Could there be a clearer indication of what's wrong with the Democrats' approach to governing than this tidbit from The New York Times?

"House Democrats are so skittish about the piece of legislation that is now the whole vehicle for overhauling the health care system --the bill passed by the Senate in December--that they are considering a maneuver that would allow them to pass it without explicitly voting for it."

Is that so they can run for re-election by saying they were for health-care reform before they were against it? That they were against it before they were for it? Or just that they were out to lunch and missed the whole thing . . . ?

Speaking of out to lunch, I spoke with a pro-choice advocate today who has been lobbying for family planning coverage about her view of the Democrats' convoluted process as they were putting together the Senate bill. Early in the morning after the Stupak amendment passed, banning abortion coverage in the bill, the members of Congress and staffers she was talking to were "shocked," she told me. "They were getting emails about it at 2 a.m. They had Nancy Pelosi in one room and the Catholic bishops in another, and they were running back and forth, negotiating," she said. Apparently, the leadership had so little idea where they were going that many of their own colleagues were blindsided by the results of these negotiations. "Why are the Democrats negotiating women's health care with the Catholic Bishops?" my advocate friend wondered.

Good question.

After consulting with the insurance companies on national health insurance (now dead), the drug companies on drug prices (now protected), and the bishops (women's access to abortion now restricted), the Democrats have come up with a bill that, as a result of their non-leadership, is a mishmash of positive steps and maddening compromises. Whether the whole thing is worth it is up for debate. The latest twist in the process, in which no one has to take responsibility for voting for it, hardly inspires confidence.

Still, most liberal groups and even some former progressive holdouts are rallying around the bill because:

1. It is so embarrassing to the Democrats and empowering for the Right if nothing gets done on the issue

And 2. It expands health care coverage to millions who need it. "Pass it and fix the problems later," is the common refrain among pro-choice advocates.

Fortunately, the Stupak amendment is out. But the health care reform bill as it stands still has compromise language inserted by Senator Ben Nelson, Democrat of Nebraska, that seriously reduces insurance coverage for abortion. Cecile Richards of Planned Parenthood calls the Nelson "compromise" “the most significant restriction in access to abortion coverage in the nearly 35 years since the U.S. Congress first adopted the Hyde Amendment.”

The Nelson language, which says that states may "elect to prohibit abortion coverage in qualified health plans," requires insurers to figure out what portion of patient premiums go toward abortion coverage and segregate these funds each month. It creates an enormous bureaucratic hassle for insurers, and operates on the absurd notion that women ought to plan for their unplanned pregnancies. And although it only directly applies to people in state-administered health care "exchanges," it would most likely affect even women who have their own, private health insurance.

A George Washington University study from last year found that the Nelson language would probably be just as damaging to abortion access as the Stupak amendment because private health insurers would adapt their coverage to the most restrictive standard set in a state's "exchange" for simplicity's sake.

"Why do the Democrats always sacrifice women first?" my advocate friend asked, as she was lobbying Congress on the abortion restrictions. "We want health care reform to pass, but we don't like the Nelson Amendment. It treats women as second-class citizens."

And the health care reform process as a whole has been a second-rate affair. Women, and everyone else affected by this compromised legislation, deserve better.

Ruth Conniff is the political editor of The Progressive magazine. To subscribe for just $14.97 a year, just click here.