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THE state attorney general’s important opinion last week on reproductive-health care is a reminder that elections matter. In this case, the general election of 1991, when Washington voters affirmed, in the unambiguous language of Initiative 120, a woman’s right to abortion.

Attorney General Bob Ferguson leaned heavily on Initiative 120 in his advisory opinion, which found that public-hospital districts must offer abortion services if they offer maternity care. The opinion is logical, thoughtful and appropriately does not prescribe how such services should be delivered.

Access has become an increasingly relevant issue as Catholic-affliated hospitals, which often offer limited or no abortion access, take a larger role in Washington health care through mergers and partnerships with secular health care providers.

Rep. Kevin Ranker, D-Orcas Island, had requested Ferguson’s opinion because PeaceHealth, the Bellevue-based Catholic health-care provider, recently replaced Friday Harbor’s secular clinic, raising concerns on the island about abortion access.

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The AG’s opinion applies to the state’s 56 public-hospital districts, most of which are in rural Washington, where options for abortion can be limited. The real impact of the opinion is unclear, because some districts don’t offer maternity care. Also uncertain is whether some providers that now offer maternity care might stop if they are also required to provide abortions.

The opinion doesn’t apply to mergers or affiliations between religious-based systems and private hospitals, such as Harrison Medical Center in Bremerton. And bedrock American principles of religious freedom mean private Catholic hospitals are obviously free to offer care appropriate to their faith.

The increased role of Catholic health-care organizations can be a good thing for Washington, given their long history of offering high-quality care, especially to low-income patients. But the state’s laws ensuring abortion access and physician-assisted suicide clearly complicate mergers and alliances.

Gov. Jay Inslee recently ordered a review of state health-care licensing procedures to ensure access to legal health-care services, including abortion, is not merged out of existence in some parts of the state. That work, which could have a broader impact, is pending.

Until then, Ferguson has sent a clear message: As a matter of state law, a woman’s right to choose an abortion is a settled issue.

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