Washington might force private hospitals to provide abortions

Will some religious hospitals in Washington be required to provide contraceptive and abortion services? That’s the question lingering in the air in the Evergreen State, where Attorney General Robert Ferguson on Wednesday issued a legal opinion saying every publicly funded hospital district must provide contraceptives, abortions, or “substantially equivalent benefits, services, or information” to women.

Washington has more than 50 “public hospital districts,” in which a local community pays taxes to help fund healthcare services for the area. The districts are allowed to contract with private hospitals to provide services.

A 1991 state law requires any public hospital district providing maternity care to also provide women with “substantially equivalent benefits, services, or information to permit them to voluntarily terminate their pregnancies,” or gain access to birth control.

In his opinion on Wednesday, Ferguson said this applies to the districts even if they hire out healthcare services to private, religious hospitals that may object to abortions or contraception.

A contract between the San Juan County Public Hospital District No. 1 and PeaceHealth, a Roman Catholic-affiliated hospital network, prompted a state senator to ask for the legal opinion. Under the contract, PeaceHealth will build and operate a hospital, and receive taxpayer funding from the district.

San Juan is an island in the northwest corner of the state. Some public hospital districts elsewhere in Washington have entered into similar arrangements with private hospitals.

PeaceHealth, following a directive from the United States Conference of Catholic Bishops, does not perform elective abortions or physician-assisted suicide. Decisions about contraceptive services, such as those for medical reasons, are handled between doctors and patients.

“At the end of the day, if you’re a … public hospital that provides maternity services, if you do that, then you must provide substantially equivalent services related to contraception and abortion,” Ferguson said on Wednesday. But his legal team declined to define what “substantially equivalent” meant, and seemed to leave the door open for public districts to provide the services outside of religious hospitals.

“We were not asked and have not answered whether a hospital district could comply by having two separate contracts, one for maternity care and one for other reproductive care,” a spokeswoman for the attorney general’s office told me by email.

“We believe the opinion was favorable in that it specifically did not attempt to define how the legal requirement must be met,” said Tim Strickland, the communications director at PeaceHealth. He said the Catholic hospital network was still reviewing the opinion to understand its implications.

Ferguson, a Democrat, told reporters he wasn’t aware of any public hospital districts currently violating the law. He added if a district wanted to legally avoid providing abortions, it could simply stop providing maternity care.

But that’s just a talking point, said Joseph Backholm, the executive director of the Family Policy Institute of Washington. Government lawyers know if a district stopped providing maternity care, it would find itself embroiled in a gender discrimination lawsuit, he said: “The idea that you have to stop providing medical care to an entire class of people [unless you provide abortions] is anti-freedom, it’s anti-choice.”