Washington may be known as a place that strongly supports women's reproductive health choices, but it can do so much better by enforcing state laws.

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I was going to write a column holding up Washington as a model for how to protect women’s access to reproductive health care, but that would be giving this state too much credit.

Disturbing trends are creeping into this famously pro-abortion-rights state. Without more vigilance and enforcement, low-income women in particular are at risk of losing basic rights to a full range of reproductive health options, including birth control and abortion.

Washington is doing some things right.

While politicians in other states and Congress clamor to cut off funding for poor patients seeking family planning help from Planned Parenthood clinics, this state consistently supports and funds those same services. Since 2010, more than 100,000 women and teens on Medicaid received some form of long-acting reversible contraception, which is a highly effective way to reduce unwanted pregnancies.

The state earns high marks from reproductive-rights advocates. In 1991, voters passed the Reproductive Privacy Act, a ballot measure that enshrines every individual’s “fundamental right to choose or refuse birth control” and every woman’s “fundamental right to choose or refuse to have an abortion.”

Thank goodness our public schools teach comprehensive sex education, too.

Over time, these smart policies have helped lower statewide abortion and teen-pregnancy rates. Since 1990, birthrates for girls ages 15 to 17 have decreased by 70 percent.

Though legislators here might not be purposely chipping away at access with ridiculous laws, maintaining the existing women’s health infrastructure is challenging:

• In 2014, Public Health – Seattle and King County struggled with a massive budget reduction that would have affected thousands of family-planning clients. Planned Parenthood, local cities and private businesses stepped in to take over or keep some clinics open for now, but the county needs a long-term strategy. (Voters can help by passing King County’s Best Starts for Kids levy on Nov. 3; a portion of those funds will pay for Public Health’s family-planning programs.)

• An April studyby Northwest Health Law Advocates revealed that insurance companies in the state’s health exchange gave secret shoppers inconsistent or false information on birth-control coverage.

• Last month, a Planned Parenthood health center in Pullman was firebombed. Instead of calling out this crime, anti-abortion officials, such as U.S. Rep. Cathy McMorris Rodgers, R-Spokane, picked a needless political fight in Congress to defund Planned Parenthood.

How does all this affect real people?

Dr. Sarah Prager, an associate professor of obstetrics and gynecology and director of the Family Planning Division at the University of Washington, sees persistent disparities among her patients.

Poor and uninsured women continue to struggle with access to comprehensive family-planning services, she says. Meanwhile, federal health benefits for military service members and Indian Health Service patients do not cover elective abortions. This restriction should be lifted, especially considering the high rates of sexual assault within these two vulnerable groups.

“When access to care is still highly dependent on financial status, racial status, immigrant status or whether you’re Native American or whether you’re in the military — that’s not really equality, and that’s not really good access,” Prager says.

Another contentious issue right now concerns a broad state rule that allows institutions and doctors to refuse to provide abortion care.

The American Civil Liberties Union of Washington has documented situations where women suffering miscarriages or nonviable pregnancies were denied abortions or the care was delayed.

I get why Catholic-run hospitals are opposed to terminating pregnancies. However, when publicly owned hospitals run by Catholic organizations or a community’s only hospital refuse to provide or refer for a legal procedure, that crosses a line.

The local ACLU is now suing Skagit Regional Health Center and has sent letters to San Juan County, Jefferson County, Mason County and Whidbey Island public hospital districts encouraging them to comply with the 24-year-old state Reproductive Privacy Act. That means if they provide pregnancy care, they must also offer abortion options.

So far, the Jefferson hospital is the only provider taking steps to comply with state law. Other providers should follow.

This is Washington, the state that legalized abortion in 1970, three years before Roe v. Wade.

If we don’t stand up for the rights we have now, they might not be there for us when we need them later.