The Attorney General for the state of Washington issued a legal opinion yesterday on the duty of “public health districts” to provide abortion and contraception services if they also provide obstetric services — and that may have implications for religious-affiliated providers in the state.  But does this order mean that Catholic hospitals and other such providers have to perform abortions?  Not quite, although the order impacts their ability to network:

Any public health district in Washington that provides maternity care must continue to offer “substantially equivalent benefits” in the form of contraception and abortion services, even if it contracts with a religious-affiliated medical organization, state Attorney General Bob Ferguson said in an opinion Wednesday.

“I fully expect all public hospital districts to comply with this opinion,” Ferguson told a Seattle news conference.

The opinion impacts a growing trend in Washington, in which small local hospitals have chosen to affiliate with larger health organizations, including Catholic-affiliated PeaceHealth and Providence Health and Services.

Under a directive by the U.S. Conference of Catholic Bishops, church-affiliated hospitals cannot perform abortions, are restricted in contraceptive services and cannot assist in patient suicides.

State Sen. Kevin Ranker, D-Orcas, asked the AG if a public hospital district would violate the state’s Initiative 120 if it solely contracts with a health care provider — such as a Catholic-affiliated hospital — that does not provide reproductive care services such as contraception and abortion.

Under the terms of I-120, adopted by voters in 1991, a public hospital district “may not provide maternity care without abortion and birth control . . . There are more than 50 public hospitals in Washington and this affects all of them,” Ferguson said.  The initiative did not impose the requirement on private hospitals.

Steven Ertelt writes at LifeNews that this will force Catholic hospitals to comply:

Washington state Attorney General Bob Ferguson issued an opinion yesterday saying that every hospital in the state — including religiously-run hospitals like Catholic hospitals — must provide abortions.

I’m not sure that’s exactly what this means.  The order refers to public hospitals, not private, and to the options that public health districts are required to support.  Catholic hospitals are private, quite obviously, although they contract with public entities to provide services, the most obvious being Medicare.

This opinion binds the districts from contracting certain operators for their facilities more than the facilities themselves. The public-health districts in Washington have been moving toward contracting with private entities rather than running them on their own. Ferguson’s opinion reads more to the point that these districts cannot avoid the responsibility to provide abortion and contraception services by seeking out only private contractors to run public facilities.

The Seattle P-I gives a little more context to Ferguson’s move:

The county has three taxpayer-supported hospitals in the process of affiliation (or absorption) by larger medical organizations.

Last November, United General Hospital of Sedro-Woolley agreed to an “alliance” with Peace Health-St. Joseph Medical Center, under which PeaceHealth will lease and operate the Sedro-Woolley hospital.

Two other hospitals, Island Hospital in Anacortes and Skagit Regional Health in Mount Vernon, have been considering similar affiliations.  The Catholic-affiliated PeaceHealth and Providence Health Services have been in the bidding, along with the secular University of Washington medical system and Virginia Mason.

The press conference and the new legal opinion are intended to warn the districts about contracting with PeaceHealth and other Catholic-affiliated private providers, and perhaps PeaceHealth, too.  The testing point will be the Sedro-Woolley facility, where PeaceHealth has already entered into a contract to operate the hospital.  If taken to court to force PeaceHealth to perform abortions, it will be an interesting fight, as the courts will be taking up the question of religious liberty in other contexts next year.  But even if courts rule against PeaceHealth and other Catholic firms operating public facilities, the end result will be the withdrawal of those organizations from operating public facilities, and not the start of abortions at private Catholic facilities.

Update: Steven has rewritten the first paragraph at LifeNews to clarify that he means public (taxpayer-funded) hospitals run by Catholic agencies.