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US Representative Patrick Kennedy's confrontation with Providence Bishop Thomas J. Tobin over abortion and health-care reform has soaked up quite a bit of ink. But the fight is just the most dramatic fallout of a larger effort by the nation's Catholic bishops to write abortion restrictions into the reform package.

Church leaders penned sharply worded letters to lawmakers on the subject starting in July. Cardinal Sean P. O'Malley of Boston lobbied President Barack Obama during Ted Kennedy's funeral. And the bishops' representatives were in Speaker Nancy Pelosi's office for three hours the night before the House's health-care vote, negotiating for abortion curbs — curbs that ultimately passed, to the horror of pro-choice forces.

Now, it's off to the Senate, where the bishops vow to continue their fight, and where abortion politics threaten to derail health reform yet.

Kennedy, in the comments that sparked his public row with Tobin, suggested that the church's effort is deeply misguided — that the bishops should not risk scuttling health-care reform, "the biggest social justice" push of our time, in the service of abortion politics. And there is something to be said for this argument, particularly when the Hyde Amendment already bans most federal funding for abortion.

But the bishops argued rather convincingly that the original health-care bill stood to underwrite abortion by funneling subsidies to plans that provide for the procedure — even if insurers were forbidden, as some proposed, from using public dollars to pay for abortions.

This was a real issue for the church. And the bishops, whatever one makes of their position on abortion, could hardly be expected to abandon a central value. The more pressing question, then, is should the Democratic leadership have listened so intently to the bishops' entreaties in the first place?

John F. Kennedy, seeking to assure voters that his faith would not dictate his actions in the White House, set the bar high during a campaign speech in 1960. "I believe in an America where the separation of church and state is absolute," he said, "where no Catholic prelate would tell the president (should he be Catholic) how to act, and no Protestant minister would tell his parishioners for whom to vote."

But that America, of course, does not exist. Religion matters in the public sphere. And even those politicians who would keep faith in proper perspective, who would weigh religious concerns without letting them dominate, must reckon with its political force from time to time. That's what happened with health care.

The House leadership did not accede to the bishops' concerns out of some slavish devotion to the Pope. Rather, Pelosi had to win over a few key pro-life Democrats — some of whom demanded that the bishops' concerns be addressed — if she was to triumph on a health-care bill. And that's what she did, winning by the slimmest of margins: 220-215.

It was a major setback for pro-choice forces, their worst defeat in years. And if Washington's abortion-rights Democrats can find a way to soften the blow in the coming weeks, more power to them.

But for now, it seems, the abortion restrictions were a necessary compromise. Indeed, Kennedy himself voted for the final version of the bill, essentially heeding his own admonition to the church: don't put abortion politics ahead of the greater goal of health-care reform.

It was a principled compromise. But not the sort of thing we can reasonably expect from the bishops. The church, for all its meddling in the politics of abortion and gay marriage, is not beholden to parliamentary reality.

Related: Call for health-care reform, Has Obama learned from Clinton’s mistakes on health-care?, You Snus you lose, More more >
  Topics: News Features , Barack Obama, U.S. Government, Patrick J. Kennedy,  More more >
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