OLYMPIA, Wash. - A coalition is urging Washington state to expand health care.

The Reproductive Health Access for All Act would help two communities in particular that face barriers to care: immigrants and the transgender or gender non-conforming communities.

Women who are undocumented can't access family-planning services because of federal restrictions, and Morgan Steele Dykeman, legislative affairs manager for NARAL Pro-Choice Washington, said nearly 30 percent of transgender Washingtonians have been denied either transition-related or reproductive care because of their gender identity.

"That might be a situation where you have a trans man, for example, who needs a hysterectomy or treatment for birth control," she said, "but because the health insurance company has that person listed as a man, they get a blanket denial on any services that would traditionally be identified with women."

Starting in 2021, the measure also would require health-insurance plans, including student plans, to cover condoms, screenings following sexual assaults, medications for needs following an assault, prenatal vitamins and breast pumps.

The Senate version of the bill, SB 5602, has a hearing in the Ways and Means Committee today.

Steele Dykeman said providing greater access to health care would be a money saver for the state in the long run.

"Not only is there a public-health component in terms of ensuring that all communities in Washington have healthy families," she said, "but also making sure that we're not delaying the cost burden of taking care of folks who didn't have the right access when they needed it."

Backing the bill is the Health Equity and Reproductive Rights Organizations Coalition. Groups signed onto the coalition include the American College of Obstetricians and Gynecologists, Gender Justice League and Northwest Health Law Advocates.

The text of SB 5602 is online at lawfilesext.leg.wa.gov.


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Illinois serves as a crucial access point for abortion services and sees the most out-of-state patients in the country.

Since Roe v. Wade was overturned in June 2022, Planned Parenthood of Illinois has seen the largest increase in abortion services than any other state. About 25% of its patients are from out-of-state.

Julie Uhal, program manager of strategic initiatives and impact measurement for Planned Parenthood of Illinois, said they planned for an initial surge but sustained high patient volume has strained their resources. She explained they saw up to a dozen out-of-state patients per month before Roe was overturned.

"We're seeing 800, 900, 1,000 out-of-state patients every single month," Uhal reported. "That hasn't changed. That's remained constant for three years now because abortion bans don't stop the need for abortion care. They just make it more difficult for people to access."

Uhal pointed out many out-of-state patients are uninsured or have insurance in other states which cannot be used in Illinois. Combined with rising health care costs, lower reimbursement rates and threats to Medicaid, she said Planned Parenthood faces financial difficulties, which have already forced them to close four clinics this year.

Planned Parenthood is the largest provider of sexual and reproductive health care in the state. More than 40% of local patients use Medicaid to cover the cost of services, which in addition to abortion care includes birth control, cancer screenings, STI treatment and prenatal and gender-affirming care. Without Medicaid funding, Planned Parenthood of Illinois said it would need about $16 million a year to continue providing services at its current rate.

"A lot of people don't realize that many Planned Parenthood clinics are in areas that are otherwise health care provider deserts for access," Uhal emphasized. "For a lot of people, going in for a birth control appointment might be the only time they see a doctor that year."

Uhal stressed the burden of accessing common health care continues to be placed on the patient since states banned abortion services. The recent Supreme Court ruling which set a precedent to allow states to exclude Planned Parenthood from Medicaid will only worsen the burden. She added helping patients to navigate emotional and logistic barriers to care has been just as important as providing them with care.

"One in four people that can get pregnant will have an abortion at some point in their lifetime," Uhal explained. "So it's really important for people to know that they're not alone. There shouldn't be as much shame and stigma surrounding this as there is."

Planned Parenthood of Illinois opened the Carbondale Health Center in 2023 to help meet the increased demand for services, particularly for patients traveling from the South. About 90% of patients there come from out-of-state.


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Abortion rights advocates in Kentucky are concerned as the Department of Health and Human Services has revoked a policy requiring hospitals to provide abortion care in emergency situations.

Known as the Emergency Medical Treatment and Labor Act, the rule offered federal protection for the procedure, particularly in Kentucky and other red states with near total abortion bans.

Tamarra Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said stripping away protection will be catastrophic for women in rural counties who already face barriers to care.

"We know in a state like Kentucky that people have already turned up at emergency rooms because of our abortion restrictions," Wieder pointed out. "Doctors have been forced to wait until patients were at life-threatening situations, sepsis, hemorrhage, before they are able to provide care."

According to the National Institutes of Health, pregnancy complications are the fifth-most common reason women of reproductive age visit the emergency room.

Weider added rural communities across the Commonwealth suffer the nation's worst family planning and sexual health outcomes and continue to struggle with access to safe and convenient obstetric and reproductive health care.

"I think it's really important to note that 57% of Kentucky's rural hospitals no longer offer obstetric services, 57%," Weider emphasized.

Kentucky's Human Life Protection Act, passed by lawmakers in 2019, banned all abortions except to save the life of the mother and it went into effect immediately after the Supreme Court overturned Roe v. Wade in 2022. The same year, voters in the Commonwealth rejected a ballot measure which would have amended the state constitution to explicitly deny the right to an abortion.

Arizona doctors have filed a lawsuit to overturn a set of restrictions which they argue interfere with access to abortion care. Arizona voters last year passed Proposition 139 which enshrined the fundamental right to an abortion, up until fetal viability, in the state's constitution.

Gail Deady, senior attorney, Center for Reproductive Rights, which is representing some of the plaintiffs in the case, explained that the abortion rights that were secured because of the measure do not go into effect automatically, and existing laws that limit access must be challenged before they can be struck down under Prop 139.

"This lawsuit is intended to honor the will of the voters and it looks to strike down the most onerous abortion restrictions that are currently on the books in Arizona," she said. "The theory behind this case is that these restrictions do not have any medical basis, they do not make abortions safer."

Deady explained that some of the restrictions include forcing doctors to turn away patients if they suspect a fetal genetic diagnosis is the reason for a patient seeking care, requiring patients to wait at least 24 hours before obtaining abortion care, and banning the use of telehealth for abortion. Mailing abortion pills - like mifepristone - is also prohibited. Conservative, anti-abortion advocates have expressed support for the restrictions, its's unclear if they'll oppose the lawsuit.

Deady argues many Arizonans are facing negative consequences as a result of the laws. She adds that it also means a delay in receiving the care most Arizonans supported last year, and added that Arizona has what she calls a "two-trip" law which requires patients make two separate visits to a clinic.

"Just to hear mandatory, state-scripted information about abortion that often is not medically correct, it spreads misinformation and is designed to make people feel ashamed of the decision that they've made which has now been recognized as a constitutional right in Arizona," she explained.

Deady said her organization is currently advocating for the restrictions to be blocked during litigation. The state attorney generals' office is currently examining the complaint.