Issue #169  ·  November 2, 2026

The Part of Women’s Health Policy I Missed at First

Menopause coverage, workplace protections and Medicaid are being decided state by state, and your ballot is where it starts.

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I’ve been building in women’s health since 2013, and when I first got into policy, I didn’t fully understand how much of healthcare happens at the state and local level. It wasn’t until I started watching Claire Coder, Founder at Aunt Flow (an angel investment of mine), use policy to change access to menstrual products at the local level that I realized just how granular policy can be. Contrast that with the work I’m leading on 51& at the national level, and it’s clear that both parts play a key role.

Right now we’re watching it play out across women’s health. With Election Day tomorrow, it seemed like the perfect time to look at the intersection of policy, elections and your career in women’s health.

Washington is a long game

Elizabeth Brewer, Head of U.S. Government Affairs at Everleap Fertility (formerly IVIRMA), joined our Mini-MBA policy session last week and talked about how long federal policy takes. Most of us only watch Washington, so that was a good reminder.

I was in the Rose Garden on October 19 for the executive order signing. The order created an NIH Women’s Health Division and a White House task force, but it doesn’t identify funding yet, so appropriations will be the real test.

Through 51& I’ve also been on the federal side: we filed a comment on the work we did around the Medicare Physician Fee Schedule in September with a coalition of 115+ organizations (you can see the comment tracker or create your own comment), and we sent a Statement for the Record to the Senate Special Committee on Aging for its menopause hearing.

In the meantime, what actually reaches a patient or a paycheck often runs through a statehouse, and sometimes a county or city. It takes all levels. That also means there are ways to work on women’s health policy at every one of them.

Menopause is being led by the states

• Rhode Island passed the first menopause workplace accommodations law in 2025.
• New Jersey enacted a coverage law in January.
• Illinois signed its Menopause Equity and Care Act on August 7. It adds workplace protections in 2027 and expanded insurance coverage in 2028.
• Illinois, Louisiana, Oregon and Washington already had some form of coverage mandate.
• California passed a provider education law, but its coverage bill and a New York bill were both vetoed.

And this is just menopause…we could run the same analysis for fertility, maternal health, endometriosis and more at both the state and federal level.

I live in Virginia, so this one is close to home. In the same session, our governor signed a menopause coverage mandate in April and vetoed a workplace protections bill in May. We have a reproductive rights constitutional amendment on the ballot tomorrow. Same state, same year, many different outcomes.

On your ballot tomorrow

Five states have measures tied to women’s health or coverage:

• Virginia’s Question 1 would add a constitutional right to reproductive freedom, including abortion, contraception and fertility care. Court challenges are still pending.
• Idaho’s Proposition 1 and Nevada’s Question 6 would each establish a right to abortion before viability, Idaho in state law and Nevada in the constitution.
• Missouri’s Amendment 3 would repeal the 2024 reproductive freedom amendment, which protects abortion until viability, and restrict most abortions.
• South Dakota’s Amendment I would end the constitutional Medicaid expansion requirement if the federal share drops below 90%. Officials disagree on whether that ends coverage automatically.

Please read the text of each one, not just the summary someone handed you. KFF, Guttmacher, Lozier Institute and Ballotpedia all track them.

Races I’m watching for the stakes, not endorsements

I co-founded a bipartisan PAC, so to be clear: these are about what’s at stake, not how to vote. I find it interesting how many clinicians and women’s health professionals are on the ballot this year, including Sen. Marshall, Elizabeth Lee, Dr. Annie Andrews and Rebecca Bennett.

• Kansas U.S. Senate: Sen. Roger Marshall, a former OB-GYN, vs. Adam Hamilton.
• Nevada governor: Gov. Joe Lombardo vs. Attorney General Aaron Ford. Lombardo vetoed a 2025 bill that would have required fertility coverage, and Question 6 is on the same ballot.
• Iowa 1st District: Rep. Mariannette Miller-Meeks, an ophthalmologist, vs. Christina Bohannan, a University of Iowa law professor. Ob-GynPAC, a federal PAC for ob-gyns, switched its endorsement to Bohannan this year, according to her campaign.
• Arizona 5th District: Elizabeth Lee vs. former Pinal County Sheriff Mark Lamb. Lee is a reproductive health nurse and IVF operations veteran, and she’s the first ASRM member to run for Congress.
• New Jersey 7th District: Rep. Tom Kean Jr. vs. Rebecca Bennett, a health tech executive who worked at Midi Health, the virtual menopause care company. Her Midi work has become a campaign issue.
• South Carolina U.S. Senate: Sen. Darline Graham, appointed after Sen. Lindsey Graham’s death, vs. Dr. Annie Andrews, a pediatrician.

And look at your own legislature and attorney general, because that is where most of the menopause bills started.

Careers at every level

Pick a level (local, state or federal) and a seat. Your clinical or business background translates: Elizabeth Lee came from IVF clinic operations, Annie Andrews is a pediatrician, and Rebecca Bennett came from health tech.

• Government: local offices, federal agencies (HHS, CMS, FDA, NIH, the Office on Women’s Health), congressional and state legislative staff, governor’s offices, and state health departments and insurance regulators, who enforce coverage mandates.
• Advocacy: nonprofits, NGOs, patient advocacy groups, PACs, campaigns and ballot initiatives, and societies and trade associations like ACOG and ASRM.
• Industry: government affairs, market access and state affairs teams at pharma, medtech, payers, health systems and digital health companies.
• Advisory: law and lobbying firms, public affairs and policy consulting, think tanks, foundations, academic research centers and policy journalism.

Some recent postings:

• ACOG District II, Government Relations and Policy Analyst (Albany, NY): a registered lobbyist role, $65K-$75K
• Hologic, Director, Government Affairs (Washington, DC)
• CooperSurgical, Vice President, Regulatory Affairs
• Women4Change Indiana, Chief Executive Officer (Indianapolis): a nonpartisan women’s advocacy nonprofit

You’ll find more in the job listings below and in the #jobs-non-clinical-roles channel in the IWH Slack.

Before tomorrow, look up your ballot and polling place at vote.gov or your state election site, then read what each measure says.

So what: if you work in women’s health, your career runs on decisions made far from your desk, and a lot of them are made close to home.

Cheers,