In 2014, the Northwest Abortion Access Fund (NWAAF), previously The CAIR Project, received a phone call to its hotline from a Washington woman requesting financial assistance to terminate her complicated pregnancy. Her doctor had informed her that she would lose a kidney if she carried the pregnancy to full term. Yet, her insurance company refused to cover the abortion, because kidney loss failed to meet the insurance policy’s life-threatening qualifications for coverage. NWAAF provided funding for the woman to get the abortion, but the severity of the situation stuck with NWAAF’s Policy and Advocacy Committee volunteer Jessi Murray.
“When a health plan covers the costs of all reproductive health care, including abortion, it means people can make decisions based on what is best for their circumstances. When politicians deny coverage, the harm falls hardest on low-income women, women of color, and young women,” Murray wrote in an email to Seattle Weekly.
The women’s predicament was a common one for adults throughout Washington whose reproductive healthcare isn’t fully covered by their insurance. Murray added that about 25 percent of clients who call the NWAAF hotline have private insurance, but still need financial help when their insurance denies coverage or their high deductible plans cover little of the procedure. In Washington, Medicaid recipients can get funding through the state, but those who have private or military insurance don’t have access to that coverage.
The same barriers to coverage applies to birth control. In fact, only 35 percent of privately insured Washington women reported that their insurance fully covered their contraception in 2013, according to Planned Parenthood Votes Northwest and Hawaii. But that will soon be changing following the State Senate’s March 3 passage of the Reproductive Parity Act (Senate Bill 6219), which requires health plans that offer maternity coverage to also cover abortion and contraceptive costs.
Following six years of mobilizing volunteers, canvassing, cold calling voters, and rallying on the State Capitol steps, reproductive health advocates in Seattle such as Planned Parenthood and Cedar River Clinics can rest easier. Beginning in January 2019, the act requires that all new or renewed health insurance plans cover all FDA-approved birth control methods including IUDs, over-the-counter birth control, and voluntary sterilization without any forms of cost sharing such as deductible or copayments. Additionally, Washingtonians whose health insurance plans cover maternity care or services will also cover the abortion of a pregnancy, although it may be subject to the same terms, conditions, and cost sharing as that of maternity coverage.
The governor’s 17-member task force on health disparities will also conduct a literature review on health disparities based on race, socioeconomic status, sexual orientation, and gender identity, and make suggestions to the governor and legislature on how to reduce barriers to access by Jan. 1, 2019. The legislation, delivered to the governor’s desk on Mar. 9, now awaits his signature to become law. Seattle healthcare providers and Washington abortion funds rejoiced in the win, calling it a model that could be replicated throughout the country.
The passage of the measure was a long time coming for its supporters. Sen. Steve Hobbs (D-Snohomish) became the prime sponsor of the bill when members of several reproductive healthcare groups approached him over five years ago. Although he was originally apprehensive about the optics of a male primary sponsor, Hobbs realized “that social justice is everyone’s business,” he said during a Jan. 31 press conference. “To progress women’s issues … everyone has to be involved, otherwise you can never advance this. You can’t let a single group fight on their own, because then all you’re doing is you’re justifying the abuse and the inequality.”
This is especially salient given that insurance carriers unduly place the burden of contraceptive care on women, according to Planned Parenthood Votes Northwest and Hawaii. Over-the-counter birth control methods for men, and vasectomies are rarely covered by insurance in the state. Although Washington is one of 15 states that allows Medicaid to cover abortions, low-income Seattleites with private insurance who are denied coverage or have out-of-pocket expenses generally pay between $650 to $1,000 for first trimester abortions, according to abortion provider Trust Women Seattle.
At Seattle’s Cedar River Clinic, over 60 percent of female clients fall under the poverty line, according to the organization’s Director of Development and Communications Mercedes Sanchez. She added that economic hardship poses a barrier for women who have out-of-pocket costs to access abortion services. “That might mean them taking lots of time to save money, it might mean things like them having to choose between rent and money, not to mention women in our more rural areas who have to travel and think about child care, as well as transportation costs,” Sanchez said.
For Julie Burkhart, the founder and CEO of Trust Women, the legislation was a breath of fresh air. Burkhart believes that the Reproductive Parity Act serves as a message to the Trump administration and congressional members who are attempting to curb abortion access.
“That will be great financial help for women, so that people aren’t having to dig into their pockets and spend that cash on a procedure that they might need when they have insurance coverage,” Burkhart said.
Washington follows in the footsteps of Oregon, which passed similar legislation in July. NWAAF volunteer Murray, hopes that Washington lawmakers will pass measures in the next legislative session that “continue to expand access to reproductive health care to all Washingtonians regardless of race, ethnicity, immigration status, or sexual orientation.”