Washington ACLU Settlement Ensures Patients Can Get Abortion Services at their Local Public Hospital

Washington State saw a victory this month – patients seeking abortion services can now get the care they need! Thanks to efforts from the ACLU of Washington, Skagit Regional Health Hospital District has agreed to provide abortions in compliance with the Washington Reproductive Privacy Act.
The Reproductive Privacy Act, approved by voters in 1991, includes provisions that prohibit the state from denying or interfering with an individual’s fundamental right to abortion, and require any hospital that provides maternity care to also provide abortion. In 2015, the ACLU filed a lawsuit against Skagit Regional Health because it was not providing abortions even though it provided maternity care.  Instead, the hospital referred women seeking abortions to other providers, like Planned Parenthood.
In 2016, a Washington state judge agreed with the ACLU — the Reproductive Privacy Act required Skagit Regional Health to provide abortion care. At first, Skagit Regional Health appealed the judge’s decision; but with this settlement agreement it has now decided to stop challenging the decision and start providing abortions.
The judge’s decision was a clear and concise affirmation of the Reproductive Privacy Act and its broad application, rejecting narrow readings by the hospital that would have applied parts of it only to some state programs or only some groups of women.  Of particular note, the judge firmly rejected the Skagit Regional Health’s arguments in defense of its referral policy, ruling that:

  1. A hospital can’t get out of providing abortions by claiming that it doesn’t have any employees willing to provide them, and
  2. Referring patients out for abortion does not fulfill a hospital’s obligation to provide abortions.

Hospitals can’t get out of their obligations by claiming no employee is willing to provide abortions
The judge’s decision made clear that Skagit Regional Health cannot simply claim that it can’t provide abortions because no employee is willing to provide them.
While the Reproductive Privacy Act allows individual providers to opt out of providing abortion, it does not allow the hospital to do so. Under the law, if a hospital is going to provide services to patients who decide to carry a pregnancy to term, it is the hospital’s responsibility to find employees who are willing to provide services to patients who decide to have an abortion.
Additionally, we know that there are many doctors and nurses out there who want to participate in abortion services but can’t or don’t because of medical training institutions’ unwillingness to train them, hospitals’ unwillingness to hire them, or general stigma around abortion in the medical community. Hospitals have to take responsibility for hiring and supporting those health care professionals who are willing to provide abortion services.
Referrals for abortion are not good enough
The judge also stated that referring patients to a local Planned Parenthood for abortion is not “substantially equivalent” to providing abortions onsite – as the judge said, Skagit Regional Health cannot just “shrug[] its shoulders and inform[] patients that they will have to find that aspect of their healthcare elsewhere.” This ruling sends an important signal that in order for hospitals to truly put patient health first, it is not enough to simply provide referrals for abortion – hospitals should be providing abortions themselves.
We know that refusals to provide abortion place patients’ lives and health at risk.
As one study found, when doctors are only allowed to refer patients out for abortion, patients in unstable medical circumstances are forced to unnecessarily move to a new location. The doctors in this study knew that they were putting their patients’ health at risk by forcing them to travel to a different health care provider for abortions, but their hospital employers had tied their hands.
Once an individual has decided to have an abortion, she shouldn’t be burdened or delayed searching for a provider willing to give her the services she needs. By forcing patients to go to yet another provider for abortion services, hospitals delay patients who are trying to access a time-sensitive health care service. Patients may have to take more time off work, travel long distances, find more childcare, and deal with the increasing cost and risk of the procedure itself as time goes on.
As Skagit County ‘s  single largest health care provider, Skagit Regional Health’s decisions about what services to provide or deny affect a huge number of people throughout the county. It is wonderful for the people of Skagit County that they will now be able to go to their public hospital for abortion services and not be told “sorry, you have to go elsewhere.”

In addition to settling this case with Skagit Regional Health, the ACLU of Washington is working to ensure that other Washington hospitals are providing abortions in compliance with the Reproductive Privacy Act. The ACLU has sent letters to other hospital districts asking them to fulfill their obligations under the law, and is in active discussion now with a number of them to ensure they are providing abortions if they are providing maternity care.
Because of the ACLU’s efforts, the Reproductive Privacy Act is now doing what it was supposed to do: Ensuring hospitals provide women with comprehensive care related to pregnancy and abortion. We are thrilled that Skagit County residents may now be able to enter their local public health care facility and receive equal care no matter what their pregnancy decisions are.