Why the White House invited a contraceptives controversy

(Andrew Harrer/Bloomberg) The fight over health reform’s mandated coverage of contraceptives has gotten very big. Which is somewhat ironic, as the battle hinges on a part of that requirement that is pretty small. It’s all about the fact that the mandate’s conscience clause, which allows churches to opt-out, doesn’t cover Catholic universities and hospitals. President Obama had been warned by senior staff that a narrow conscience clause would provoke backlash. So why’d the administration move forward on it?

One answer is that the White House saw a political upside in standing firm for birth control. For more on that, see this post. But another answer is that, just a few weeks before, the White House had rendered a decision that bitterly disappointed reproductive health advocates.

The contraceptives decision came down on Jan. 27. On Dec. 8, however, the White House had been faced with another tough call on contraceptives —whether to permit the over-the-counter sale of the emergency contraceptive Plan B, as the Food and Drug Administration had recommended. In that case, they chose to overrule the FDA and bar the sale of Plan B over-the-counter.

In the wake of that decision, abortion-rights legislators caught wind that the White House was considering widening exemptions from the contraceptives mandate to cover hospitals and universities. They staked out a position of staunch opposition, lobbied aggressively against it and, in the end, they won.

If the White House had settled on a wider conscience clause, the reproductive health community likely would have viewed it as the administration issuing a second strike against it. For the White House, that would have been seen as a major political problem. As I wrote yesterday, the voters that propelled Obama to victory to 2008 — the voters he’ll be courting this time around — tend to be disproportionately young and female. And those demographics tend to be most supportive of federal laws that increase the availability of contraceptives.

Taking the Plan B decision and contraceptives mandate together, many reproductive health advocates saw an administration that was splitting the difference. A wider conscience clause very well could have headed off a political controversy. But, it also came with its own political risks, of alienating a constituency with whom the administration was already on shaky ground.