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Well, the battle is now joined. With the addition of the Stupak Amendment to the , we are reminded once again that the fight to preserve women's reproductive rights remains literally a constant struggle. Now the nation's attention turns to the Senate, where there will be votes in the coming weeks on whether or not the health care reform bill will substantially narrow women's reproductive health choices for the first time since the adoption of the Hyde Amendment that barred federal funding for abortions except in the case of rape, incest, or when the life of the mother is at risk. The Stupak Amendment, in fact, takes that next limiting step by extending the Hyde restrictions to millions more women.

The House health care reform bill creates an exchange — a roster of health insurance plans available to those individuals who are entitled to receive federal subsidies to help them afford such coverage. The exchange will also be open to those who receive no federal subsidies — though it is expected that at the outset 85 percent will receive some subsidy and 15 percent will be purchasing without public dollars. Rep. Stupak's amendment, however, bars the use of any federal subsidies to purchase any plan that includes coverage for abortion services. Moreover, there are limitations on the plans a company can offer on the exchange. Accordingly, insurance companies — being profit-oriented - are more likely to compete for the 85 percent of that pool of participants than the 15 percent. And that means that abortion coverage will effectively be denied to that 15 percent of exchange participants — thousands of women — who would be using their own money to purchase health coverage. And, of course, there is the absolute bar to abortion coverage to the 85 percent who will receive a federal subsidy — no matter how small the subsidy. And over time, the exchange will become available to larger businesses (with up to and perhaps over 100 employees), thereby extending the reach of this abortion coverage ban.

On Wednesday, November 18, hundreds of leaders of the reproductive rights movement from across the country came to Capitol Hill on very short notice to speak to senators who will be voting on these issues in the coming weeks. The leaders included heads of faith organizations, civil liberties groups, as well as women's rights and reproductive rights groups. We heard from the current generation of leaders — people like Cecile Richards of Planned Parenthood — and from some of the giants of the movement who remain just as active today as they were years ago including Eleanor Smeal and Kate Michelman. In addition, strongly supportive Senators gave us insights into the likely legislative strategy. Sen. Debbie Stabenow (D-Mich.) was encouraged that the overwhelming majority of Democrats were on board and that there might be a good shot at getting some Republican support. She focused on the notion that the basic premise of health care reform should be an expansion of coverage — and that under Stupak, one segment of the population — women — will be singled out to lose coverage. Sen. Barbara Boxer (D-Calif.) urged the issue leaders to focus their attention on activism in their home states. She, too, argued eloquently that the reproductive rights movement must not take one step back. Sen. Christopher Dodd (D-Conn.) is a likely member of the conference committee who will resolve any differences between the House bill and the bill that comes out of the Senate and therefore will be a key voice in determining the shape of the final law. He urged activists to focus on the home districts of their elected representatives — getting to meetings, writing to local papers, calling radio stations. We also heard compelling presentations from Sens. Patty Murray (D-Wash.) and Sherrod Brown (D-Ohio), two more stalwarts in the fight to preserve reproductive choice. Sen. Murray, in particular, said that education is key: people across the country and their representatives have to be educated about why the preservation of health care options is so important.

Groups will be organizing activities in states across the country in the next several weeks. It's absolutely critical that you make sure your voice is heard. There are lots of ways to do that. Write to your senators and representative. Call a local radio show. Send a letter or email to your local newspaper. When you see misinformation, don't let it slide — correct it. If we do the best job possible at the local level, the Senate and the House will get the message — and the majority who believe in reproductive health care for women will prevail. To start, go to our and tell your elected officials to STOP STUPAK!