray, D-Wash., hailed the Senate’s vote and pledged to fight what they viewed as efforts to restrict women’s access to birth control and other preventive health care. “The Senate will not allow women’s health-care choices to be taken away from them,” Murray said.

The vote to table Blunt’s amendment to a transportation bill followed more than a week of debate during which he and other supporters framed the amendment in terms of religious liberty while opponents presented it as a veiled attack on women’s rights that also could be used to weaken other mandates in the Affordable Care Act.

Three moderate Democrats backed Blunt’s amendment and one Republican — Sen. Olympia Snowe, R-Me. — opposed it. Sens. Claire McCaskill, D-Mo., and Dick Durbin, D-Ill., voted to reject Blunt’s amendment. Sen. Mark Kirk, R-Ill., is still recovering from a stroke and did not vote.

While she did not speak during the Senate debate, McCaskill had told reporters last week that she would oppose Blunt’s amendment because it goes “too far.” She said she is “very concerned about the war on contraception” now being waged by some conservatives. “If we want to now decide that whether or not a woman can get birth control depends on who she works for, I just think that is a giant step backward for our country.”

In his remarks, Durbin, D-Ill., the second ranking Senate Democrat, opposed Blunt’s amendment as “a step in the wrong direction for this country.” He contended that its “conscience” loopholes would have led to “a patchwork quilt of health-insurance coverage with many people in this country — men and women — denied basic health coverage in their health insurance because the employer believes ‘in conscience’ that it shouldn’t be offered. That is an impossible situation.”

Blunt rejected that interpretation, saying that “this provision would simply preserve the fundamental religious freedom that we enjoy today. For the first time in our history, the Obama administration’s health-care mandate is an egregious violation of our First Amendment rights.” 

Senate Majority Leader Harry Reid, D-Nev., condemned Blunt’s proposal as an “extreme ideological amendment,” but Republican leader Mitch McConnell, R-Ky., argued that it was a First Amendment issue because the Obama administration’s contraceptives-coverage rule would “make it impossible, for the first time, for religious institutions" to practice what they preach.

Reading letters from religious leaders supporting Blunt’s amendment, McConnell said: “If the ‘free exercise of religion’ clause of the First Amendment means anything at all, it means that it is not within the power of the federal government to tell anybody what to believe or to punish them for practicing those beliefs. And yet that is precisely what the Obama administration is trying to do through its health-care law.”

Condemning the Obama administration’s contraception rule as “discrimination masquerading as compassion,” Sen. Orrin Hatch, R-Utah, pledged that Republicans would continue fighting such health mandates under the Affordable Care Act. Blunt agreed that further efforts will be made to repeal parts of that “Obamacare” law.

The GOP rhetoric rankled most Senate liberals, including Sen. John Kerry, D-Mass., who said Obama’s revised contraceptives-coverage rule specifically exempts religious institutions and allows religious-affiliated employers to avoid direct coverage of contraceptive services, with insurers providing that option.

He and other critics said the wording of Blunt’s amendment was so vague that it would be a Pandora’s box, leading to many lawsuits related to employers’ claims of religious or moral objections to providing a wide range of preventive health procedures. “It is overly broad, vague and it violates the core principle of privacy,” argued Sen. Richard Blumenthal, D-Conn., who said it would “create jobs only for lawyers.”

Democratic women were especially critical, although McCaskill kept out of the limelight and avoided a Senate speech. At a Capitol press conference on Wednesday, Sen. Barbara Mikulski, D-Md., called Blunt’s amendment as “politics masquerading as morality” and Sen. Jeanne Shaheen, D-N.H., claimed it would “turn back the clock on women’s health care.” 

But Sen. Kelly Ayotte, R-N.H. criticized the “mischaracterizations and distortions” by opponents. “Many have tried to characterize this amendment as denying women access to contraception. That’s a red herring, and it's false,” said Ayotte in a Senate speech. “We are talking about government mandates that are interfering with conscience protections here that have long been engrained in our law.”

Future compromise possible?

Despite the Senate vote, it was clear that Blunt and other Republicans planned to pursue the “religious liberty” issue. After the vote, Blunt told reporters that “this is an issue that will be out there until the administration figures out how to accommodate the true religious beliefs and First Amendment rights” that religious institutions have.

“My view is that we’ve probably done about as much as can be done in the Senate,” Blunt said. “Now it’s up to the House, the [Obama] administration and maybe eventually the courts to see who makes the next move.” 

During the Senate debate, Sen. Susan Collins, R-Me., blamed both sides for “playing politics” on the issue, and said she hoped that the Blunt measure — which she said “has its flaws” — could be revised in a way that allay women’s concerns about contraceptive coverage and related issues.

Arguing that “a good compromise should have been worked out,” Collins said she stills hopes “that its scope will be further narrowed and refined” to clarify its impact. But Blunt said after the votes that he talked with Collins afterward and she seemed less convinced that compromise language would be needed. 

Durbin said a “religious liberty” amendment on health care is unnecessary because Obama’s revised plan on the contraceptives coverage issue “strikes the right balance between respecting the conscience and religious values of certain institutions while still protecting the freedom of individuals.”

The Illinois Democrat said the compromise “removes the church-sponsored institution from making the initial decision that might run counter to its values but gives the freedom to the individual employee to pursue health care under the law which they consider to be essential, such as family planning.”

But McConnell rejected that interpretation and said he and most other GOP senators disagreed with suggestions by some opponents of the Blunt amendment to work out compromise language.

“They want to be the ones to tell the religious institutions what their ‘core mission’ is,” said McConnell. “That isn’t a compromise; that’s another government takeover.”

Added McConnell: “Who do you think has a better grasp of the mission of the Catholic church — the Cardinal archbishop of New York or the president’s campaign manager?”

Several senators said that HHS Secretary Kathleen Sebelius and her staff are still working with religious institutions to adopt the final language on Obama's compromise on contraceptives coverage. In a statement, Sebelius opposed the Blunt amendment as "dangerous and wrong," asserting that it "would allow employers that have no religious affiliation to exclude coverage of any health service, no matter how important, in the health plan they offer to their workers.”

The debate over the Blunt amendment reached the GOP presidential campaign Wednesday, with front-runner Mitt Romney at first telling an Ohio News Network reporter that he did not back it but later clarifying on Boston radio show that "Of course I support the Blunt amendment. I thought [the Ohio reporter] was talking about some state law that prevented people from getting contraception so I was simply — misunderstood the question." Romney pointed out that Blunt is his point man in lining up support on Capitol Hill.

Meanwhile, both sides criticized Romney on the issue. On the right, Republican presidential candidate Rick Santorum touted his support of such religious liberty initiatives during an appearance in Tennessee, and his campaign criticized Romney for having a "liberal record" on freedom of religion.

Obama's reelection campaign also went on the attack, with deputy campaign manager Stephanie Cutter writing to supporters: "For a brief moment this afternoon, it looked like Mitt Romney was showing some spine and opposing the [Blunt] proposal. But literally within minutes, his campaign walked it back . . . If the bill passes, you can thank Mitt Romney and Rick Santorum's support for helping to pave the way for this anti-contraception agenda.”