Complying with the state law on access to abortion is not a choice for public hospital districts.

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ACCESS to abortion is settled law in Washington. Voters passed the Reproductive Privacy Act (RPA) by initiative in 1991, prohibiting the state from interfering with this “fundamental right.” Voters spoke again in 1998, rejecting an initiative to criminalize late-term abortions.

But the politics of abortion requires vigilance to ensure the law is upheld. A court ruling this week correctly held the duty of public hospitals to follow the 1991 voter-approved law. The RPA requires abortion services if the public facility provides maternity care.

Technically, the ruling by Whatcom County Superior Court Judge Raquel Montoya-Lewis applies just to Skagit County’s hospital district, which was sued by the American Civil Liberties Union of Washington.

But it sends an unequivocal message to public hospitals around the state that they cannot send patients seeking abortions to Planned Parenthood — as Skagit Valley Hospital routinely did — instead of providing that service themselves.

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“In effect, the Hospital District shrugs its shoulders and informs patients that they will have to find that aspect of their health care elsewhere,” wrote Montoya-Lewis. “Compliance with the RPA is not aspirational; it is mandatory.”

The ACLU notified public hospital districts in Jefferson and Mason counties, as well as the Whidbey Island hospital district, that they were similarly violating the law. Jefferson County quickly moved to comply with the law. The others have not yet, but should.

The law does not apply to private hospitals, including Catholic facilities. But the increasing number of religious-affiliated hospitals in the state underscores the need for public hospitals to provide access to the full range of health care, including abortions.

Finding providers willing to perform abortions can be difficult, and the 1991 law allows doctors to opt out of the procedure. Attorneys for the Skagit Regional Health district said no doctor there was willing to provide the procedure. And they argued, with a bit of pretzel logic, that the district faced a potential discrimination claim if a physician were hired who was unwilling to perform abortions.

If that argument is to be believed, the Legislature should alleviate the bind that public hospital districts may face in hiring.

But shrugging off the duty to follow the law is not, as Montoya-Lewis writes, a choice.