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State Laws

Washington


Political Information

Executive (Governor)

Pro-choice

Senate

Mixed-choice

House

Pro-choice

Abortion-Care Policies

Abortion Providers

Abortion Providers: Restrictions

Restrictions on Who May Provide Abortion Services

Washington prohibits certain qualified health-care professionals from providing abortion services.

Only a physician licensed by the state may provide a surgical abortion. Wash. Rev. Code Ann. §§ 9.02.110, .120, .170(4) (Enacted 1991).


Abortion Providers: Expanded Access to Non-Surgical Abortion

Advanced Registered Nurse Practitioners may furnish or prescribe medication abortion. Wash. Op. Att’y Gen. No. 1 (Jan. 5, 2004).


Abortion Rights

Protections: Freedom of Choice Act (FOCA)

Washington has created additional protections for reproductive rights by adding an affirmative right to choose into its state law.  In 1991, Washington voters narrowly passed this law via a ballot initiative, reaffirming the holdings of Roe v. Wade in the state.  

The initiative was so close that the final results had to wait on the full count of absentee ballots.  The ballot initiative also reaffirmed a fundamental right to choose or refuse birth control.  This law ensures women’s access to pre-viability abortion services and would remain in effect even if Roe v. Wade were overturned.  Absentee Ballots Put Washington Abortion Rights Initiative Ahead, Assoc. Press, Nov. 14, 1991.

"The sovereign people hereby declare that every individual possesses a fundamental right of privacy with respect to personal reproductive decisions.  Accordingly, it is the public policy of the state of Washington that:  (1) Every individual has the fundamental right to choose or refuse birth control; (2) Every woman has the fundamental right to choose or refuse to have an abortion . . . ; (3) . . . the state shall not deny or interfere with a woman’s fundamental right to choose or refuse to have an abortion; and (4) The state shall not discriminate against the exercise of these rights in the regulation or provision of benefits, facilities, services, or information."  Wash. Rev. Code Ann. § 9.02.100 (Enacted by Initiative 1991).  Additionally, "[t]he state may not deny or interfere with a woman’s right to choose to have an abortion prior to viability of the fetus, or to protect her life or health."  Wash. Rev. Code Ann. § 9.02.110 (Enacted by Initiative 1991).


Post-Viability Ban

  

No abortion may be provided after viability unless necessary to protect the woman’s life or health.  Wash. Rev. Code Ann. §§ 9.02.110 (Enacted by Initiative 1991), 9.02.120 (Enacted by Initiative 1991), 9.02.170 (Enacted by Initiative 1991).

NARAL Pro-Choice America supports the legal framework established in Roe v. Wade and does not oppose restrictions on post-viability abortion, such as Washington’s, that contain adequate exceptions to protect the woman’s life and health.  


Biased Counseling

No state measure.

Mandatory Delays

No state measure.

Insurance Coverage & Abortion

Supports Insurance Coverage of Contraception

Washington law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.

What is required?  If a health-insurance plan provides generally comprehensive coverage of prescription medication, it must provide coverage for Food and Drug Administration-approved prescription contraception, including prescription barrier methods and emergency contraception.

To which insurance plans does the law apply?  Health-insurance plans issued or renewed on or after January 1, 2002 that provide generally comprehensive coverage of prescription medication.

Does the law provide additional protections for women?  Yes.  Insurers may not impose copayments, deductibles, waiting periods, limitations, or restrictions on prescription contraceptives that are not imposed on other covered prescription medication.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?  No.  Although a separate regulation allows employers to refuse to provide insurance coverage for services they oppose for religious or moral reasons, the same regulation explicitly recognizes that an individual has a right to obtain a health plan that covers the full range of services regardless of an employer’s religious or moral objection to a particular service.

In a recent opinion, former Washington Attorney General (now Governor) Christine Gregoire determined that, even if an employer refuses to purchase insurance coverage for contraception, an employee may not be denied contraceptive coverage and an insurer may not charge the employee an extra fee for such coverage.  Former Attorney General Gregoire further stated that nothing in the regulation requires insurers to provide services without appropriate payment or fee and that other mechanisms of recovering the cost of such coverage should be considered.  Wash. Op. Att’y Gen. No. 5 (Aug. 5, 2002).

Wash. Admin. Code § 284-43-822 (Adopted 2001).


Improves Insurance Coverage of Contraception

Washington law requires health-insurance plans to cover dispensing of a 12-month supply of all FDA-approved contraceptives.

What is required?  Health-insurance plans must cover dispensing up to a 12-month supply of contraceptives.

Wash. Code § 48.43.195 RCW, WA H.1234 (Enacted 2017).


Improves Insurance Coverage of Contraception

Washington law builds upon federal law by requiring that insurers cover all unique therapeutic products for contraception without cost-sharing, including those available over the counter without a prescription. Insurers must also cover patient education and counseling on contraception, and related services, such as device insertion and removal. The law applies to all health-insurance plans issued or renewed in the state on or after January 1, 2019.

S.B. 6219, 65th Leg., Reg. Sess. (WA 2018) (to be codified at Wash. Rev. Code § 48.43).


Improves Insurance Coverage of Contraception

Washington prohibits most insurers from imposing any cost-sharing on all unique FDA-approved contraceptive products.

S.B. 6219, 65th Leg., Reg. Sess. (WA 2018) (to be codified at Wash. Rev. Code § 48.43).


Supports Abortion Coverage in the State

Does Washington support statewide private insurance coverage of abortion services?  

Yes.  Private health-insurance plans that provide coverage for maternity care or services must also must also provide substantially equivalent coverage of abortion.  This requirement does not apply to multi-state plans that do not provide coverage of abortion. Wash. Code § 48.43 RCW (Enacted 2018).


Low-Income Women & Abortion

Supports Low-Income Women’s Access to Abortion

Washington allows women eligible for state medical assistance for maternity-care benefits to obtain public funds for abortion services.  Wash. Rev. Code Ann. § 9.02.160 (Enacted 1992); Health & Recovery Servs. Admin., Physician-Related Servs. Billing Instructions, Reproductive Health Servs. (Dec. 31, 2009) at http://www.dshs.wa.gov/pdf/oip/Physician-Related_Services_BI.pdf.

In August 2013, Washington Attorney General Bob Ferguson issued an advisory opinion interpreting this provision of state law.  The opinion provides that where 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, it] … must also provide … ’substantially equivalent benefits, services, or information’" regarding contraception and abortion.  AGO 2013 No. 3 (2013).


Young Women & Abortion

No state measure.

Family-Planning Policies

Insurance Coverage & Contraception

No state measure.

Low-Income Women & Contraception

Supports Low-Income Women’s Access to Contraception

Washington provides increased access to reproductive-health-care services through a Section 1115 family-planning waiver.  The waiver allows the state to cover family-planning services for all men and women of childbearing age with incomes at or below 260 percent of the federal poverty level (FPL), who are not otherwise eligible for state and federal health-care programs.    Additionally, enrollees must be (1) U.S. citizens or persons who meet the state’s defined immigration requirements and (2) Washington residents.

Beneficiaries of family-planning coverage available through the waiver are not required to pay premiums or co-payments for covered services.  Covered services include: medically necessary services and supplies related to birth control, pregnancy prevention and preventive services (includes abstinence counseling, natural family planning, birth-control pills, the contraceptive ring and patch, male and female condoms, contraceptive injections, diaphragms, cervical caps and the contraceptive sponge, emergency contraception, spermicides, IUDs, and male and female sterilization); annual gynecological exam.

The waiver is set to expire June 30, 2023.

Washington Family Planning Only Program 1115 Family Planning Demonstration, Project No. 11-W-00134/0.


Supports Low-Income Women’s Access to Contraception

MEDICAID COVERAGE OF EMERGENCY CONTRACEPTION (EC)

Washington provides Medicaid coverage of emergency contraception without a prescription.

Washington State Health Care Authority, Prescription Drug Program Provider Guide (July 1, 2016).


Improves Insurance Coverage of Contraception

Washington law requires all Medicaid programs offered through managed-care plans or fee-for-service programs to cover dispensing a 12-month supply of prescription contraceptive drugs.

WA S.6052 (Enacted 2015).


Emergency Contraception

EC in the ER

Washington law ensures that sexual-assault survivors receive access to emergency contraception (EC) in hospital emergency rooms.  As part of the minimum standards for the examination and treatment of a sexual-assault survivor, a physician or other health-care provider must provide a woman with medically and factually accurate information about EC, offer her EC, and provide EC upon request.

The secretary of health, in collaboration with sexual-assault programs and other relevant entities, must develop, prepare, and produce informational materials about EC for distribution to and use in all hospital emergency rooms in the state. The secretary also may approve such materials from other sources. Wash. Rev. Code Ann. §§ 70.41.020, .350, .360 (Enacted 2002).


Other Important Issues

Clinic Protections

Clinic Protections

It is unlawful for a person willfully or recklessly to interfere with access to or from a health-care facility or willfully or recklessly to disrupt the normal function of such a facility by:  (1) physical obstruction; (2) noise that unreasonably disturbs the peace within the facility; (3) trespass; (4) repeated telephoning or knowingly permitting the use of any telephone under his or her control for such purpose; or (5) threats to inflict injury upon the owners, agents, patients, employees, or property of the facility, or knowingly permitting the use of any telephone under his or her control for such purpose.  A person convicted is guilty of a misdemeanor and will be fined at least $250 and jailed for at least 24 consecutive hours for a first offense; fined at least $500 and jailed for at least seven consecutive days for a second offense; and fined at least $1000 and jailed for at least 30 consecutive days for a subsequent offense.  A person or facility aggrieved may bring an action for damages, injunctive relief, costs, and attorneys’ fees.  Wash. Rev. Code Ann. §§ 9A.50.005 to .070, .900 to .902 (Enacted 1993).

It is unlawful for an insurer to take an underwriting action on a policy of property insurance because an insured has made one or more insurance claims for any loss that occurred during the preceding 60 months that is the result of arson of malicious mischief or arson. Such prohibition includes health-care facilities and providers. If an insured sustains a loss that is the result of arson or malicious mischief, the insured must file a report with the police or other law-enforcement authority within 30 days of discovery of the incident, and a law-enforcement authority must determine that a crime has occurred. The report must contain sufficient information to provide an insurer with reasonable notice that the loss was the result of arson or malicious mischief.  Wash. Rev. Code Ann. §§ 48.18.555 (Enacted 2006).


Fake Health Centers

No state measure.

Refusals & Guarantees

Refusals of Medical Care

ABORTION REFUSAL CLAUSE

Washington allows certain individuals or entities to refuse to provide abortion services.

To whom does the refusal clause apply? Individuals and private medical facilities.

What does the refusal clause allow? Allows individuals who, or private medical facilities that, object to refuse to participate in abortion services. No person may be discriminated against in employment or professional privileges because of participating or refusing to participate in abortion services.

Does the law require the refusing entity to notify the persons affected? No.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.

Wash. Rev. Code Ann. § 9.02.150 (Enacted 1992).

HEALTH-CARE PROVIDER AND HEALTH-CARE INSTITUTION

Washington allows certain individuals or entities to refuse to comply with an individual health-care instruction or decision based on conscience.

To whom does the refusal clause apply? Individuals, religiously sponsored health insurers, and health-care facilities.

What does the refusal clause allow? Allows health-care providers, religiously sponsored health insurers, and health-care facilities to refuse to participate in a service if it objects for reason of conscience or religion.

Does the law require the refusing individual or entity to notify the persons affected? In some cases, yes. Religiously sponsored health insurers must provide written notice to enrollees upon enrollment with the plan, listing the services that the insurer refuses to cover for reasons of conscience or religion.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for services? No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? Yes. The law provides that the health-care provider must provide written information descirbing how an erollee may directly access services.

Wash. Rev. Code Ann. § 48.43.065 (Enacted 1995).


Guarantees Access to Prescriptions

Washington law requires pharmacies to dispense women’s birth control.  Upon receipt of a valid and lawful prescription, or upon request for a medication or device approved by the FDA for behind-the-counter distribution by pharmacies, a pharmacy must dispense the medication or device or a suitable alternative without delay.  If the pharmacy does not have a prescription medication or device or a suitable alternative in stock, the pharmacy must obtain it in a manner consistent with customary pharmacy practice.  In the alternative, a patient may choose to have the prescription transferred to a different pharmacy or have the prescription returned to her.

Nothing under Washington law interferes with a pharmacist screening for potential drug-therapy problems, including inadequacies in the instructions, contraindications, drug interactions, or potentially fraudulent prescriptions.  Wash. Admin. Code 246-863-095; Wash. Admin. Code 246-869-010 (Enacted 2007).

A group of pharmacists challenged the law and, in November 2007, a federal district court granted the motion for a preliminary injunction.  Storman’s Inc. v. Selecky, No. 07-CV-05374-ORD (W.D. Wash. Nov. 8, 2007) (order granting preliminary injunction), appeal docketed, Nos. 07-36039, 07-36040 (9th Cir. Dec. 13, 2007).  The state appealed and, in July 2009, the Ninth Circuit Court of Appeals lifted the injunction, noting that pharmacists were required to dispense the emergency contraceptive Plan B, even if they personally objected to the medication based on religious reasons. This decision restored women’s access to birth control in the state.  While the injunction was lifted and the requirement for pharmacies to stock and dispense Plan B took effect immediately, the case was remanded back to the district court for further consideration.  Storman’s Inc. v. Selecky, No. 12-35221 (9th Cir. Jul. 8, 2009).

The pharmacists petitioned the Ninth Circuit for a rehearing and, in October 2009, the court vacated its July opinion but came to a similar decision; it found that the district court abused its discretion when it preliminarily enjoined the enforcement of the law and remanded the case back to the district court to determine if the pharmacists qualify for injunctive relief (however, the court specified that this relief could only apply to the pharmacists in the case, not to the entire state).  Storman’s Inc. v. Selecky, No. 12-35221 (9th Cir. Oct. 28, 2009).

In February 2012, the district court enjoined enforcement of the law against the pharmacists in the case.  Storman’s Inc. v. Selecky, No. 07-CV-05374 (W.D. Wash. Feb. 22, 2012).  The state appealed the decision and the case returned to the Ninth Circuit.  In July 2015, the Ninth Circuit upheld unanimously the law requiring pharmacies to dispense all medications, including contraception and emergency contraception.  Storman’s Inc. v. Selecky, No. 12-35221 (9th Cir. Jul. 23, 2015).  However, the pharmacists objecting to the law asked for a stay while they request that their case be heard by the U.S. Supreme Court.  The Ninth Circuit granted the stay while the Supreme Court decided whether to hear the case.  (9th Cir. Oct. 10, 2015).

In June 2016, the Supreme Court denied the pharmacists petition for the high court to hear the case (Supreme Court June 28, 2016).  As a result, the Ninth Circuit lifted the stay and the law went into effect.  (9th Cir. June 30, 2016).


Guarantees Access to Prescriptions

Washington law requires pharmacies to dispense women’s birth control.  Upon receipt of a valid and lawful prescription, or upon request for a medication or device approved by the FDA for behind-the-counter distribution by pharmacies, a pharmacy must dispense the medication or device or a suitable alternative without delay.  If the pharmacy does not have a prescription medication or device or a suitable alternative in stock, the pharmacy must obtain it in a manner consistent with customary pharmacy practice.  In the alternative, a patient may choose to have the prescription transferred to a different pharmacy or have the prescription returned to her.

Nothing under Washington law interferes with a pharmacist screening for potential drug-therapy problems, including inadequacies in the instructions, contraindications, drug interactions, or potentially fraudulent prescriptions.  Wash. Admin. Code 246-863-095; Wash. Admin. Code 246-869-010 (Enacted 2007).

A group of pharmacists challenged the law and, in November 2007, a federal district court granted the motion for a preliminary injunction.  Storman’s Inc. v. Selecky, No. 07-CV-05374-ORD (W.D. Wash. Nov. 8, 2007) (order granting preliminary injunction), appeal docketed, Nos. 07-36039, 07-36040 (9th Cir. Dec. 13, 2007).  The state appealed and, in July 2009, the Ninth Circuit Court of Appeals lifted the injunction, noting that pharmacists were required to dispense the emergency contraceptive Plan B, even if they personally objected to the medication based on religious reasons. This decision restored women’s access to birth control in the state.  While the injunction was lifted and the requirement for pharmacies to stock and dispense Plan B took effect immediately, the case was remanded back to the district court for further consideration.  Storman’s Inc. v. Selecky, No. 12-35221 (9th Cir. Jul. 8, 2009).

The pharmacists petitioned the Ninth Circuit for a rehearing and, in October 2009, the court vacated its July opinion but came to a similar decision; it found that the district court abused its discretion when it preliminarily enjoined the enforcement of the law and remanded the case back to the district court to determine if the pharmacists qualify for injunctive relief (however, the court specified that this relief could only apply to the pharmacists in the case, not to the entire state).  Storman’s Inc. v. Selecky, No. 12-35221 (9th Cir. Oct. 28, 2009).

In February 2012, the district court enjoined enforcement of the law against the pharmacists in the case.  Storman’s Inc. v. Selecky, No. 07-CV-05374 (W.D. Wash. Feb. 22, 2012).  The state appealed the decision and the case returned to the Ninth Circuit.  In July 2015, the Ninth Circuit upheld unanimously the law requiring pharmacies to dispense all medications, including contraception and emergency contraception.  Storman’s Inc. v. Selecky, No. 12-35221 (9th Cir. Jul. 23, 2015).  However, the pharmacists objecting to the law asked for a stay while they request that their case be heard by the U.S. Supreme Court.  The Ninth Circuit granted the stay and the law is now enjoined again until the Supreme Court decides whether to hear the case.  (9th Cir. Oct. 10, 2015).


Counseling & Referral Bans

No state measure.

Everyone should be able to decide if, when, how, and with whom they start or grow a family.

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