WASHINGTON -- A Capitol Hill vote on Thursday over insurance coverage for birth control spilled into the Nevada race for U.S. Senate, elevating a sharp contrast between the candidates and all but ensuring it will become a key issue in the campaign.
Democrats in a 51-48 vote defeated a Republican effort to roll back President Barack Obama's policy on contraception insurance coverage.
The amendment would have allowed employers and insurers to opt out of portions of the president's health care law they found morally objectionable, including a requirement starting in 2013 that insurers cover the costs of birth control.
Republicans said it was a matter of freedom of religion. They said the Obama policy violates the First Amendment guarantee by forcing insurers and employers to pay for contraception even if their faith forbids its use. Roman Catholic leaders oppose the requirement.
Democrats called Thursday's proposed amendment an assault on women's rights, so broad it would have allowed employers and insurers to opt out of nearly any medical treatment with the mere mention of a moral or religious objection.
Nevada Republican Sen. Dean Heller voted for the rollback after criticizing Obama's policy as a government overreach and an infringement on religion.
Democratic Rep. Shelley Berkley, who is challenging for Heller's seat, had defended the policy as a safeguard for women's health rights.
While their stances were not new, the Senate action ignited a furious message war among the candidates and their surrogates. Each side sought to frame the issue in their favor while declaring the other candidate to be on the wrong end.
Analysts in Nevada predicted voters will not have heard the last of it, although it remains to be seen which candidate might profit the most.
"It will have some legs," said Fred Lokken, political science professor at Truckee Meadows Community College, "I have a hunch there will be an effort to resurrect this stuff in debate. The other way it will be resurrected will be in all these negative advertising campaigns. We will see that pummeling in both directions."
Heller said his vote was against the president's health care law and a contraception provision he believes is unconstitutional.
"This was always a religious freedom issue, and it continues to be a religious freedom issue, and anyone who wants to make it something else, it is just red herrings," Heller said. "I have supported access to contraception in the past, and I will continue to support contraception accessibility to women in the future."
The argument that women would be deprived of birth control if employers exercise a conscience objection is "crazy," Heller said. "Statistics show 91 percent of women in this country have access to contraception. We spent billions of dollars in this country providing access to contraception through health care clinics. So if you work for a business or a religious group that conscientiously objects to providing this service, you do have access through your health clinics in your community."
Nevada law provides an exemption for religious organizations that choose not to insure for birth control. But Democrats contended the Republican amendment, sponsored by Sen. Roy Blunt of Missouri, would have opened the way for employers to refuse other coverages as well.
Berkley was traveling late Thursday and could not be reached. Earlier she told The Associated Press the issue "is about one thing: Providing preventive care for women to ensure that they have basic access to health care. This is as fundamental to women as breathing."
The public is in favor of requiring birth control coverage for employees of religiously affiliated employers, according to a CBS News/New York Times poll from Feb. 8-13. The survey found that 61 percent favor the mandate, while 31 percent oppose it. Catholics support the requirement at about the same rate as all Americans.
Senate Majority Leader Harry Reid, D-Nev., voted to kill the measure, calling it "an extreme ideological amendment that takes aim at women's access to health care."
The Senate vote aside, the debate "won't be over until the administration figures out how to accommodate people's religious views as it relates to these mandates," Blunt said. "This is a debate that might be settled at that building across the street," he said, referring to the Supreme Court.
Nevada Democrats were preparing attacks on Heller over the vote to drive a wedge between him and female voters, similar to earlier campaigns that sought to raise questions about him among Latinos and senior citizens.
A poll of the too-close-to-call race last October conducted by Democratic-leaning Public Policy Polling showed Berkley with a 52 percent to 38 percent edge among women.
"Dean Heller just took the war against women to the next level," Berkley said in an opening salvo video released by her campaign on Thursday.
Heller's campaign responded by tying Berkley to the controversial Obama health care law, "the very law that has given the government enormous control over the health of all Americans."
"Congress should be focused on creating jobs and passing a budget, not stuck in a wrestling match to protect Americans' religious freedom," Heller spokeswoman Chandler Smith said. "If Shelley Berkley and the Democrats hadn't forced a $2.6 trillion health care plan through Congress, this would not even be an issue."
Heller said he is prepared to duke it out.
"This is a constitutional issue," Heller said. "At the end of the day people will understand this is a religious issue."
Lokken said Heller could be in a challenging spot.
Heller's vote "becomes a potential problem for him. He is not going to get a groundswell of voting support for having taken this position, although it will probably lead to more contributions," Lokken said.
"Berkley, however, on the issues of women's rights and privacy rights could get a lot of traction. This is something that could be termed as positive for Berkley and something that Heller could literally be put on the defensive about."
Mark Peplowski, a political science professor at the College of Southern Nevada, said the impact could be limited.
"I don't think it's going to bring many more votes to the fold," he said. "I don't think it is going to turn many more voters who aren't already leaning toward supporting Berkley and the Democrats."
Peplowski said the major things on the mind of Nevada voters will remain housing, jobs and taxes, and "I don't see (birth control insurance) as a top three issue."
The Associated Press contributed to this report. Contact Stephens Washington Bureau Chief Steve Tetreault at firstname.lastname@example.org or 202-783-1760.