Frequently Asked Questions About Health Care Regulation and Washington State Abortions

The US Supreme Court is expected to issue an opinion in June 2022 that could impact the current Roe vs Wade dominant. Washington State professional health regulators recognize that if Roe vs Wade is affected may raise practical issues for our licensees.

The Washington State Medical Commission, the Board of Osteopathic Medicine and Surgery, the Nursing Care Quality Assurance Commission, and the Pharmacy Quality Assurance Commission have written these frequently asked questions (FAQs) to clarify how Washington regulators will continue to address this issue. regardless of the US Supreme Court ruling.

What is the history of abortion laws in Washington state?

Washington became one of the first states to decriminalize abortion before Roe v. Wade in 1970 with the Referendum 20. In 1991, Initiative 120 was approved. Initiative 120 guarantees that “the state cannot deny or interfere with the right of a pregnant person to choose to have an abortion before the viability of the fetus, or to protect her life or health”.

The Reproductive Parity Act became law in June 2018. This legislation has improved access to reproductive health benefits and preventative services for all Washingtonians. It also specified that health plans cannot limit abortion services and that if health coverage includes maternity care it must also provide coverage that allows for abortion.

The Washington Abortion Access Act, effective June 9, 2022, helps preserve a pregnant person’s access to abortion care. This legislation expands the list of providers legally authorized to terminate pregnancies and updates the language from the 1991 Initiative 120 to include transgender, non-binary, and gender-expansive people such as those who can receive abortion care. It guarantees that abortion care providers in Washington will be able to serve any person who comes to Washington State seeking abortion services.

Will abortions remain legal in Washington state?

Yup.

Washington law states that “everyone has a fundamental right to privacy with respect to personal reproductive decisions” including “the fundamental right to choose or refuse to have an abortion.” (RCW 9.02.100)

In addition, state law makes it clear that no one can interfere with either a pregnant person’s right to choose an abortion before fetal viability or a health care practitioner’s right to provide an abortion. (RCW 9.02.110). For more information on feasibility, see below.

Under current state law, state regulators cannot inhibit, prevent, hinder or interfere with a health care practitioner, acting within their practice, from providing an abortion that meets state standards of care.

What is an abortion and in how many weeks can it be done?

Washington law defines abortion as “any medical treatment intended to induce termination of a pregnancy other than for the purpose of producing a live birth.” (RCW 9.02.170)

In Washington, abortions are legal to the point of fetal survival or to protect the life or health of the pregnant person. (RCW 9.02.110) Viability is defined as “the point in pregnancy where there is a reasonable probability of prolonged fetal survival outside the womb without the application of extraordinary medical measures”.

Feasibility is determined by the judgment of a physician, PA, ARNP or other health care provider acting within the provider’s practice on the particular facts of the case. (RCW 9.02.170)

Additionally, Washington legally considers a practitioner’s good faith judgment as a defense for violations of RCW 9.02. This means that suppliers acting in good faith are generally protected should the vitality or health of the pregnant person be in question.

How state regulators determine discipline and licensing if Roe vs Wade is it overturned?

The ruling is without prejudice to the way health care regulators operate in Washington State.

Washington regulators rely on complaints. Any complaint filed with a state health authority will be evaluated based on its unique facts and circumstances, as is the current practice.

The Uniform Disciplinary Act (UDA) defines the standards of discipline, licensing and powers conferred on health care regulators and the Secretary of Health. UDA section RCW 18.130.180 details what constitutes unprofessional conduct. The health professions regulators use their discretion, regarding both the license and the discipline to enforce these laws.

In Washington, performing an abortion by the means found in RCW 9.02.170, which does not harm the pregnant person and is prior to the viability of the fetus, does not amount to a violation of the UDA.

In general, Washington does not regulate or refuse licensing based solely on the state of licensing or regulating in another state.

Who can perform an abortion in Washington state?

A physician (MD), osteopathic physician (DO), medical assistant (PA), advanced nurse practitioner (ARNP), or other healthcare professional acting within the provider’s practice can provide an abortion as defined in RCW 9.02 .170 within their scope of practice. (EHB 1851, Chapter 65, Laws of 2022)

In addition, the Washington regulation requires that all hospitals with emergency rooms provide emergency contraception as a treatment option for any woman seeking treatment due to sexual assault. (WAC 246-320-286)

Providers can direct patients and the public to the Washington State Department of Health website for a compendium of resources on who can provide abortions, insurance coverage mandates, privacy laws, and more: DOH Abortion Resources webpage.

Can a pharmacist dispense hormonal, non-hormonal, or emergency contraceptives in Washington State?

Yes, a pharmacist can dispense hormonal, non-hormonal or emergency contraceptives based on a valid prescription or table order. As with all other prescribed drugs, pharmacists must comply with all applicable laws and rules when dispensing hormonal, non-hormonal, or emergency contraceptives, including the requirement to ensure that a prescribed contraceptive is safe and appropriate for each patient (WAC 246- 945-305 (2).

Any complaints received by the Pharmacy Commission relating to the administration of hormonal, non-hormonal or emergency contraceptives by pharmacists will be reviewed and evaluated. The Pharmacy Commission will evaluate each complaint based on its facts and circumstances.

Several councils and commissions are united – here’s how.

The following professional health regulators acknowledge that while a U.S. Supreme Court ruling could impact the rights of pregnant people nationwide, the laws in Washington state would not be changed by such a ruling. For information on how each committee is addressing this issue, click on the following links:

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