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August 21, 2013
Attorney General’s Opinion addresses public hospital districts and reproductive health
SEATTLE—The Attorney General’s Office today released a formal Attorney General’s Opinion in response to a request by Sen. Kevin Ranker, D-Orcas Island.

Ranker asked if a public hospital district violates Initiative 120 if it solely contracts with a health care provider that does not provide reproductive care services such as contraception.

Initiative 120, approved by Washington voters in 1991, declares that residents have “a fundamental right to choose or refuse birth control or abortion,” and it prohibits the state from discriminating against the exercise of these rights in the “regulation or provision of benefits, facilities, services or information.”

It also requires that, if the state (or a part of the state such as a public hospital district) provides maternity care service or information, it must also provide “substantially equivalent benefits, services or information” regarding contraception and abortion.

The Attorney General’s Office formal opinion (AGO 2013 No. 2) states that the plain language of the law dictates that a public hospital district providing maternity care must also provide “substantially equivalent benefits, services or information” under Initiative 120.

“We express no opinion on exactly how hospital districts may comply with this requirement or what constitutes ‘substantially equivalent benefits, services or information,’” the opinion states. “It is clear under the statute, however, that hospital districts may not administer or fund programs to provide “maternity care benefits, services or information” to women without making provision for the rights secured by [Initiative 120.]”

The opinion says nothing about purely private hospitals, and instead addresses only hospitals funded by tax dollars through public hospital districts.

As the chief legal officer of the state, the Washington Attorney General provides official opinions on questions of law at the request of designated public officials on issues arising in the course of their duties. Opinions are processed through the Solicitor General’s Office.

The majority of legal advice given by the Attorney General’s Office in response to requests for opinions consists of informal opinions--or letters that present the considered legal analysis of the Assistant Attorneys General who write them. Formal opinions typically are reserved for highly important issues of broad public significance.

Formal opinions involve a lengthy process of research and review. Each formal opinion is carefully drafted by the assigned attorney, then reviewed by the Opinions Editor, at least one other Assistant Attorney General and, finally, the Attorney General. During the process, the opinion may be revised several times.

While these formal legal opinions are not binding in any way, they have historically been given great weight by the courts.


The Office of the Attorney General is the chief legal office for the state of Washington with attorneys and staff in 27 divisions across the state providing legal services to roughly 200 state agencies, boards and commissions. Attorney General Bob Ferguson is working hard to protect consumers and seniors against fraud, keep our communities safe, protect our environment and stand up for our veterans.


Janelle Guthrie, Director of Communications, (360) 586-0725
Alison Dempsey-Hall, Dep. Communications Director, (206) 641-1335

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