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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Birth doulas across Arkansas have formed a new organization to improve maternal health care across the state and help pass legislation they hope will make doula services accessible to more families.

Doulas are members of a birthing team providing emotional, physical and educational support to expectant mothers.

Cora Crain, cofounder and board vice president of the Doula Alliance of Arkansas, said research shows doula services can reduce cesarean sections, premature deliveries and length of labor.

"We have people reaching out to us. This is their first time they don't know what they don't know," Crain explained. "It's all very overwhelming. There's definitely a certain amount of fear that a lot of people are bringing to the birth experience and then of course if you had a doula in your previous birth then you usually continue."

Doulas provide services during pregnancy, childbirth and postpartum.

Members of the alliance are supporting a bill before state legislators next year mandating insurance companies and Medicaid to cover doula costs. Crain noted if passed, the legislation will make services available to more expectant mothers.

"Doula services can be so important in getting healthier outcomes and also just more positive experiences that lead to more positive postpartum times," Crain emphasized. "But it's just not as accessible to so many women that can't afford that out-of-pocket expense. "

Arkansas has one of the highest maternal mortality rates in the nation.


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Wisconsin law bans telemedicine abortion care, yet new data show an increasing number of Wisconsinites have been getting abortion pills through shield law providers.

An 1800s Wisconsin law caused a temporary statewide ban on abortion services after Roe v. Wade was overturned in 2022.

Jenny Higgins, professor of obstetrics and gynecology at the University of Wisconsin-Madison and director of the UW Collaborative for Reproductive Equity, said even after the ban was lifted in 2023, demand for abortion pills in Wisconsin remained high.

"Suggesting that even when brick-and-mortar facilities are offering abortion care in our state, telehealth abortion still is a really important service that many people in our state are taking advantage of through these shield laws," Higgins explained.

There have been about 130 orders for abortion pills per month made through shield law providers since July 2023, according to WeCount data. There have also been reports of stockpiling nationwide since the election. In a recent interview, President-elect Donald Trump said he would "probably" not restrict medication abortion pills during his second term.

With only four abortion clinics statewide, 96% of Wisconsin counties do not have an abortion provider and about 70% of Wisconsinites of reproductive age live in a county without an abortion clinic.

Higgins noted while shield law clinicians provide critical and affordable care to Wisconsinites who grapple with numerous restrictions to abortion, attempts to criminalize both providers and patients are expected, with Black and brown patients at the highest risk.

"We know historically that Black and brown women are the most likely to be criminalized during pregnancy, whether that pregnancy is ending in abortion or birth," Higgins pointed out. "I think we need to pay great attention to the ways in which some of the pregnant people with the least social power could be putting themselves at risk."

She added barriers to care must also be recognized, including distance to brick-and-mortar facilities, state insurance prohibitions affecting affordability and negative past health care experiences.

Another 1800s law could come into play under the new administration, although about 70% of Americans have never heard of it. Project 2025 directs the use of portions of the Comstock Act to criminalize abortion, while some state attorneys general have already asked courts to make mailing abortion pills illegal under the act.


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Voters across the country approved a majority of measures in November to affirm abortion rights and supporters of an initiative to legalize abortion in Idaho said they are feeling momentum.

Voters approved seven of 10 state abortion-rights measures, including in Montana. A Florida measure received a majority of votes but did not reach the state's 60% threshold for passage.

In Idaho, pro-choice advocates are waiting for approval to collect signatures on a 2026 measure which would allow access to abortion until viability of the fetus.

Melanie Folwell, executive director of Idahoans United for Women and Families, is leading the effort.

"If there's anything that was very clear in November's election, it's that abortion amendments and abortion laws -- laws that expand access to reproductive options -- do well at the ballot, even in very 'red' states," Folwell asserted.

Idaho is one of six states with a near-total abortion ban. Folwell noted her organization is awaiting approval from the attorney general's office and could start collecting signatures by the end of January.

However, unlike many other states allowing voter initiatives to amend the state constitution, Idaho does not. If approved for the ballot, the abortion access measure would mean passing legislation, which in turn means legislators could repeal it. Folwell argued it is unfortunate, when people have been telling lawmakers since Roe v. Wade was overturned about the negative effects of banning abortion.

"They've heard from doctors, they've heard from health care systems, they've heard from patients themselves -- from women who have suffered needlessly as a result of these laws -- and they've done nothing," Folwell observed. "They've had two legislative sessions to do something. They've done nothing. And we think there's an imperative to just take this question to the people."

If the measure is approved to collect signatures, it would need 6% of signatures from registered voters from at least 18 of the state's 35 legislative districts, a total of about 70,000 signatures before April 30, 2026.


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