Ranker and Attorney General Add Comments to Hospital Discussion

State Senator Kevin Ranker issued a statement praising the State Attorney General’s response to his question about health care access provided by public hospital districts.

The Washington State Attorney General’s office responded, in part, as follows:

By letter previously acknowledged, you have requested our opinion on the following question:

Does a public hospital district violate RCW 9.02 if it solely contracts with a provider of health care services that refuses to provide services or information including contraceptive care, voluntary termination of pregnancy care, and other services that relate to a patient’s fundamental rights, as described in RCW 9.02.100, and the public hospital district does not provide “substantially equivalent benefits, services, or information” with respect to voluntary termination of pregnancy care, as required by RCW 9.02.160?

BRIEF ANSWER:

Initiative 120, enacted by the people in 1991, states: “(1) Every individual has the fundamental right to choose or refuse birth control,” and “(2) Every woman has the fundamental right to choose or refuse to have an abortion, except as specifically limited by” RCW 9.02. RCW 9.02.100. The state cannot “discriminate against the exercise of these rights in the regulation or provision of benefits, facilities, services, or information.” RCW 9.02.100(4). RCW 9.02.160 says:

If the state provides, directly or by contract, maternity care benefits, services, or information to women through any program administered or funded in whole or in part by the state, the state shall also provide women otherwise eligible for any such program with substantially equivalent benefits, services, or information to permit them to voluntarily terminate their pregnancies.

The term “state” is defined for purposes of RCW 9.02 to include “municipal corporations.” RCW 9.02.170(6). Public hospital districts are municipal corporations. RCW 70.44.010.

Applyng the plain language of this section, if a public hospital district provides, “directly or by contract, maternity care benefits, services, or information to women,” through any “program administered or funded in whole or in part by the” district, the district must also provide the “substantially equivalent benefits, services, or information” required by RCW 9.02.160. We express no opinion on exactly how hospital districts may comply with this requirement, or what constitutes “substantially equivalent benefits, services, or information.”  [Italics added]

It is clear under the statute, however, that public hospital districts may not administer or fund programs to provide “maternity care benefits, services, or information to women” without also making provision for the rights secured by RCW 9.02.100 and .160.

[For the full opinion, go to https://www.atg.wa.gov/AGOOpinions/opinion;]

In a statement issued by Senator Ranker, he says:

“From the very start of this process, my concern with the issue of hospital mergers has been whether or not women in our state would continue to have access to the full range of health care options afforded to them by law.

“This opinion clarifies that women served by public hospital districts in our state should and will continue to have those options regardless of the organization – religious or otherwise – delivering those services, if the district provides any other maternity care.

“The Attorney General’s opinion reaffirms what voters intended when they approved I-120; that when the state provides benefits, services and information to women intending to carry a pregnancy to term, the state also must provide substantially equivalent benefits, services and information to those women who chose to terminate a pregnancy.

“Women and their families who are served by the more than 50 public hospital districts in the state will continue to have the assurance they can exercise their legal reproductive rights.

“We are all proud of our state’s history of respecting an individual’s right to access the health care services that are most appropriate for them and their families. This opinion reaffirms that right.”