Progress and Priorities: A Legislative Update from Open Arms

Every year, Open Arms advocates for progressive policies to support the needs of birthing people and their families. Our legislative agendas select bills and budget items that promise to increase access to culturally appropriate and affordable healthcare, increase funding for programs for community health workers, and put the needs of birthing people of color at the forefront of state health policies. We are encouraged by the significant gains this year and expect that many failed bills necessary to protect affordable healthcare access will make strong comebacks in 2024.

The 2023 legislative session in Washington State proved to be a significant step forward in addressing critical issues related to reproductive rights, maternal healthcare, and social support services. Affordable housing received a much-needed boost in funding, with ten bills signed into law this month and $1 billion pledged to ease the crisis. The progress made for reproductive health care is being hailed as “historic” with $21 million allocated to abortion services and access.

Reproductive Rights and Healthcare

Washington State continued its commitment to being a sanctuary for out-of-state folks seeking reproductive health services. The passage of the ‘My Health, My Data Act’ ensures the protection of consumers’ private health data, even if collected by companies not bound by HIPAA regulations, adding a layer of protection to people arranging services and travel for abortions. The state also passed a new shield law to increase protection for abortion providers and patients from other states, safeguarding them from investigations and prosecutions from outside Washington. Notably, the state also proactively acquired 30,000 doses of mifepristone, the abortion pill, in anticipation of efforts to revoke FDA authorization. Although the Supreme Court voted to protect access to the medication for now, the political landscape leaves no room for inaction when protecting abortion care.

Maternal Mortality and Healthcare Access

A significant milestone during this legislative session was a key report on maternal mortality in Washington State. The Maternal Mortality Review Panel examined maternal deaths from 2017 to 2020 and identified that 80% were preventable. The report’s findings aligned with long-standing calls from organizations like Open Arms, health providers, and Black and patients of color: lowering maternal mortality in this country requires confronting systemic racism and bias in healthcare. Six critical measures were proposed to improve maternal healthcare outcomes:

1. Undo racism and bias
2. Address mental health and substance use disorder.
3. Enhance healthcare quality and access
4. Strengthen clinical care
5. Meet basic human needs
6. Address and prevent violence

Legislation targeting these areas was a significant focus during the 2023 session. Several bills passed, including HB 1168, which provides prevention, treatment, and support for prenatal substance exposure. Additionally, increased funding for midwives was approved through budget item #4, raising the reimbursement of birth kits from $75 to $500. Notably, budget item #2 allocated funds to increase maternity support services for pregnant folks at risk for poor birth outcomes. While the development of new culturally appropriate birthing centers in underserved areas did not receive funding through budget item #5, budget item #7 ensured continued funding for establishing Community Health Workers in primary care settings to support families with young children.

Increased Assistance to Families & the Healthcare Authority’s Reimbursement for Doula Services

Last year’s victory for doulas saw the state move forward with creating a new professional credential for doulas at the Department of Health with the passage of HB 1881, paving the way forward to the state’s reimbursement of their services. Within the Healthcare Authority’s section of the budget, funding was included to reimburse credentialed doulas for their maternity services, although how much is still yet to be announced. Families with young children also received a needed boost from the state as the general fund earmarked $17.3 million to increase the Temporary Assistance for Needy Families (TANF). Additionally, state family assistance cash grants were budgeted for $100 per month for households with children under three years old.

Early Childhood Development and Education

We are also pleased with the significant progress in funding programs for early childhood development and education. The Fair Start for Kids Act, which expands the state’s early learning resources, continued to be funded through budget. The final budget allocated about $9.5 million in combined state and federal funds to expand home visiting programs, while SB 5225 was passed to expand access to the Working Connections Childcare Program to benefit childcare workers and those previously excluded due to immigration status. The final budget also included funds to strengthen the Investment in Early Childhood Education and Assistance Program (ECEAP) to ensure that quality pre-K is available to all children in Washington State, regardless of economic background. The warm line received $1 million for the next two years, while the diaper bank received $5 million.

Looking Ahead

While many positive strides were made during this legislative session, it is important to acknowledge that some crucial bills did not pass. However, they are expected to be reintroduced in the future and as soon as 2024. Keep Our Care Act (KOCA), which aims to combat the consolidation of the healthcare system, improve patient costs and care quality, and preserve access to abortion services and gender-affirming healthcare is expected to come back in 2024 for the third time. Similarly, SB 5470, which seeks to establish a state professional credential for lactation consultants, did not pass but will be revisited next year.

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