The headwinds will turn again: The state of bodily autonomy in Washington State and beyond

Make no mistake: The nationwide assault on the right to bodily autonomy has had ripple effects here in Washington state.

Yes, Washington passed a spate of bills that defended and expanded access to abortion and gender-affirming health care in the wake of the Supreme Court overturning Roe v. Wade and the ongoing attacks on gender affirming care. And yes, the right to abortion is found in the Washington state constitution and in laws.

“At the end of the day, however, the right to abortion doesn’t mean that access to abortion necessarily exists,” said Leah Rutman, the ACLU of Washington’s health policy program director.

Rutman says Washington, in some ways, is fortunate for its state of bodily autonomy rights, because of the state constitution and laws.

However, many health institutions refuse to provide services like abortion and gender affirming care in Washington. When these health systems consolidate with other health systems — which happens frequently — it reduces access to services like abortion, which Washingtonians have a right to.

“And as always, people who already faced barriers to care tend to be disproportionately impacted when there are access issues,” Rutman said.

Abortion has existed in America since its founding and has undergone periods of varying legality and illegality throughout its history.

In the wake of Dobbs

In this current moment of restriction, 14 states banned abortion in the year after Roe was overturned.

Washington took the approach of protecting and expanding access to bodily autonomy in the wake of the Dobbs decision, which overturned Roe v. Wade. The state had already passed the Protecting Pregnant Patients Act, which prevents hospitals from interfering with a doctor providing pregnant patients with the care they need when their bodily health or life is at risk, including abortions. The state also passed a shield law in 2023 to protect out-of-state patients seeking care that is legal in Washington; and My Health, My Data, which helps reduce barriers to care by protecting people’s private health data.

“In the wake of the Dobbs decision, and the ongoing attacks on access to reproductive health care and gender affirming care, it is all the more important that this information is protected,” Rutman said about My Health, My Data. “People seeking or providing health care shouldn’t need to fear that private health information will be used against them in the future.”

Progress to be made in Washington

There is still progress to be made on bodily autonomy in Washington, however. To address the issue of hospital and provider group consolidations, for example, our organization has worked in coalition for years to pass the Keep Our Care Act (KOCA). The bill got further than it ever had in this year’s legislative session. If it had passed, KOCA would have provided meaningful oversight over consolidations to ensure hospitals and provider groups do not create barriers to care when merging.

There are also other tests of Washington’s system coming from national sources. Just this week, the Supreme Court heard arguments that could limit nationwide access to mifepristone, abortion medication used in almost two-thirds of cases in the country.

The court is also set to weigh if EMTALA, a federal law that requires hospitals to provide necessary stabilizing treatment to pregnant people who come to an emergency room, covers abortion. Pregnant patients’ lives and health will be put at risk if the court determines that EMTALA does not cover abortion, as abortion can be the medically appropriate and needed response to a pregnancy emergency.  

Washington has also dealt with challenges from other states. Seattle Children’s Hospital recently sued the Texas Attorney General’s Office after Texas AG Ken Paxton demanded the hospital turn over information regarding gender-affirming care provided in Seattle to children from Texas.

“And so, we are seeing attempts from other states … because their values don't align with our state's values, trying to get at care provided in our state,” Rutman said. “Which is completely unacceptable.”

Increasing access and hope

But Rutman is hopeful. She notes that Seattle Children’s and the Washington Attorney General’s Office acted to protect the health information that Texas sought.

The fight to secure bodily autonomy continues, and she is optimistic that, as in the past, our country will one day expand access to care rather than restricting it.

“The more that we are seeing a really bleak future right now, I think we still know that the headwinds will turn again, and we will be able to ensure that there is more access to care, more bodily autonomy within our country,” she said. “So much of this is about changing the narrative and changing the way people speak to each other and people interact on these issues.

“Because at the end of the day, bodily autonomy shouldn’t be about politics. It should be you doing what you need and want to do with your own body.”