MS. DIANE REHMThanks for joining us. I'm Diane Rehm. When third-year law student Sandra Fluke testified before Congress about contraceptive coverage in the new health care law, she had no idea the controversy her words would spark. Fluke supported the mandate and was followed by a flurry of criticism from conservatives. Talk-show host Rush Limbaugh called her a slut and a prostitute on the air. President Obama phoned Fluke to offer his support.

MS. DIANE REHMShe went on to address the Democratic National Convention. Sandra Fluke joins me from a studio at NPR West to discuss her entry into politics and the women's issues about which she is so passionate. We'll take your calls throughout the hour, 800-433-8850. Send us your email to drshow@wamu.org. Follow us on Facebook or Twitter. Good morning, Sandra, it's good to have you with us.

MS. SANDRA FLUKEGood morning, Diane, thank you for having me.

REHMI would appreciate your taking us back to last spring. Remind us of the issue that was facing Darrell Issa's House Committee.

FLUKEWell, this was a hearing that Chairman Issa called to discuss the Affordable Care Act, Preventative Services Requirements and this is a part of the Affordable Care Act that guarantees that women have access to preventative services without cost sharing. And one of those is contraception, but there are many others, things like breast cancer screenings and domestic violence screenings and a host of other services that are important to women's health care.

FLUKEAnd so the hearing was regarding that requirement and what I had hoped to testify about was how important access to a contraception that is affordable is for women and how important it is that it be covered on the private insurance that women are paying for through their own deductibles.

REHMWell, now, tell me why you were asked to testify? You were a third-year student at Georgetown University Law School so how come you were asked to testify?

FLUKEWell, I had been organizing about this issue on my campus for several years, along with many other students who were very concerned about it. At Georgetown, the faculty and staff have access to contraception through their insurance plans that are subsidized by the university, but the students who pay entirely their own deductibles on an unsubsidized plan do not have coverage for contraception.

FLUKEAnd what we saw was that the students around us were being really negatively impacted by this. Many had reasons that they needed contraception, in addition to preventing unintended pregnancies, medical reasons like treatment of fibroids or cysts or to focus on one woman who needed it to regulate her hormones to prevent seizures.

FLUKESo there are a lot of other reasons that women need access to contraception and unfortunately, because of the restrictions on our insurance there, these women were not getting the coverage that they needed and for some, it was resulting in very dire medical consequences.

REHMSo how come you were asked to testify?

FLUKEWell, several students from different campuses, because this is a problem that was occurring across the country and still is to some extent, we came together and formed a group called Catholic Students for Women's Health. Because at that point, the discussion about this policy was not focusing on women's health and we were concerned about that.

FLUKESo we held a press conference and some of the staff attorneys for this Congressional Committee saw the press conference and asked me if I would be willing to testify based on what I had shared at that press conference.

REHMI see, but then you were not allowed to testify. How come?

FLUKEThat's right. Unfortunately, Chairman Issa determined that my testimony was "not appropriate" and that was really problematic in my opinion because instead of hearing from any woman or anyone describing the consequences of this policy for women and for women's health, he heard only in that first panel from five male religious leaders.

FLUKEAnd I'm sure they had an important perspective, but it was inappropriate for there not to be anyone representing the women's health aspect of this policy.

FLUKEBut then the following week, you got a second chance. What did you tell the House Democratic Steering and Policy Committee?

FLUKESo I spoke to them about the testimony that I had originally planned to share with the committee and that was about those dire health consequences that women on my campus were experiencing. And when I had originally crafted my testimony, I had hoped that it would be part of a broader discussion, not just about the barriers that students face, but the barriers that many women face to the affordability of contraception and what that means as a public health policy.

FLUKEUnfortunately, because of the way that initial hearing in front of Chairman Issa was structured, it only ended up being my testimony that was shared, but there are so many women across the country. We know that 55 percent of women ages 18 to 35 have struggled to afford contraception at some point and that creates, unfortunately, a very high rate of unintended pregnancies in this country, which is a severe public health problem.

REHMNow, you've already mentioned the story you told about your gay friend who needed contraceptives to treat her polycystic ovarian syndrome, but couldn't pay any more and had to stop taking it. But isn't that a fairly rare case?

FLUKEI don't think it is, actually. And in her case, the consequences were very extreme, but there is a high percentage. I believe it's around 30 percent of the women who are using contraception are using that for medical reasons, aside from preventing unintended pregnancy.

FLUKEI would have to double-check that percentage, but there are a high number of women and I hear from them on such a regular basis. I've posted many of their stories on my Tumblr site and it's really overwhelming how many women do have this need.

FLUKEI think it's something we don’t discuss because we consider it to be private, but that means that our health care can be under attack in the government without people realizing how many women will be affected.

REHMAnd then what about the people who say, well, you chose to attend a Roman Catholic school. Do they have a point?

FLUKEWell, I think that it's fine to have the conversation about religiously-affiliated universities, but what's important to know is that many, many of the students who attend that school are not Roman Catholic and many women don't realize when they sign up to attend that they won't have coverage of contraception on their insurance plans.

FLUKESo what I think is important is that President Obama's staff has worked out a really, I think, a really appropriate plan in this regard because it requires that all women who attend those schools or who work at those universities or institutions will have coverage for contraception through the plans that they're paying the deductibles for. And at the same time, the institutions for those that are contributing money to the plan, their money won't go toward any of the services that they object to.

REHMSandra, after you gave your testimony, here's what Rush Limbaugh said on the air.

MR. RUSH LIMBAUGHA Georgetown University, co-ed told Representative Nancy Pelosi's hearing that the women in her law school program are having so much sex they are going broke buying birth control pills. What does it say that college co-ed Susan Fluke who goes before a Congressional Committee and essentially says that she must be paid to have sex? What does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex.

MR. RUSH LIMBAUGHShe's having so much sex, she can't afford the contraception. She wants you and me and the taxpayers to pay her to have sex. What does that make us? We're the pimps.

REHMHow did you feel about what he had to say about you?

FLUKEWell, you know, I tried not to put too much emotional energy into being concerned about him. What I was more concerned about was that this was an attempt to silence me and to silence other women from speaking publicly about reproductive health care and reproductive health needs.

FLUKEAnd I wanted to make sure that that wasn't the takeaway message from the situation and that especially young girls didn't take away that message that they should not come forward and not speak publicly about things that they were concerned about. And, you know, it's really striking to hear his description right alongside what my testimony actually would have been because it's such a misrepresentation of what I was discussing or what anyone defending this policy was saying.

REHMAnd the awful part of all this, not only what he had to say, but then I gather you started getting calls, harassing messages from his listeners?

FLUKEYes, unfortunately, that's true. It's pretty staggering what folks will say when they feel anonymous or what they'll even put their name to if they don't know you and will reach personally and, based on misinformation, accuse you of things and comment on your personal life. It's an unfortunate situation I think we have right now in our society is that we feel empowered to do that especially via social media.

REHMI think it's important to point out here that Rush Limbaugh lost over 100 major advertisers as a result of those remarks. He claims he's gotten a lot of them back. Don't know about that. We're going to take a short break here and when we come back, we'll talk further with Sandra Fluke and take your calls as well.

REHMAnd welcome back. Sandra Fluke is joining us from NPR West. Glad to have you. Now on NISDN, Sandra, we were just talking about the reaction that you received after Rush Limbaugh made his comments. You got lots of harassing calls from his listeners. But then you got a call from the President of the United States. What did he say to you?

FLUKEOh well, you know, he was just really kind and really wanted to reach out and make sure that I was doing okay and wanted to thank me for speaking out and for making sure that the concerns of women were represented in this public debate. And also he just wanted to encourage me and say that, you know, he hoped that I realize that my parents would be proud of me because that was something that Rush Limbaugh had questioned.

REHMDid the Rush Limbaugh controversy in some way propel your entry into politics?

FLUKEWell, it certainly -- you know, it gave me a larger microphone to speak about some things that I have been working on for a long time and that I've been concerned about for a long time. I spent several years working on anti-domestic violence and antihuman trafficking policy on issues like gay rights and just a whole host of social justice concerns.

FLUKESo this has given me a larger opportunity to speak about those issues. And it has also really shown me the ways in which the political process can have such an impact on those types of questions. It's interesting to think about the fact that there was a Republic chairman who didn't want to hear from any women about how this policy would affect them. And what that indicates for who we're electing to congress.

REHMAnd of course now you've joined the Obama campaign. You spoke at the Democratic National Convention last month. Tell us what that was like for you.

FLUKEWell, you know, I volunteer my time. I'm not on staff with the campaign or anything like that but I'm always happy to speak out because I think that President Obama has been a -- repeatedly a champion of women's health concerns and of many of the other social justice issues that I'm concerned about. And so speaking at the convention was quite an honor clearly and I was happy to do it. But it was striking to me how many folks spoke at that podium who were not necessarily elected officials but were, you know, quote unquote "everyday people" who had been affected by one of the policies that was up for debate.

FLUKEThere was an amazing woman who had worked at General Motors who spoke about how much of a difference it had made to save the auto industry in Detroit. So it was a very inspiring convention to hear from a lot of people who had looked around their everyday lives and seen how government policies affected them and had chosen to speak out.

REHMYou know, it's interesting that studies show women care a lot about many of the same issues as men. But when they vote they do think about issues that especially apply to them. Do you think that your statement before the Democratic Committee and before the Democratic National Convention is going to make a difference?

FLUKEWell, I hope that the facts behind it make a difference. I hope that it makes people aware of some of the policies that we have seen debated, especially over the last two years in the House of Representatives as well as in state legislatures across the country. What I think is the, you know, positive thing to come out of this situation is that it's shown a light on what was happening and that there was more media coverage of what some of these bills were.

FLUKEYou know, we saw repeated attempts to defund Planned Parenthood. And at the federal level there is no federal funding for abortion care unless it's a case of rape, incest or the life of a mother -- or of a woman, excuse me. And it -- so that defunding of Planned Parenthood is really about cutting access to breast cancer screenings and cervical cancer screenings and prenatal care, things like that. We've also seen bills that would limit federal affordability when it comes to abortion care for a woman depending on which type of rape she had suffered.

FLUKEAnd those are terrible distinctions that, as we saw in response to Representative Akin's comments, are clearly out of step with what the public believes and with what voters in this country want their representatives to be accomplishing in D.C. and in state legislatures. So I'm thankful that folks are paying attention and that this is getting coverage, what's been happening. And I'm really hoping to see that this does make a difference this November because I think it's important that we send a signal to our legislatures about what we want them to be focusing on and what attitude we want them to have toward women's health.

REHMBut, you know, the controversy continues on Saturday, October 6 at George Washington University. Bill O'Reilly and John Stewart debated and O'Reilly called you the poster person for the Entitlement Society. Let's hear what he had to say.

MR. BILL O'REILLYThe poster person for the Entitlement Society is Sandra Fluke. You know Sandra? I left two tickets for Sandra plus a month's supply of birth control pills at will-call. Is she here tonight? No, she's not. Sandra, buy your own. Coupon, right? We shouldn't be paying for this or a lot of other stuff. That's we owe $16 trillion.

REHMAnd what do you make of that, Sandra?

FLUKEWell, I find what is so problematic about that statement -- and Mr. O'Reilly has made similar statements on many, many occasions as have many other commentators -- is that it's so misleading. They are misleading their listeners and their viewers about the content of the policy that I testified regarding. This is not a policy that contributes to the federal debt in any way or that is taxpayer money because it's not government funding of contraception. And that's clearly what they are trying to make people believe.

FLUKEBut what this policy is about is private insurance that women pay the deductibles for themselves and that they just want to make sure that their insurance covers for young women especially one of their most primary health care needs. The Center for American Progress has really documented how important that is for young women's health care.

FLUKEBut if we can just take a step beyond that and think about, you know, what if this were government funding or what if we were talking about programs like Title X, which is government funding for contraception services? That's a really good public health policy. Every dollar that we invest in contraception saves us a $4 return in terms of unintended pregnancies, because those unintended pregnancies not only have consequences for individual women and families in terms of whether or not they can pursue their education and their careers, it also has consequences for our social safety net.

FLUKESo it can be costly for us as a society not only in the direct costs if the family's unable to support that new child, but also if the woman is unable to contribute as fully to our society and our economy as she would have otherwise. And that's really what my primary concern is with this Entitlement Society Entitlement Generation theme is that it's such a mischaracterization of my generation of any of these health policies or these government policies.

FLUKEBecause this is not about anyone feeling entitled to something. It's actually about thinking about what kind of society we want to be and that we want to be a society in which we care for each other and care for those who are struggling. And that we ensure that everyone has access to things like contraception so that we can have a quality of opportunity so that women can control their own reproduction to pursue their dreams.

REHMAt the same time you heard, as I did, both the laughter and the applause from that audience. I'm not sure what to make of that. Do you think that the people who applauded were in agreement with Bill O'Reilly or were they applauding what they perceived as his humorous remarks?

FLUKEWell, I'm sure, you know, that was meant to be an entertaining event so I'm sure there was some element of the crowd that was thinking about the humor in it, and I can understand that. But I think it's also an indication of how thoroughly this misinformation has been spread in our public consciousness unfortunately. And that's really such a disservice for commentators to do. It's -- you know, I can understand disagreeing with a policy but when you need to mislead your viewers in order to get them to agree with you then you're probably just wrong.

REHMAll right. Let's open the phones. We'll go first to Norman, Okla. Good morning, Amanda, you're on the air.

AMANDAHi, Sandra. Hi, Diane.

REHMHi.

AMANDAOh, it's such an honor to talk to you guys. A couple of students and I have started a student organization on the University of Oklahoma's campus. It's called Gender Equality and Reproductive Rights. And as you guys know, Oklahoma's a very conservative, very anti-choice state. And I was wondering if you have any advice to give us and groups like us who are kinda organized on college campuses and facing opposition from the main party.

REHMSandra.

FLUKEYes. Well, I'm so glad to hear that you are organizing on a campus. You know, I did a lot of that when I was in college and certainly in law school. And I think it's a really important part of your education. And we have a responsibility really being -- you know, folks who are privileged enough to have those educational opportunities to work on issues of public concern while we're there.

FLUKESo what I tried to do when I was organizing on campuses is to think about a long term campaign, an issue to really focus on. Because I think unfortunately a lot of student groups can get caught up in too many awareness-raising events and too many movie nights and just particular events. And there's a lot of work put into it, but it feels like the students are sort of preaching to the choir. And it doesn't give the same impact. So what we did with the contraception policy, for example, was that was a many-many-year campaign and it was going on on our campus years before I arrived as well.

FLUKEBut those types of campaigns I think are valuable because it draws in students who really want to have an impact on something. And it builds skills among the students who are involved, advocacy skills, research skills, meeting with administrators, you know, thinking -- you know, especially for law students thinking about what laws are applicable and learning how to organize in our communities. So it's really valuable for the participants as well.

FLUKEIn terms of, you know, how to respond to opposing views on campus, I think that's one of the other really important experiences to gain is how to have a respectful conversation and how to have a dialogue where you understand their disagreement and their concerns. And think about how to present your arguments in a way that can be not alienating, but persuasive to folks.

REHMI think that's excellent advice. Good luck to you, Amanda. And you're listening to "The Diane Rehm Show." Let's go to Jane who's here in Washington, D.C. Good morning, you're on the air. Jane, are you there?

JEANOh Jean, it's Jean.

REHMOkay. Go ahead.

JEANOkay. Hi. I was calling in to give a comment about the prior discussion about whether or not Catholic universities or schools would necessarily be -- students that go there would necessarily have the idea that absolutely there would be no contraception allowed because of it being a Catholic institution. And I attended Catholic University in D.C. and I'm not Catholic myself, but I was in the nursing program. And in that program, the instruction never gave any indication that there would be any prohibition of contraception.

JEANAs a matter of fact, the issues were debates in our class which seemed to me entirely appropriate. But it struck me as strange if in fact the school supported it for purposes -- or acknowledges it at least, does not object to it as for purposes of a nursing program but would object to it for the remainder of the university community.

REHMInteresting point. Sandra.

FLUKEYes. Catholic University does not cover it on their insurance and I can't speak to what's taught in the nursing program specifically. But I know that at Catholic University students can be subject to discipline for possessing condoms on campus for example. So it's really a quite problematic environment for students' health in that respect. I know that at many universities in their medical or nursing programs there are restrictions on what can be taught. And that's very problematic for the rest of us who will potentially be receiving care from students who have not been trained on the full range of women's health care options.

FLUKEBut, you know, it's a very good point that many students who are attending these universities don't necessarily agree with removing that from the insurance or from the curriculum. And the other point that I actually wanted to make on this topic is that when we say, you know, don't you know that this is going to be a restriction when you go to a Catholic or a religiously affiliated school and didn't you make that choice to go there is that we're asking female students to either compromise on their health care or compromise on their education. And that's not something that we're asking of our male students. So this does have a discriminatory impact for students as well.

REHMNow is there any provision about Viagra in any of these schools? Did that come up at all or even the question of condoms, Sandra.

FLUKEWell, I know that there are universities that have restrictions on distributing condoms on campus and some that have restrictions on possessing them there, which is such a concern because we know that college students do engage in sexual behavior. That's such factually accurate and therefore they're being put at risk of sexually transmitted infections as well as unintended pregnancy.

FLUKEAs for the question about Viagra I think it's slightly different because so many students are of an age where contraception is critically important to their health care, where as many are not actually of an age where Viagra is essential. But I think that both should be covered on insurance if they're critical to someone's health care so I wouldn't want to see either denied.

REHMSandra Fluke. She's women's rights and social justice activist. We'll be back with more questions, your comments. Stay with us.

REHMAnd welcome back. If you've just joined us, Sandra Fluke is with me. She joins us by ISDN from a studio at NPR West in Culver City, Ca. She is a graduate of Georgetown University Law School. She is currently women’s rights and social justice activist.

REHMHere's an email from Mark in D.C., who says, "I support choice for women, have no objection to contraception, but I fail to see why the taxpayer should subsidize it. If, as Ms. Fluke claims, some anti-pregnancy drugs are required to treat other medical conditions, let them be covered by insurance, but only in the event of a doctor's prescription. Pregnancy, in the absence of such conditions, is not an illness and is an individual responsibility." What do you say, Sandra?

FLUKEWell, it's interesting that he's reflecting the same piece of misinformation about so many policies and whether or not they are taxpayer funded. So, again, the Affordable Care Act is actually not taxpayer funded, but in regards to things like Title X, that is government funding for contraception, it's important to see this as part of healthcare. It doesn't need to be an illness to be an important health need. I think that you can ask any woman who has been pregnant or who has been concerned about an unintended pregnancy, whether or not that felt like that affected her health and I think she will say that it did.

FLUKEAnd there are a lot of things that are aspects of personal responsibility that we do see as part of our healthcare needs. We could say that, you know, anyone who is not eating the most healthy diet possible, therefore needs blood pressure medicine or cholesterol medicine because of their diet, that that's an aspect of personal responsibility and we shouldn't be caring for that on our health insurance. But, of course, we don't make that decision because that's inappropriate.

FLUKEWe should take care of folks' healthcare needs and encourage them to make positive decisions. We should have comprehensive sex education and education about how to care for ourselves, but it doesn't mean that we don't address the healthcare needs.

REHMHere's an email from Allen, who says, "One poll this morning shows a swing of more than 15 points to Romney from female voters. Now, this poll shows the candidates dead even among women. What do you think happened?"

FLUKEWell, I think it's important to note that President Obama has had a double-digit lead among women since early this spring. And I don't think that's ultimately going to disappear. I am confident that women and the men who care about them, will be coming to the polls and will show their support for the fact that he has stood up for our right to fair pay and our ability to enforce that, for the Violence Against Women Act, originally authored by Vice President Biden and for the host of reproductive healthcare concerns that we've been discussing, as well and that Mr. Romney has been absent or problematic in his views on each of those areas.

FLUKEAs for the polls at this particular moment, I'm sure that we're going to see those go back and forth between now and election day. It's an important reminder to everyone that this will be a close election and that none of us should take anything for granted. That's why I'm doing everything that I can between now and then. And that's why it's so important that we, you know, vote early, if we can and make sure to get there at least by election day.

REHMAll right. To Fairhaven, Mass. Good morning, Laurie.

LAURIEHi, good morning. I'd like to bless and thank Sandra for the work she's doing and remind people this isn't just about college students. I work for the Diocese of Fall River. And I get Blue Cross/Blue Shield through my work. I pay over -- get this -- $140 a week for the family plan. And if it wasn't for Sandra's work, the one and only prescription in the house, birth control, would not be covered by Blue Cross/Blue Shield.

REHMInteresting.

FLUKEThank you so much for sharing that. And it is really important to know, you know, while houses of worship are not covered by this policy and won't have to provide contraception to their staff, it does apply to staff who work at other types of religiously affiliated organizations if they are primarily not employing people only of their faith and serving people only of their faith. Those are parts of the legal test. So places like hospitals and universities that employ so many folks who often don't have a lot of economic stability.

REHMSo glad you called, Laurie. To St. Louis, Mo. Good morning, Vincent.

VINCENTHello. I wanted to first of all express my support for Ms. Fluke. I also wanted to mention something that hasn't been mentioned yet in this discussion, which has to do with the nature of the relationship between Catholic universities and the federal government. What is not known by most people is that legally--and this has been demonstrated in court because some Catholic universities have gone to court to prove this--legally they're nonsectarian, not sectarian, most of them.

VINCENTBecause in order to gain federal funds for various kinds of research activities, like National Science Foundation funds and others, a lot of these universities reincorporated themselves in the mid '60s onward. When they say they are religious affiliated, that's kind of a dodge, because they are nonsectarian institutions. In hiring, they are bound by E.O. regulations. And I think if this went to court they'd be in a bad position because they're not really Catholic.

VINCENTThey're not owned by the Catholic Church. They're not owned by a Catholic Order. That includes Georgetown, where Ms. Fluke went. They're operated by an independent board whose members don't even have to be Catholic. So that's something that needed to be brought into the debate. There's a certain disingenuousness on the part of the Catholic Bishops. They don't mention this.

REHMSandra, do you want to comment?

FLUKENo. That's true. That distinction is an important one. And I think there's also a legal argument to be made that not offering comprehensive healthcare to women while providing comprehensive care for men and having the discriminatory impact on women's ability to focus on their education and to not have the economic hardship is a violation of Title IX, for universities that are receiving federal funds. So that's another legal concern.

FLUKEWhat really, I think, is telling is that we are seeing pushback against this policy, not only from organizations that have any type of religious affiliation, but also from entirely private organizations. Organizations and businesses that are owned by, you know, a family and they say that they personally don't believe in contraception or have religious or moral qualms about it and that they don't want to provide it to their employees for that reason. And those cases are currently pending in the courts, but we've also seen legislation to allow that.

FLUKEIn several states these bills have passed and they've been under consideration in both houses of Congress. Bills that would allow any employer to deny any aspect of healthcare on the insurance for any reason.

REHMWhat do you think is motivating…

REHMSo that means, you know, you work at a fast food -- I think it's about focusing only on the concerns of the employer and not the employee and not realizing the impact that that will have. But that, you know, you could work at a fast food place and if your boss doesn't believe in chemotherapy, which, you know, some people don't, that might not be covered on your insurance. And that's just an incredible aspect of our individual control of our healthcare to turn over to our bosses.

REHMAll right. To Houston, Texas. Good morning, Karla.

KARLAGood morning, Diane. It's a pleasure talking to you this morning.

REHMThank you.

KARLAAnd I want to make a comment on something, you know, I've read all of the ramifications of this, but to the Conservatives I'm going to make four points. Number one, they're the greatest hypocrisy I've ever seen. They are talking against Sharia Law and at the same time, they're trying to push Sharia Law on women. They stand on the Bible and yet the Bible condemns them because, number one, it says, if you look at one of the points on the anti-Christ, he shall disregard the desires of women.

REHMAll right. Karla, I thank you so much for your call. What do you think about religious leaders, Sandra, who are pushing this kind of no-contraceptive portion of the healthcare law, feeling as though they want to control women's bodies?

FLUKEWell, I think there's a long and complicated relationship between religion and faith and sexuality. And we've certainly seen a lot of ways in which women's healthcare is policed by religion, as well as LGBTQ folks' sexuality being not condoned by religion. And ultimately, that is a decision for the leaders and the adherents of that particular religion. So I think it's interesting to note that so many women in the Catholic faith and in other faiths that disagree with use of contraception, actually don't agree with the leadership and the hierarchy of the institution on this.

FLUKEAnd that's something that, you know, that's an interesting question of social change, how those beliefs will permeate and how their voices will be heard within the religious institution. But for me, my focus is on the government policies and making sure that we both respect religious choices and religious liberty, but that at the same time, everyone in our society has the healthcare that they need.

REHMHere's a posting on Facebook from Jim, who says, "I'm guessing we won't hear much about the Target store three miles from Georgetown University campus, that sells a month's supply of birth control pills for $9 or how someone going to a major law school, where she'll later join the one percent, but she can't afford to take responsibility for her own sex life. Nine bucks a month is less than most college kids are paying for lunch or a visit to a coffee shop for latte and breakfast."

FLUKEWell, I'm really glad that Jim raised that because there are a few important points. First of all, not all women can use that $9 contraception. Many women have reasons that they need access to contraception that's much more expensive. The Center For American Progress documented that it can be over $1000 a year for some women, depending on their physiological and medical needs. And more to the point, this is healthcare. This is medicine. We don't ask people to go to the bargain basement for their medicine. We respect that they and their doctors can make appropriate choices about what should be prescribed for their particular circumstances and we try to make that affordable so that they have the healthcare that they need.

FLUKEAs to the second point, I realize, absolutely, the privilege that students have who are attending these universities. It's important to know that many of those students are doing that entirely on loans and student aid because it's not affordable for so many students. I actually have not ever publicly discussed my own financial situation or even my own use of contraception. So it's not really about me, but this is a policy about women across the board, whether they're students or employees of these institutions or generally women who are having trouble affording contraception.

FLUKEWe know that 55 percent of reproductive-aged women have had that difficulty. And they deserve to have access to the healthcare that they need.

REHMAnd you're listening to "The Diane Rehm Show." What are you doing right now, Sandra?

FLUKEOh, my work at this point is focusing on a lot of other concerns beyond just this Affordable Care Act policy. I have been working to see the Domestic Worker Bill of Rights passed here in California. Unfortunately, that legislation recently was vetoed so that's going to be an ongoing effort next year. I'm also working on the Trafficking Victims Protection Reauthorization Act, that passage in Congress. We saw a great, you know, speech by President Obama a few weeks ago, regarding the scourge of human trafficking in our country and around the world and what we need to do address that, but unfortunately…

REHMAnd you've--haven't you just taken the California Bar?

FLUKEI have. I took that at the end of July and I'm awaiting my results. And so in the meantime I'm focusing on public policy and things like getting Congress to act on that trafficking bill.

REHMAnd would you plan to practice law in California?

FLUKEWell, my home is here in Los Angeles, in California, so I'll certainly be here. I don't know that I'll be practicing, specifically. I think I'll be doing public policy work rather than litigation. And I'm sure that that's going to focus on issues of social justice.

REHMAnd…

FLUKEI think, perhaps, anti-poverty work.

REHMDo you intend to run for office?

FLUKEWell, you know, I've been asked that a lot lately and, you know, maybe it's something that I would think about some day. It's not my focus at this particular moment, but I am really concerned that we don’t see enough women in office. We only have 17 percent in Congress. And that's lagging behind many developing countries. So I am getting out and working on behalf of many female Congressional candidates, as well as some men who really stand with us on these concerns.

REHMAll right. And last comment from Susan in Newark, Ohio. Very quickly, please, Susan.

SUSANHi, Sandra, I just wanted to applaud you for the dignified and eloquent way you've dealt with the slanderous accusations from that idiot Limbaugh. I'm sure I could use many stronger words than idiot, but they wouldn't be anywhere near as dignified as your replies back to him. And I think I speak for many when I say that you're an inspiration to all of us and just keep up the good work. And I think you're awesome. You've made my day. So thank you very much and keep up the good work. Thank you.

FLUKEOh, thank you very much. That's kind of you to say.

REHMI must say, I think there are an awful lot of people out there, Sandra, who feel exactly that way, that you have conducted yourself with such grace amid this kind of really ugly onslaught of words that came after you spoke out. And I presume, even after this election is over, you'll continue to speak out. Am I correct?

FLUKEOh, absolutely. These are issues that I care very deeply about and I think that when we have an opportunity to speak out about them and to work on them, we have a responsibility to do so. And what I hope and what I see when I talk to people around the country is that, you know, while I appreciate the support for me very much, I also see that people are getting motivated to speak out and to act in their own communities.

REHMIndeed.

FLUKEAnd to work on campaigns that they care about. And that's what's so important, is that we all engage publicly with the issues we're concerned about.

REHMAbsolutely. Well, next time you're here in D.C., I hope you'll drop in to our studio here at WAMU. Sandra Fluke, she's women's rights and social justice activist. She's a graduate of Georgetown University Law School. She joined us from NPR West, in Culver City, Ca. Good luck to you, Sandra.

FLUKEThank you so much.

REHMAnd thanks for listening. I'm Diane Rehm.