The New York Times.

Only one Senate Republican — Olympia Snowe of Maine, who is retiring — voted against a truly horrible measure on Thursday that would have crippled the expansion of preventive health care in America. The amendment, which was attached to a highway bill, was defeated on a narrow 48-to-51 vote. But it showed once again how far from the mainstream Republicans have strayed in their relentless efforts to undermine the separation of church and state, deny women access to essential health services and tear apart President Obama’s health care reform law.

The amendment, which was enthusiastically endorsed by Mitt Romney and Rick Santorum, would have allowed any employer or insurance company to refuse coverage for any activity to which they claim a religious or moral objection.

That would have meant that any employer who objects to cervical-cancer vaccines could have refused to provide health insurance that covers them. The same goes for prenatal sonograms for unmarried mothers, or birth control, H.I.V. screening or mammograms.

Health care reform, for the first time, required virtually all insurance policies to cover a package of preventive services without co-payments, including flu shots, pap smears and prenatal care. In August, after an Institute of Medicine recommendation, the Obama administration expanded that list to include birth control and screening for H.I.V. and cervical cancer, among other services.

Churches were exempted on religious grounds from covering birth control. And, last month, Mr. Obama announced a plan to let church-related institutions, like hospitals and universities, shift the cost of this coverage to their insurance companies. But that still wasn’t enough for Republicans.

If churches are exempted on religious grounds, they said, why shouldn’t any employer be allowed to refuse coverage if they have objections? Imposing this mandate, Senator Orrin Hatch of Utah said Thursday, constitutes “tyranny,” a bullying of the little guy by President Obama at the behest of his “feminist allies.”

But the real bullies are those who would allow any employer to arbitrarily cut off access to services recommended by the Institute of Medicine. Individual employers can no more claim exemptions from important public health requirements than they can to paying taxes for government policies they oppose.

Republicans claimed the issue was about religious freedom. But it was really about denying consumers — and particularly women — the right to make their own medical decisions and keeping up the antigovernment and anti-President Obama drumbeat.

Naturally, the party’s presidential candidates support it, having based their campaigns on the canard that Mr. Obama is using government to control people’s lives or trample on their religious beliefs. But most Americans support free access to contraception. Few people want their bosses or their insurance companies to tell them how to live their lives.

The good news is that the amendment was defeated. And, by championing it, the Republicans may well help inform more people about the popular benefits of health care reform — and about the extremism of one party that seems determined to take them away.