Washington – President Obama, who took office pledging to put science ahead of politics, averted a skirmish with conservatives in the nation’s culture wars on Thursday by endorsing his health secretary’s decision to block over-the-counter sales of an after-sex contraceptive pill to girls under age 17.
The administration action inevitably raised questions about whether politics was trump in this instance — especially from disappointed supporters in the scientific and women’s rights communities. Mr. Obama, who had criticized how his predecessor made decisions on issues like contraceptives, sought to dispel that idea in remarks to White House reporters.
“I did not get involved in the process,” he quickly asserted.
Mr. Obama said the decision was made by his secretary of health and human services, Kathleen Sebelius. On Wednesday, in a rare move, she overruled the Food and Drug Administration, which had recommended that the morning-after pill Plan B One-Step is safe and should be sold without a prescription to people under 17, just as it is now to those who are 17 and older.
“I will say this, as the father of two daughters: I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine,” Mr. Obama said.
“And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old going into a drugstore should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could end up having an adverse effect. And I think most parents would probably feel the same way.”
Asked if he fully supported Ms. Sebelius, Mr. Obama said, “I do.”
The president’s remarks suggested social and cultural concerns even as he said Ms. Sebelius had acted out of scientific concerns; in particular, she cited the manufacturer’s failure to study whether girls as young as 11 could safely use the drug. And the issue has been a matter of political contention, with conservative and anti-abortion groups opposed and public health and women’s rights groups in favor.
Yet the response of those disappointed by the administration’s decision was more muted than in many such controversies, reflecting a broad sense that this was not a fight to pick with Republicans and conservative groups. On Capitol Hill, Representative Nancy Pelosi, the Democratic minority leader and a stalwart of reproductive rights groups, neither endorsed nor criticized the decision, deferring to Ms. Sebelius even as she praised the F.D.A. commissioner, Dr. Margaret Hamburg.
Some Democrats suggested that the administration, by avoiding a divisive debate over teenagers’ sexuality, had preserved maneuvering room as it confronts a separate challenge from the nation’s Catholic bishops, who seek a broad exemption for Catholic hospitals from the 2010 health care law’s requirements for contraceptive coverage.
The episode is the latest in which the administration has ducked a confrontation on an issue that risks alienating one constituent group or another as Mr. Obama approaches an election year. Recently, for example, the president shelved until after 2012 decisions on authorizing the Canada-to-Texas Keystone XL pipeline, which has divided environmentalists and unions, and on approving antismog regulations sought by his Environmental Protection Agency but opposed by industry and some unions.
White House advisers declined to speak about the issue, echoing Mr. Obama’s comment that the decision rested with Ms. Sebelius and had nothing to do with politics. On Tuesday, the day before Ms. Sebelius announced her decision, she flew with Mr. Obama on Air Force One to Kansas, where she had been governor, for his speech against rising income inequality. But the two did not discuss the issue “at any point,” an administration official said.
Geoff Garin, a Democratic pollster, said it was not clear what the right politics would be for Mr. Obama on the issue because “there’s a sort of ‘damned if you do, damned if you don’t’ quality to this.” But beyond the scientific questions, he said, were legitimate policy ones about making a contraceptive freely available to young girls, without a prescription.
“You’re not saying a parent has to be involved, but the prescription means that a doctor or medical professional has to be involved,” Mr. Garin said. “I would think that that question would have a special meaning for President Obama, given that he is the father of young girls, and I don’t think this is wholly out of sync with the kinds of values he has expressed over the years. So the idea that this is a sudden reaction to the political moment seems a leap to me.”
Conservative groups had applauded the decision by Ms. Sebelius, but progressive women’s groups let the White House know of their disappointment.
“We’re less than a year out from the election, and at this point we really want to be talking to voters, in particular a core segment of women voters, about the president’s strong record on women’s health and freedom,” said Ted Miller, spokesman for Naral Pro-Choice America. A decision like that on Plan B, he said, “makes it much more difficult.”
Mr. Miller and others in women’s groups argued that science was on their side, citing the support of major medical groups. Plan B was adjudged safe and became available over the counter to those 17 and older in 2009, after initial opposition from the Bush administration and then a federal court order.
Teva, the pill’s maker, commissioned two large studies in adolescents to satisfy government concerns about selling freely to them, but in her rejection Ms. Sebelius said neither study included 11-year-olds.
“How could you possibly get parental consent to include 11-year-olds in a study like this?” asked Dr. Phillip Stubblefield, a contraceptive expert from Boston University School of Medicine. And there is no reason to believe that they would react any differently than older girls, he added.
“Where is an 11-year-old going to get the $50 to buy this product?” asked James Trussell, director of the Office of Population Research at Princeton University. “Why would they want to? It’s all nonsense.”
The outcome is that Plan B will continue to be sold from behind a pharmacy counter, with purchasers required to show identification. Teva had said its goal was to get the product on shelves along with condoms and other contraceptive products, where it would be more likely to be seen by older teens and adults.
Some of the controversy about Plan B stems from its confusion with RU-486, the abortion drug. But Plan B has no effect on established pregnancies. Instead, its principal effect is to delay ovulation. It is intended to be taken as soon as possible after sex because it gradually loses effectiveness.
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