Monisha Brown: Ms. Klein, thank you so much for joining us here today on rolling out. You are the Director of the White House Gender Policy Council. Tell us about your role.
Jennifer Klein: Thank you for asking. President Biden created the Gender Policy Council in March of 2021, and it’s the first time there has been a policy council at the White House focused on gender equity and gender equality. What it means is that across both our domestic and foreign policy, we’re focused on how to actually achieve gender equity and equality.
I would say that in my daily life, I spend most of my time working on three sets of issues, both global and domestic. Those are health, which includes reproductive health (but not exclusively reproductive health) economic security for women, and, the third is preventing and responding to gender-based violence wherever it occurs.
Monisha Brown: Those are all very important issues and topics. Today, you are here to speak with us, specifically, about the proposed rule to the expansion of the Affordable Care Act. They’re expanding contraceptive options for women, and I think this is a great pathway to reproductive autonomy. Tell us a little about what this proposed rule can do for women.
Jennifer Klein: First of all, just to start with the basics, President Biden and Vice President Harris believe, as you just said, that contraception is an essential part of reproductive health care and that women should have access to the contraception that they need. We’ve already taken some significant steps and made progress in expanding access to contraception, including through an executive order that the president signed just one year after the Supreme Court overturned Roe v. Wade.
So, today’s rule builds on the work we’ve already been doing. It will be the most significant expansion of contraceptive coverage in a decade. When the rule goes into place, it will expand coverage for contraception for 52 million women of reproductive age who have private health insurance.
The rule does two things. The first is to enable women, for the first time ever, to obtain over-the-counter contraception at no cost, without a prescription. This is particularly important because there’s obviously a full range of contraceptive products and services that you can get over the counter. Importantly, as of March, for the first time ever, there is an over-the-counter oral contraceptive. The FDA approved it back in late 2023, and it has been available since March. This rule will cover that, and help women access oral contraceptive without a prescription and without cost sharing.
The second thing the rule does is require health plans to cover more prescription contraceptives at no cost. Historically, while the ACA, the Affordable Care Act, has required that preventive services including contraception be covered without cost, there have been barriers. Right now, the FDA has certain guidelines, and insurers are only required to cover one—or sometimes a few more– but only one contraceptive within each category. A doctor may prescribe something for their patient, but it doesn’t work or has side effects. This rule will make sure that remaining barrier is taken away so women can access the contraceptives that work for them, again, at no cost.
Monisha Brown: Wow, you answered a lot of my upcoming questions. Thank you for that. Now, this seems like it is a very strong response against the extreme attacks that we see against women and their reproductive autonomy. Tell me how can a man view this proposed policy expansion? How can he view this as being important to him? Let’s say we have a father that’s listening. Why does this matter to him?
Jennifer Klein: Well, I think what we’ve seen across the country is that men do see reproductive health and reproductive freedom as important to them. First of all, a lot of them have wives, partners, mothers, or daughters. But also, they are worried about their own health care, and that has been affected by the ability of families, men and women, to make decisions about their families. The most personal decisions have really been affected by these extreme abortion bans across the country.
And by the way, the president warned about this right when the Dobbs decision came down. This is absolutely about abortion. It’s also about contraception. It’s also about IVF. It’s also about a lot of health services that we take for granted, that we think are really important to men and women across this country.
Monisha Brown: I notice that you all are pushing the initiative and working to get the information out to the community. We appreciate being a part of that communication channel. You’re also partnering in a public-private partnership with Upstream. Can you talk about the work you’ve done with Upstream to ensure that this information reaches the grassroots level?
Jennifer Klein: Yes, thank you for raising that, because you’re right. This rule today is very focused on the Affordable Care Act and private health insurance under the Affordable Care Act. But what we’ve also done is make sure that contraception is available wherever women are trying to get it. Upstream is a perfect example of that. We created this public-private partnership to ensure that people have full access wherever they are getting their care. We’ve also made progress under Title X clinics, under federally qualified health centers, and Medicaid, so that wherever and however you get your health care, you should be able to access contraception and the full range of reproductive health services.
Monisha Brown: Thank you for that. And the final question—I always say, sometimes these conversations can be high-level, but we want to make sure everyone can tune in and understand. So, if you had to give us the main points and explain it to a 10-year-old, how would you do that? I want to make sure those key points are easy to understand. Can you recap for us in simple terms?
Jennifer Klein: Obviously health care policy is complicated; but, this one’s really simple. What this is about is making sure that people can access the health care that they need and that is affordable. In this case, it’s a very basic preventive health service, which is contraception. So, what we are doing today is announcing a rule which, when it is finalized, will mean that 52 million women of reproductive age in this country can access contraception.
Monisha Brown: Awesome. Ms. Klein, again, thank you for your work. You’ve been at it for a long time, and you have made a lot of progress for gender equality across this country and the globe. Again, thank you so much, and we look forward to more conversations like this.
Jennifer Klein: Yes, thank you for telling the story and doing everything that you do.
Monisha Brown: You’re welcome.
