— The state House on Thursday approved a proposal to add regulations to the operations of North Carolina abortion clinics.

The House voted 74-41 in favor of the bill, which now returns to the Senate for a final vote before going to Gov. Pat McCrory. He pledged on the campaign trail last fall that he wouldn't support more restrictions on abortions in the state.

House members rolled out the regulations Wednesday in committee, adding them to an unrelated bill on motorcycle safety without advance notice. Hours earlier, McCrory threatened to veto a raft of abortion regulations that the Senate passed last week, saying they crossed the line between protecting patient safety and restricting access to a legal medical procedure.

The House proposal instructs Department of Health and Human Services regulators to write rules "not unduly restricting access" of women seeking abortion.

"This is really all about protecting the health and safety of women," said Rep. Ruth Samuelson, R-Mecklenbug. "Problems do exist in some of our abortion clinics, and that's what we're trying to address."

Samuelson said the House softened provisions in the Senate proposal to resolve the concerns McCrory and DHHS Secretary Aldona Wos expressed earlier this week.

The Senate bill would have required abortion clinics to meet the same standards as outpatient surgery centers and required physicians to remain with patients throughout an abortion, even if it were drug-induced.

The House version calls for only relevant standards of surgery centers to apply to abortion clinics and requires that a physician be present for only the first dose of RU486 or other abortion drugs. Such drugs are usually administered in two to three doses, and the doctor wouldn't need to see the patient for later doses under the House proposal.

Opponents argued during a vigorous three-hour debate that such changes were only cosmetic, and they said the legislation is intended to shut down abortion clinics by regulating them tightly. Similar laws in other states have forced clinics there to close.

"It’s about politics. It’s not about women’s health. It’s not about safety," said Rep. Alma Adams, D-Guilford.

"This is an anti-woman bill in disguise, a wolf in sheep’s clothing,” said Rep. Jean Farmer-Butterfield, D-Wilson.

Rep. Sarah Stevens, R-Surry, took exception to those characterizations, insisting that the bill isn't part of any "war on women."

"We know that abortion is out there, but it should be safe and clean and sterile as well as legal," Stevens said.

Rep. Pat McElraft, R-Carteret, later chided Democrats, saying they should have pushed for higher standards for abortion clinics years ago.

"Some of these clinics are nothing but money-making facilities," McElraft said. "It's not about the health of women. It's about abortion on demand at any cost to women."

The bill also contains the following provisions:

Allows any health care provider, not just doctors and nurses, to opt out of participating in abortion procedures.

Prohibits health plans offered on the exchange established under the federal Affordable Care Act from offering coverage for abortion.

Prohibits cities and counties from offering coverage for abortions in health plans they offer their employees.

Prohibits abortions for the purpose of selecting the sex of a child.

Rules for abortion clinics haven't been updated since the mid-1990s, Wos said this week, but she also noted that state funding for inspections is so paltry that clinics can be examined only every three to five years.

"For 19 years, we have not looked at and reviewed and updated the standards and requirements" for abortion clinics, said Rep. Marilyn Avila, R-Wake. "Don’t you think there have been some changes that we need to look at?"

Rep. Jacqueline Schaffer, R-Mecklenburg, said standards for animal shelters are often more extensive that what's required of abortion clinics.

"As a state, we're doing a poor job advocating for the health and safety of women," Schaffer said.

Noting that regulators shuttered a Durham abortion clinic last week over questions about its blood testing, she said, "We do have problems here. It's recurring, and we have to do something to fix that."

Abortion clinics statewide have been cited 205 times over the past decade for health and safety violations, Stevens said, and several have been written up repeatedly for the same problems.

Rep. Marcus Brandon, D-Guilford, questioned how Republican lawmakers could square their arguments that women's health and safety need to be protected with other legislation they've pushed in the session, such as refusing to expand Medicaid access and cutting benefits to jobless workers.

"Pro-life doesn't end at birth," Brandon said. "We need to at a comprehensive way for women to have access to health care and not just at abortion clinics."

Rep. Joe Sam Queen, D-Haywood, noted the irony that lawmakers have been trying to strip away state regulations for other businesses but are trying to add new rules for the operators for abortion clinics.

"It's transparent to me that this is just government obstruction to women's rights," Queen said.

Rep. Nathan Baskerville, D-Vance, took issue with the provision prohibiting local and county governments from providing abortion coverage to employees, calling it a "power grab."

"(It's) another example of the state being tutored by this Republican majority on what big government really looks like," Baskerville said.

Democratic lawmakers were as upset about the handling of the bill as they were about its content.

After criticizing the Senate for its rush to pass abortion regulations last week with little public input, the House held a two-hour public hearing Tuesday on the measure. House Republicans then shelved the Senate bill, tweaked the language and stuck it in a separate bill without advance warning Wednesday and brought it to the floor within a day.

"This is just another version of the same political game-playing," said Rep. Susan Fisher, D-Buncombe. "It is what it is, a deceitful hijacking of women's access to a constitutionally protected medical procedure."

"As a woman, I am personally insulted by the maneuvers around getting this bill to the floor today," Adams said. "We’ve made a mockery of women’s health and safety. We deliberately put up all kinds of barriers to keep the public out."

An exasperated Rep. Becky Carney, D-Mecklenburg, noted that the House has already approved many of the provisions of the bill and asked simply, "What are we doing here?"

Carney said lawmakers should study abortion clinic operations more carefully and invite input from the medical community instead of putting DHHS on the spot to write new regulations.

"We're passing off our responsibility," she said. "We're not being deliberative and doing what we're charged to do."