This Goes Out to All the Ladies

Having won re-election on the backs of women voters, Obama should thank them by reversing last year's disasterous decision on Plan B.

This past election, President Obama made blatant appeals to female voters to great success. Fifty-five percent of women and a jaw-dropping 68 percent of single women voted for the president this round. Feminist and reproductive-rights groups especially campaigned hard, not just to reward him for some significant wins for women in office, but because they widely believed that he could do even more in a second term, especially with 18 congressional seats swapping from anti- or mixed-choice to pro-choice.

In other words, feminist-leaning women helped usher in Obama's victory, and now they're wondering how he intends to show his gratitude.

Even though most of 2012 was a love-fest between feminists and the Obama administration, the administration came under plenty of fire from activists who felt he was often too quick to compromise. Some feminist organizations, like the National Organization for Women, denounced the president for signing an executive order barring insurance plans on health-care exchanges from covering abortion, even though a handful of anti-abortion Democrats were determined to destroy health-care reform if they didn't get this concession.

More troubling was that, in late 2011, the administration took away a victory that feminists thought was in the bag. For years, anti-choicers from the Bush administration had killed applications to make Plan B, an emergency contraceptive, available to all customers over the counter, even though the makers had repeatedly demonstrated that their product met all the safety standards required. The debate centered around giving access to minors. Bush-appointed FDA officials voiced concerns that Plan B on shelves would encourage teenage girls to have sex, and even, in the words of one official, that the drug would "lead adolescents to form sex-based cults around the use of Plan B."

In 2011, the scientific arguments in favor won out, and the Food and Drug Administration prepared to grant Plan B over-the-counter status. But in a historically unprecedented move, Department of Health and Human Services Secretary Kathleen Sebelius overruled the FDA, requiring Plan B to stay behind pharmacy counters, where only those 17 and older can buy it without a prescription if they show identification.

Despite Obama's comments defending the decision, in which he claimed "common sense" holds that Plan B shouldn't be sold "alongside bubble gum or batteries," the move was widely perceived as shameless political pandering. Prior to this, the president had defended the reproductive rights of minors, opposing parental-notification laws for abortion and arguing for comprehensive sex education. By stating that girls should not be "punished with a baby" for having sex, he showed he was not just pro-choice, but understood the right-wing obsession with sin and punishment, which is what drives their opposition to expanded reproductive health-care access.

Beyond such prudish moral policing, there are no real reasons to oppose making emergency contraception accessible. The administration's decision was almost surely a reaction to concerns that anti-choicers would run ads conflating Plan B with abortion in order to claim little girls were buying abortions alongside bubble gum and magazines. (Plan B works by suppressing ovulation before sperm can make the multi-day journey to the Fallopian tubes; it is not an abortifacient.)

But last year's failure presents an opportunity for the administration not only to pay the feminist coalition back for its support, but also to reiterate support for putting science and evidence above ideology when it comes to policy-making. A group of feminist organizations, led by the Reproductive Health Technologies Project, are using the December 7 anniversary of Sebelius's decision to push her department to reconsider and allow the FDA to put emergency contraception on shelves next to condoms and tampons. Without having to think about getting re-elected, the administration has much more political leverage to let scientists and doctors take the lead on this.

Medical organizations have given HHS a solid reason to revisit the issue. Citing a high rate of unintended pregnancies among teenagers, the American Academy of Pediatrics recommends that pediatricians simply write their teenage patients emergency-contraception prescriptions ahead of time so they don't have to worry about the current age restrictions. Implicit in the recommendation is disapproval of the current government policy that makes their pre-emptory actions necessary. In addition, the American Congress of Obstetricians and Gynecologists has recommended that the FDA make the birth-control pill available over the counter. Such strong recommendations for freely available birth control should make it a lot easier for HHS to agree that a one-time dose of Plan B shouldn't be treated like a big deal.

When the Obama administration made contraception part of a larger package of preventive services that insurance companies will be required to cover without a copay in January, they did so by following a very simple principle: They put medical evidence first. The HHS's copay-free contraception decision was based on the recommendations of the Institute of Medicine; it was not, despite Mitt Romney's insistence otherwise, a "gift" crafted to lure single female voters.

Now the administration should do the same with emergency contraception instead of caving to pressure from right-wingers hostile to science. Not only would such a move signal to feminists that they were right to enthusiastically support Obama; it would help bolster the image of the Democrats as the party of evidence-based policy, especially health-care policy. It would also help reassure the liberal coalition that the Democrats really are striving to escape their reputation for compromising with the right even when they don't have to.

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