In the early morning on Thursday the South Carolina House approved an amendment to the state budget that would ban state insurance policies from covering abortions except to save the life of the mother. The budget proposal submitted by Gov. Mark Sandford, similar to the proposal from the previous year, allowed for state health insurance policies to pay for abortions in cases of rape, incest and to save the life of the mother. The vote on Thursday was a reversal from a Tuesday vote where an amendment proposing such restrictions had failed.

Jessica Bearden is the director of public policy for Planned Parenthood Health Systems, which covers North Carolina, South Carolina and parts of Virginia and West Virginia. Bearden said that the original amendment sponsored by Republican Representative Rex Rice would have imposed a total ban on coverage by the state health insurance plan of all abortions, including those performed to save the life of the mother.

“[Rep. Rice] was talking like those kinds of procedures cost $350, and why can’t women just pay for them out of pocket. But most abortions done to save the life of the mother you are talking about something done at a hospital and those cost thousands of dollars,” Bearden said. “So we educated him.”

Bearden said by the time the amendment came to a floor vote on Tuesday Rice was willing to include an exception to save the life of the mother, but not in cases where an abortion is performed in cases of rape or incest. The amendment failed in a 57-54 vote on late Tuesday. However Bearden said that on Wednesday anti-choice groups managed to exert pressure on some of the Republican representatives who had voted against the amendment and reopened debate on the amendment.

After four hours of debate the House passed the amendment at 5 a.m. on Thursday in a vote of 75-38.

The amendment reads:

No funds appropriated for employer contributions to the State Health Insurance Plan may be expended to reimburse the expenses of an abortion except in cases where the life of the mother is at risk and the termination of the pregnancy is incidental to the lifesaving intervention, and the State Health Plan may not offer coverage for abortion services or services incidental to abortion except as permitted by this paragraph. The physician shall act in accordance with the standard of care to preserve both the life of the mother and the life of the pre-born child.

Bearden says that this standard is unclear. “What are ‘services incidental to abortion,’” she asks. “I don’t know and I don’t think the House knows either.”

Bearden pointed out is that last year the state covered only six abortions total, and all were cases for reasons of rape, incest or to save the mother’s life.

“I just want to make a point that in a state where reproductive health outcomes are incredibly poor… state legislators spent hours and hours debating just these six abortions,” Bearden said. Debates about funding healthcare, sexual transmitted infection testing, family planning, comprehensive sex education, those are the debate we never get to, she said.

The fate of the amendment now moves to the Senate which will take it up next week.

The Greenville News quotes one Republican senator who does not give the amendment much of a chance of survival.

The abortion proviso wouldn’t have much practical effect since few state employees find themselves in that situation, said Sen. Mike Fair of Greenville, an ardent anti-abortion supporter. While he said senators who oppose abortion might vote for the proviso, he is sure it will draw opposition and may not survive.

“I don’t think there are many over here who would agree with that strong a position,” he said. Fair said the health plan already doesn’t pay for elective abortions, the usual battleground for anti-abortion activists.

Sen. John Land, leader of Senate Democrats, said he couldn’t predict how the proviso would fare in the Senate but wouldn’t personally support it.

“All I can say is I would not be willing to change the existing contract state employees have with their state insurance to preclude any service that has heretofore been rendered to them,” he said.