Washington State Hospital Association response to Gov. Inslee’s directive on emergency reproductive services

June 11, 2024

Gov. Inslee this morning announced that he is directing the state Department of Health to reaffirm and clarify state law requirements for hospitals to provide emergency abortion services. He is making this directive in anticipation of a Supreme Court ruling in the Idaho Emergency Medical Treatment and Labor Act (EMTALA) case, titled Moyle v. United States and Idaho v. United States. The case centers on the conflict between Idaho’s Defense of Life Act and federal EMTALA, leaving providers in limbo or at risk of prosecution for assisting someone with an ectopic pregnancy, experiencing a miscarriage, or facing other life threatening or serious health emergency pregnancy complications.

Washington state hospitals are already required by state law to provide emergency care to people experiencing these types of pregnancy complications. Washington hospitals are providing this care, including to people who have crossed the border from Idaho in need of care. There is no evidence that Washington hospitals are not providing appropriate emergency care.

Washington has strong state laws in place protecting patients seeking emergency pregnancy-related care and health care providers delivering these vital services.

“Washington hospitals are committed to providing emergency services for all conditions. It is our duty and privilege to provide excellent, comprehensive care for people in all kinds of emergency situations,” Washington State Hospital Association (WSHA) CEO Cassie Sauer said. “Washington hospitals are committed to and support both state law on care in emergencies and the federal Emergency Medical Treatment and Labor Act.”

“Hospitals’ commitment to emergency care includes a commitment to providing a whole host of services to which some people might apply a moral character. This includes not just emergency pregnancy-related services, but also drug overdoses, injuries sustained in fights, sexual-related emergencies, services to undocumented immigrant, and many other services that some people have said hospitals should not provide. Our core mission is healing. We disagree with any limitations on hospital provision of emergency services,” Sauer said.

Hospitals vary in their levels of capability to perform emergency services for pregnant patients. For example, some rural critical access hospitals do not perform surgeries. Guided by state and federal law, and in keeping with the standard of care, these hospitals may stabilize and transfer patients who need a higher or more complex level of care to a facility capable of providing the care safely.

WSHA supported the American Hospital Association (AHA) in its amicus brief in opposition to the Idaho law. The AHA and several large hospitals in Idaho are advocating against the law as damaging to patients and because it asks providers and hospitals to potentially violate EMTALA, which is contrary to hospitals’ missions.

The following are the citations of relevant state law protecting both patient access to emergency care and provider ability to deliver that care:

  • Chapter 70.400 RCW protects medical professionals providing care for emergency pregnancy complications, such as miscarriage management and treatment for ectopic pregnancies.
  • Chapter 9.02 RCW protects the right of pregnant individuals to make their own reproductive decisions.
  • RCW 70.170.060 protects access to hospital emergency care, including emergency reproductive care, regardless of ability to pay.
  • Chapter 70.03 RCW protects medical professionals providing medically accurate and comprehensive information to patients.

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