Governor Inslee Acts to Codify Emergency Abortion Access in Washington

Washington Gov. Jay Inslee (D), who is set to leave office tomorrow after not seeking reelection after his third term as governor, issued a directive on Friday to establish emergency abortion access as state law.

“Codifying clear legal requirements to provide emergency abortion care according to the standard of care and the informed consent of pregnant persons will promote patients’ access to needed care and health care providers’ ability to serve their patients in a manner consistent with their sound professional judgment,” Inslee said in the recent directive.

Directive 25-01 requires the Washington State Department of Health to create a rule mandating that hospitals offering emergency services provide treatment, including abortion when medically necessary, to pregnant people with emergency medical conditions. The rule must ensure care is delivered according to the standard of care or through a legally authorized transfer.

While there have been no reported cases of pregnant people being denied emergency abortions in Washington state, since 2022, over 100 women across the country have been turned away from emergency rooms, in states both with and without strict abortion bans. In particularly egregious examples, a Texas woman miscarried in an emergency room restroom after being denied care; a hospital turned away a woman in Florida even though her fetus had no heartbeat; and a North Carolina woman gave birth in her car to a baby who did not survive, after an emergency room was unable to provide an ultrasound.

The directive also requires the Washington State Department of Health to create a rule which requires hospitals to prioritize the health of the pregnant person over the continuation of a pregnancy or the health of a fetus, unless the patient explicitly chooses otherwise. This measure comes in response to incidents in states like Missouri, Kansas, Texas and California, where hospitals have made decisions that prioritized the health of the fetus over the wellbeing of pregnant women, endangering their lives and sometimes killing them.

Following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization in 2022, Inslee had instructed the Washington State Department of Health to issue a policy statement reaffirming state legal obligations for hospitals to provide emergency abortion care and to ensure enforcement when these requirements are not met.

“Subsequent events call for further strengthening the bulwark guarding reproductive freedom and pregnant people’s right to receive treatment in a medical emergency in our state,” Inslee said in the recent directive.

While Medicare-participating hospitals are legally required to provide abortion care in emergency situations, ongoing legal challenges have raised doubts about the statute’s future, and the incoming Trump administration is likely to reverse Biden-era policies that ensured abortion care in medical emergencies. In fact, according to the National Women’s Law Center, Project 2025, the conservative blueprint for the next Trump administration, proposes policies aimed at undermining or eliminating federal protections under EMTALA that guarantee the right to emergency abortion care.

“[G]iven the likelihood of imminent changes to federal abortion policy that would interfere with access to emergency abortion care and imperil the health of pregnant persons in Washington state, immediate adoption is necessary for the preservation of the public health, safety, and general welfare,” Inslee said in the recent directive.

Inslee’s directive coincides with efforts by governor-elect Bob Ferguson (D), who has formed a committee within his transition team to address Project 2025. Ferguson announced that the committee will be co-chaired by Jennifer Allen, CEO of Planned Parenthood Alliance Advocates, to combat Project 2025’s recommendations aimed at “gutting access to abortion.”