We welcome and commend today’s Attorney General Opinion 2013-No. 3, which reaffirms that hospitals supported by taxpayer dollars have important obligations under Washington law to maintain access to services for Washington’s residents.
The Opinion makes clear that hospitals receiving public dollars through public hospital districts—even if the hospitals are operated by private entities—must comply with the requirements of I-120 (the Reproductive Privacy Act), in which Washington’s voters approved strong protections for reproductive freedom. The Opinion sends a strong message that as hospitals in our state—such as the “Interlocals” (Skagit Valley Hospital, Island Hospital, and Cascade Valley Hospital)—move forward with potential mergers, they must ensure their obligations under I-120 are met by providing reproductive and contraceptive services as well as maternity care services. These are essential, basic health care services to which all Washington women should have access.
While today’s action is an important step forward, it is limited in its scope given the narrow question to which it responds. It addresses only obligations to provide reproductive services covered by I-120, and does not address the obligations of private entities outside of the public hospital district context.
Our overarching goal remains much broader—that all patients should have access in their local communities to a full range of lawful, best care medical services, and that no patient should be refused access to such services because of the religious doctrines of the organization controlling a hospital, clinic, or other medical facility. Washington’s Certificate of Need statute and Gov. Inslee’s directive 13-12 both emphasize the need to “promote, maintain, and ensure the health of all citizens in the state by providing accessible health services, health facilities, and other resources....”
Washington’s policymakers must act far more comprehensively to meet the threat to access to health care services posed by hospital mergers in Washington. And they must do so quickly—the pace of Washington’s hospital mergers is unprecedented nationally. A full-scale response requires:
- a complete review of Washington’s health care laws and policies in light of this game-changing trend;
- a clear, transparent process for meaningful government oversight of mergers;
- legislative and regulatory safeguards that protect access to a full range of services, including end-of- life care, care for LGBT families, and reproductive services, when mergers do move forward; and
- more enforcement mechanisms to ensure that entities that fail to provide a full range of services are held accountable.
These changes require concerted, decisive action from the Governor’s office, lawmakers, executive agencies, and other public entities. We look forward to working with all of those to protect Washingtonians’ access to health care.