Plan B: Understanding Obama's cynical but savvy political calculation

Health and Human Services Secretary Kathleen Sebelius overruled the FDA to prevent the plan B emergency contraceptive from being offered without a prescription to girls under 17. The practical impact is to limit access to the “morning after” pill. The drug will remain behind the pharmacy counter and those under 17 will need to get a doctor’s prescription before they can purchase it.

The official reasoning is that the data submitted did not prove it would be used appropriately by young girls. But in fact this is a highly cynical decision that has everything to do with the upcoming presidential election.


  • The decision of the HHS Secretary to overrule an FDA decision appears to be unprecedented
  • The drug isn’t dangerous even when it isn’t taken properly
  • The FDA made the applicant (Teva) jump through a lot of hoops for this submission, then reviewed the data thoroughly
  • Scientific panels have been in favor of OTC use since 2003, but political pressure (at that time from the Bush Administration) kept access restricted. In 2005, assistant FDA commissioner Susan Wood resigned over political interference in Plan B

Obama came to office vowing to change course from the Bush administration by respecting science and supporting reproductive freedom. His supporters will be very disappointed in this decision. And yet it is the right thing to do from the standpoint of supporting Obama’s re-election and the move is unlikely to cost Obama votes. Political discourse has moved so far to the right over the past few years that the Obama Administration could have gone considerably further than it did (like pulling Plan B from the market entirely) and still be well to the left of the Republican candidates.

With Republicans treating Planned Parenthood (which historically had bipartisan support) like the Devil, calling Obama a socialist, Bernanke treasonous and treating talk of any new taxes as completely off the table, one really has to wonder where things are headed. An Obama supporter enraged by the Plan B decision would really have to think seriously before jumping over to support a Republican Party whose commitment to things long taken for granted –such as the right to abortion in the case of rape or incest and the legality of contraception — is unclear.

You can bet a decision to widen access to Plan B would have given Republican candidates plenty of fodder to go after Obama as pro-abortion and in favor of 11 year old girls having sex. He did the right thing politically.

December 8, 2011

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