The State of Reproductive Healthcare in Washington with Megan Burbank

“Roe v. Wade was never the whole story” by Megan Burbank from Crosscut

“Long uncertain, young people's access to abortion is more complicated than ever” by Megan Burbank from NPR

“‘Ask for Jane:’ Who were the pre-Roe underground abortionists?” by Megan Burbank from Crosscut

“A landmark study tracks the lasting effect of having an abortion — or being denied one” by Megan Burbank and Emily Kwong from NPR

“Who is traveling to Washington for abortion care?” by Megan Burbank from Crosscut

“Abortion rights in WA fall into limbo at religious hospitals” by Megan Burbank from Crosscut

“Students lobby for WA bills on abortion and gender-affirming care” by Megan Burbank from Crosscut

“New Yakima clinic to expand abortion access in Eastern Washington” by Megan Burbank from Crosscut

“How a Texas ruling on abortion pills would affect Washington” by Megan Burbank from Crosscut

HB 1469 - Concerning access to reproductive health care services and gender-affirming treatment in Washington state

HB 1340 - Concerning actions by health professions disciplining authorities against license applicants and license holders

SB 5242 - Prohibiting cost sharing for abortion

HB 1155 - Addressing the collection, sharing, and selling of consumer health data

[00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Be sure to subscribe to the podcast to get the full versions of our Friday almost-live shows and our midweek show delivered to your podcast feed. If you like us, the most helpful thing you can do is leave a review wherever you listen to Hacks & Wonks. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes.

So today I am thrilled to be welcoming Megan Burbank, who's a writer and editor based in Seattle. Before going full-time freelance, she worked as an editor and reporter at The Portland Mercury and The Seattle Times. She specializes in enterprise reporting on reproductive health policy, which she's covered locally for Crosscut, the South Seattle Emerald, and The Seattle Times, and recently at The New Republic and NPR. Have appreciated her coverage - really comprehensive coverage - of reproductive healthcare, which spurred wanting to have this conversation just to talk about what the status of reproductive healthcare is here in Washington in the backdrop of the Dobbs decision and abortion access not being guaranteed from a national level. Welcome so much, Megan.

[00:01:43] Megan Burbank: Thank you so much for having me.

[00:01:44] Crystal Fincher: So just starting off, what got you interested in covering reproductive health policy?

[00:01:49] Megan Burbank: Yeah, it's a good question. So I began covering reproductive health policy in 2011 when I was a news intern at The Stranger. And there was a bill introduced in the Legislature that would regulate these centers that are called crisis pregnancy centers that are often set up near actual abortion clinics, but they're operated by a centralized, evangelical-affiliated organization that is designed to dissuade people from having abortions. And so I was part of an investigation of those centers when I was a young and impressionable news intern with The Stranger, and it really opened my eyes to a lot of the ways that abortion access was complicated even before we were even talking about Roe v. Wade being overturned. And also I would say that I just have always been aware of it on a personal level. I grew up knowing about Roe v. Wade, and I thought of it as something that - the older generation had secured this freedom for us and it was just not something that I questioned. And then when I became an adult and started actually reporting on it and realized the systemic barriers to people actually accessing that type of care, even under Roe, I realized that there was a lot that needed to be reported out about that.

[00:03:02] Crystal Fincher: I think you've done a good job really diving into covering the difference between - yes, I can technically access this service, I have the right to do it, it's healthcare that is available in places, but it's not always that simple that something that is technically available is accessible to everyone. Even before, as you talked about, Roe v. Wade being overturned, what were some of the barriers and challenges that people were facing when it came to accessing these services?

[00:03:33] Megan Burbank: There were so many of them. There are so many of them. I think the thing that we often forget about abortion access is that women of means - wealthy white women - have always had the option to have an abortion. Before Roe v. Wade, it was common for people with the finances to travel to do that - even to travel to other countries for care. And so when we talk about abortion access, I think it's really important to build in this sort of class piece to it - it's expensive, right? It's expensive to have an abortion. It's typically - it's not always covered by insurance. It is here in Washington because we have a law that mandates that, but that's pretty unique. And another thing to note is that we've got the Hyde Amendment, which was enacted in 1978, so shortly after Roe v. Wade was overturned. This essentially bans public funding for abortion, so if you're on Medicaid, Medicare, any sort of military healthcare plan, if you're in the Peace Corps - there are a lot of different scenarios that are impacted by this - you don't have abortion coverage through your insurance. And what that means is that, especially for low-income women, for people of color, for folks who are young - young people - they've been left out of this access picture for quite a long time. And actually that's how that amendment was designed. I think one of the things that people find so horrifying when I talk about this is that Henry Hyde, the lawmaker behind that policy, said explicitly that he wanted to ban abortion access for all women, but that low-income women - what was available to him through legislation through Medicaid.

So I think that was a barrier that cropped up shortly after Roe v. Wade was decided. And then of course, we've got just an influx of state-level restrictions that began around that time and have really snowballed since. So we see things like basically bans based on gestational age - so like 15-week bans, that kind of thing. We see things like parental notification laws, which can be really complicated for young people who perhaps are caught up in the foster care system and trying to access care or for other reasons, cannot ask their parents for support in them making their decision. There are also things like 24-hour, 72-hour waiting periods. And those types of restrictions were commonly enacted in the states before Roe v. Wade was overturned. And so the upshot of that is essentially that even though we had the legal backstop of Roe during that time, access could look pretty spotty already based on wherever you were in the country. And then in Washington, we have very robust state-level protections for abortion, but that is not the norm and has not been the norm elsewhere.

[00:06:12] Crystal Fincher: Absolutely true. And even though it was ruled to be a constitutionally protected right at that time, there's just a lot of red tape that you're able to put in front of people's ability to be able to access abortion - whether it's having to visit doctors in-person when you might not otherwise have to, whether it is extra requirements for the prescription, and availability of medication that can help with a medicated abortion or preventing implantation, that type of thing. And it really has been used to manipulate people's access to this. Why is this such an important issue overall? You hear people say sometimes - If you don't wanna get pregnant, then don't have sex. And - People can just keep their legs closed and avoid this whole thing. Why does that not tell the whole story?

[00:07:06] Megan Burbank: When I hear people say things like that, it just makes me think of the conversations that I had with this woman named Judith Arcana, who was a part of the Janes in Chicago before Roe vs Wade - this group of women who were activists, who essentially established a network to help people seeking abortions access care. And they were successful because they were able to secure training in abortion. And they also, by Judith's telling, I feel like they were very underestimated and so it was easy for them - not easy, but it was possible for them to get away with this for a long time. And I think one of my major takeaways from that conversation was just that - if someone wants to have an abortion, it's not really this thing that they're gonna take or leave, right? If you're in that situation, you're desperate. You're gonna make it happen, and you're gonna make it happen legally and safely, or you are going to make it happen through whatever underground economies are available to you.

And so I think the reality of that is just that people can feel however they want about abortion, but the fact of the matter is that someone in that situation is going to seek out care to the extent that they can. And I think the idea behind laws that are protecting access is just that - wouldn't it be better for them to do this in a way that's safe? And that's the difference. And I think when you look at reporting from the pre-Roe era, you can see that that's really true - that women commonly died from abortions that were obtained through these extra-legal networks, and it was more dangerous for them too. One of the things that I heard about in my reporting for that piece was just that people who sought abortions in the pre-Roe era were often subjected to things like abusive behavior from the people they sought support from. There was often a threat of sexual violence, and they often didn't know what kind of care they were getting or what the credentials of the person performing it were. And they also - they had to pay for it, it was expensive. So you'd have to come up with this large sum of money and just trust someone who you had no reason to believe was actually a doctor to perform this procedure. Women did it anyway. When I talked to Judith, one of the things she told me was that nobody ever changed their mind. And I think that that's something that's just really important to remember because it's not really a choice between no one having abortions ever and people having abortions. It's a choice between people having abortions in safe, medically appropriate environments or having abortions in situations that are much more harmful.

[00:09:40] Crystal Fincher: Absolutely. I think another thing that has happened during this conversation and greater awareness about how perilous the right to abortion is and how impactful it is - is not just the conversation about how important the ability to choose when and how you have children impacts your social and economic mobility, ability to participate in the workforce, but that just being pregnant is a very, very difficult and traumatic thing on someone's body. You're essentially displacing all of your internal organs, massive hormonal and body changes. And this is not something that is without consequence, or simple, or without challenges for people who are pregnant - and this is a big deal and comes with a lot of risk. I'm a Black woman, certainly very familiar with mortality rates for Black women who are pregnant - an issue that goes beyond issues of access into just straight racism - and just overall with maternal health in this country, we don't do a great job. So it is a really challenging issue. And even though abortion, which is really a routine procedure for most people - and on the risk of things out there, it doesn't seem like it's an outlier in the way that you would think, given all the regulations about it. But what does it mean to be able to have efficient, safe, affordable access to contraception, and how far away are we to be able to provide that for everyone?

[00:11:23] Megan Burbank: I think we're pretty far from that, Crystal. I think that what it means is that people have a sense of self-determination and autonomy. And I would say a sense of psychological safety too, because one of the things that often comes up around abortion when I do my reporting on it - you were talking about pregnancy. And pregnancy statistically is much more of a health risk to take on than to have an abortion, especially an abortion early in pregnancy, which is when most abortions occur. When I talk to providers, they will often tell me that - actually - remaining pregnant is pregnant, especially as you pointed out in the United States where we have these huge racial disparities in terms of maternal, perinatal outcomes and maternal morbidity and mortality, that kind of thing. I think that it's the ability to not put yourself in that level of risk - can be really life or death for many people. And I think that having access to abortion and birth control - it allows people to space their pregnancies. One of the things that I think is often forgotten in this conversation is that I think it's something like over half of people seeking abortions are already parents. And so they are making a decision that allows them to care for, and provide for, and have the economic supports to raise the children that they already have.

The other thing that I think is really crucial to note here is that there's been some really excellent research on the consequences of being denied an abortion. And there is an excellent study called the Turnaway Study that was conducted over a number of years among people who had sought out abortions and been turned away, not due to state laws, but because of gestational age of their pregnancies. And it follows them in the outcomes that they had. And what it found is that for the people who did not receive abortions and carried to term, they didn't regret carrying to term - but if you looked at the outcomes in their lives in terms of their financial and emotional wellbeing, they took huge hits because they weren't able to access care. And so having access to an abortion is something that can prevent someone from being caught up in a cycle of poverty, which is why I often think that it's useful to frame it as an economic issue because the impact is such that being able to get timely care means that someone is able to care for their family in a way and remain afloat financially. And not being able to do that can mean the opposite - raising a child is expensive.

[00:13:57] Crystal Fincher: Very expensive. And in a state like Washington, you mentioned we do have a lot of protections, but that doesn't mean that everyone has access to abortion and abortion care. What are the types of challenges that we face in Washington state?

[00:14:12] Megan Burbank: One of the things we're dealing with now is just the fallout from abortion restrictions in other states. And so what that means is that there has been this gradual influx of patients from out-of-state, which focuses more demand on clinics. That can be complicated because it can create more delays for folks trying to access care in Washington. And I wanna be super clear that this is not just tied to Roe v. Wade - this was happening before Roe v. Wade was overturned, with the passage of legislation like Texas's Senate Bill 8, which is the six-week ban that includes this provision that allows people to have these sort of vigilante lawsuits against ordinary citizens or doctors for facilitating abortion care. And so after that law went into effect, what happened in states like ours is that we began to receive an uptick in patients from states like Texas and surrounding states. Because when a state bans abortion, people seeking care will go outside of that state, which creates a delay at clinics in states around that state. And then that sort of creates a ripple effect all the way up to states like ours. So I think it's easy to say - We're in Washington, access isn't a problem here. But when access is restricted elsewhere, we feel the effects of that.

And then I would also say that one of the things that I think is important to remember is access is not universal here either. Especially if you live in rural areas, your options may be really limited in terms of finding a provider. I think it's something like 50% of counties in Washington don't have an abortion provider. And so that means that simple geography can be a barrier. And then I would also say we have - Washington has a policy which essentially allows for state Medicaid funds to pay for abortion. So if you're on state Medicaid here, you can - having an abortion is covered. And that's pretty rare. We're only a handful of a number of states that have that sort of policy. So we have these sort of state-level protections that can serve to mitigate some of the federal policies that have impacted access in other states. But that doesn't mean that we have a super clear, facile approach here. I think one of the things that I also see is - in Washington, we've had so many hospital mergers over the past decade between secular healthcare systems and religiously affiliated institutions. And often when that happens, it results in limitations on what reproductive healthcare is available in those hospitals. And so that may mean that even though you're in Washington, the institution where you are accessing care may not provide abortions.

[00:16:58] Crystal Fincher: Yeah, and this is a major issue here. And these are healthcare systems like Franciscan and Providence and names that are pretty well known throughout the region. I don't think people necessarily always recognize that these are religiously affiliated hospitals and they frequently restrict access in a way that matches the religious convictions. But with these mergers, these may be the only hospitals that are available for someone in an emergency situation needing abortion care. And again, I think lots of people have been exposed to by now - that abortion is not always something that just happens, as people elect. There are lots of different situations where someone needs an abortion, including when a fetus is no longer viable and it can be a significant risk to a mother's health to not receive prompt medical care and a prompt abortion in that kind of situation. It can kill the mother - it's a big, big risk - and to not have that available, or not something that hospitals choose to offer really puts a lot of people in danger. We've seen this in areas where abortion access has been restricted and these stories have made the news - but this is something that doesn't always make the news - but these issues of access are really important. Is there anything happening legislatively, anything happening to help improve the access situation in this religious hospital merger situation, or just in rural areas who have lost healthcare capacity?

[00:18:40] Megan Burbank: Yeah, there's been several legislative attempts. There was a law passed, I believe in 2021, called the Protecting Pregnancy Act. And this was drafted in response to scenarios like the one you're describing - where someone would present with an emergency situation related to pregnancy, like an ectopic pregnancy or a miscarriage, and would need abortion care as treatment. And there was a case in Bellingham where a woman was turned away several times while having a miscarriage, which can be quite dangerous. An ectopic pregnancy also, as you rightly pointed out, is - that can be an emergency situation. People can die from that if they don't receive timely care. And so this law was drafted with the intent of protecting providers who are in institutions that may have internal bans on abortion - that allows them to perform a procedure, an abortion procedure, in that type of situation and to be legally protected while they do it. I think it's not clear how useful this law has been in practice, if it's really expanded access in any meaningful way. I spoke with a provider about it this year, or in 2022, and she said that it was pretty hard to gauge how much of an impact it had. And she also told me that it was still common for patients in that type of situation to be transferred to a hospital like the University of Washington that does provide abortions and is known for that. So I think that's one piece.

And then the other is this law called the Keep Our - or this bill - called the Keep Our Care Act that has been introduced in the Legislature. It was brought up this session and last session as well. And this would impose more stringent reporting requirements when healthcare institutions merge. And the focus of this one is not just on reproductive health but also on end-of-life care and gender affirming care, because those are the types of care that are often impacted by these mergers. And that bill appears to be stalled in committee - I don't think it made the cutoff. So we'll see what happens with that - I'm tracking it. But I think there have been these legislative approaches to address that type of situation where someone presents at a hospital in an emergency and can't receive care based on the ideology of the hospital they happen to be in. Which honestly is not something that - I think if I were in an emergency, I don't know that I would be checking the religious affiliation of the hospital. I think I would just want to go to the closest one.

[00:21:07] Crystal Fincher: Yeah, and get the care I needed to survive and recover. Absolutely. You mentioned that you're tracking these bills and they can overlap and impact gender affirming care, other care - which is definitely true - we use abortion care as an umbrella term, similarly to contraception as an umbrella term. But this can impact a lot of different types of care. We certainly - after Roe v. Wade was overturned, heard of several situations where people had been prescribed medication that could be used for abortion, but that is used for treating a variety of other ailments, chronic conditions, and that's just necessary for healthcare in their situation that isn't related to an abortion at that point in time. But that medication's still being restricted because it has the potential to cause an abortion. Are we seeing these impacts in Washington state? And overall, what does it mean that reproductive health can be restricted, but also conflated with so many other conditions and treatments?

[00:22:15] Megan Burbank: It's complicated. I think one of the things that has been interesting to follow is just - abortion care has often been siloed medically. And I think that we're seeing the same thing happen in real-time with gender affirming care, where it's treated as this separate thing that is not part of traditional healthcare. At the same time, it's something that is crucial for the people who seek it out. And one of the things that I have found to be interesting is that a lot of attempts to restrict gender affirming care resemble, policy-wise, restrictions on abortion. They have the same sort of mechanisms. There was a law recently introduced that really resembles Texas's abortion ban, but is focused on gender affirming care. And so I think that there is a nexus between the two. Another thing that I think is worth noting in this area is that - so Cedar River Clinics, which operates a number of clinics in Western Washington and they have one in Eastern Washington now that recently opened, they have provided gender affirming care for a long time. It's part of their practice. They also do abortions and provide other sort of basic healthcare services. And when I spoke with their communications person in 2022, we were talking about abortion - one of the things that she said was that people have been traveling to that clinic for decades because - they have been traveling there because it is a place where they can access later abortions, but it's also a place where they can access gender affirming care that may not be available in the state where they live. And so I think it is interesting to see these types of care sort of siloed and treated as separate from the rest of healthcare, even though people - they're critical treatments for the people who need them. And I think when you look at abortion, it's such a common procedure. I think it's something like one in four women before age 45 - it is a very normal part of healthcare in that sense, just looking at the numbers. And so I think that it's important to look at that and to look at where that - what agenda is animating the sort of fight against these types of care.

And then the other thing I would note is that - you had mentioned abortion medication - and one of the things that we're following right now is the lawsuit in Texas that could potentially take one of two commonly used abortion drugs, mifepristone, off the market. And that's an example of a situation where - mifepristone is not just used in abortions, it's used for other things as well. But it has a REMS designation, which is a restriction that includes a lot of complex dispensing requirements - and so it's been at the center of a lot of debate for a long time for that reason. And I think one of the things that I found pretty alarming in a lot of the coverage of that case was that there were headlines saying that it would ban abortion pills across the country, which is technically true - it would ban, it would affect access to this one abortion pill. But the way that that framing exists, it suggests that there would be no medication abortion available to anyone, which isn't true. Providers in Washington, if that decision goes the way that it's likely to go, are prepared to pivot to a different dispensing protocol where they would use one abortion pill, misoprostol, which already is part of that typical protocol where people take both misoprostol and mifepristone. They work better together but misoprostol does work by itself and there is a lot of data, especially in countries where abortion is banned, that shows that it's effective in ending pregnancy on its own. And so I think it's just - when we look at the way that these drugs are regulated, it's really important to have that context and to see that it does not necessarily mean that all access is going away. It often means something a bit more nuanced that still is going to be hugely impactful on people, but I think that's a situation where clarity in reporting is really important.

[00:26:24] Crystal Fincher: Yeah, I really appreciate you bringing that up - because to your point, I saw a ton of headlines that said - Medication abortions are going to be illegal if this court case is decided in a way that it looks like that judge is inclined to decide it. And lots of people hear that - certainly if I wouldn't have read beyond the headline, I would have been under that impression. And so I appreciate you bringing that up. I also really appreciate you bringing up how similar the political and policy playbooks are for the regulation of abortion care and gender affirming care - how we seem to artificially silo them in ways that don't come from the medical profession. These are not experts and doctors doing this. These are politicians saying - We need these extra requirements, extra red tape, extra reporting guidelines, extra waiting periods, extra requirements. And this is not coming from doctors, this is not coming from experts across the board, whether it's abortion or gender affirming care.

And how subjective we get when it comes to gender affirming care, just as you said, subjective when it comes to the types of medications that are considered for abortion, not for abortion, and there can be a crossover there certainly - that's the case with gender affirming care. People need the healthcare appropriate to their situation, whether it reinforces their gender or not. There's certainly a lot of things that fall into the bucket of gender affirming care that we see as normal, everyday things - that the amount of people who have BBLs and breast enhancements and are taking hormones for a variety of reasons. There are so many people on hormones to treat a variety of ailments, but we act like it's just the scariest, most wrong thing in the world when it comes to trans people or people who need that kind of care. So I appreciate just the calling out and knowledge that there really is a similar playbook here being employed, and we're seeing a lot of the same tactics being used to place barrier after barrier. And the way that they get these things through - I think with both abortion and the gender affirming care - is they aren't going after outlawing the entire thing all at once, but just one more barrier, one more waiting period, one more regulation. And when you make people repeatedly jump through all these hoops, they eventually just get tired out, worn out, and not everyone makes it through all the hoops. And they know this and this is how they restrict access, even though there technically may be the ability to get it if everything aligns perfectly and you have enough money and time and the ability to take off work and that kind of stuff, which so many people don't have. So as we move forward, what should we be looking at and what can the average person who's interested in ensuring that reproductive access remains available and accessible to most people - how can people make a difference in their own community and what can they do to help this?

[00:29:38] Megan Burbank: So there are three laws, or three bills, that have been introduced that have made it past the house of origin cutoff. One is a shield law that would protect providers of abortion care and also gender affirming care from being prosecuted for doing their jobs, essentially. There's another bill that would prevent licensing boards from retaliating against clinicians for providing care like abortions and gender affirming care. And then there's a third bill which would prohibit cost sharing for abortion. This is a really interesting bill because what it means is that if you are seeking abortion care - we have this law in the state of Washington that requires insurance plans to cover abortion if they cover maternity care, but that doesn't always translate to abortion being affordable because you may have high deductibles, your copay may be high. So this policy would essentially make it so that if you are seeking abortion, you don't have any coinsurance responsibility for it as a patient - which is a pretty wonky thing, but what it means is that you'll be able to get care without paying a high copay. You'll be able to just go and receive the care that you need. And so those laws are pretty instrumental in expanding protections for abortion access in Washington. And I think it's important, if this is something that people care about, to follow these pieces of legislation and just make sure that you're informed about it.

I would also say - one of the issues that I've heard from activists since Roe v. Wade was overturned was that there's been a huge interest in their work and it's overwhelming. And I've also seen, I've also heard that there's been a lot of doubling up on existing activism. I think probably the most insidious example of this is like the camping meme that was going around after Roe v. Wade - of people in blue states being like, "Come camping with me, I'll help you get an abortion." Which is - I think comes from a good place of wanting to really help - but the thing is there are existing networks in the United States called abortion funds that have been around for a long time. And they exist to help people access abortion care and pay for things like travel expenses and childcare and their procedures. And so I think instead of doubling up on the work that already exists, it's really important to seek out the activist organizations that are already doing the work - because what I hear from them is that they see their work being redoubled in this way that's not really informed in the long shadow of the movement. And so it's really important to find out who is already doing the work and if you wanna be part of it, how can you support them rather than starting your own thing?

But yeah, I think also - one of the things that I often say to people is if you care about abortion access and the policies that impact it, that should be a year-round activity. That shouldn't just be something that happens whenever there is a particular piece of legislation in the news - you should be following coverage of this on an ongoing basis because it's deep and complicated and wonky and it really helps to immerse yourself in it and to look into who are the players, who are the people that are advancing this legislation, and how is it gonna impact you? I think that's really important. And I think that there's been a lot of emphasis on things like stocking up on abortion pills and offering to drive people to their appointments. Again, I think it comes from a really good place, but I think it doubles up on existing work in a way that is often harmful to people who are actually already really immersed, on the ground, in that work.

[00:33:21] Crystal Fincher: Absolutely. I guess finally, for people who are just living their lives, who may need abortion care at some point in time, but who currently are using period tracking apps, fertility apps, that type of thing. And while we see headlines like Meta or Twitter or other companies turning over data to authorities that may be looking to prosecute people or determine who is seeking abortion care, contraception. We see in Florida - for girls to participate in sports, they have to report their period dates and activity. And concerns about privacy, the technology, all the stuff surrounding that. How would you advise people as they navigate through these times that come with potential legal ramifications?

[00:34:17] Megan Burbank: Yeah - I'm not a lawyer. I do talk to them a lot for my work, but I just want to preface this by saying that. But I would say it's a good idea to, I would say, be careful about what sort of social media channels you may be using for this type of information. Because it's very rare to actually be prosecuted for something like purchasing abortion pills, but it has happened. And often it involves an Internet trail of someone having purchased the drugs online. So this happened in Pennsylvania - I think it was in 2014 - a woman was prosecuted because she had purchased abortion pills for her daughter, and they went to a hospital because her daughter's miscarriage was incomplete so they were seeking care. And they were essentially reported on by someone who saw them when they came for care. When I speak to lawyers about this, it's unlikely. It's not, there's not a huge amount of precedent of people being prosecuted for the things that they do and say online, but it's also not impossible. There is precedent for it, despite the fact that it's not super robust. And so I think it's important to be careful about how you're engaging in that type of behavior.

And then I would also say - we talked about a slate reproductive health bills going through the Legislature. There is another one called the My Health, My Data Act, which is focused exactly on this. And it's about setting up privacy protections for people using things like period trackers and doing online searches, that kind of thing. And so this is a piece of legislation that's meant to address sort of the gap between private health data that is protected by HIPAA and private health data that an app might have access to, where they don't have the same sort of legal responsibilities. And so I think this type of policy can actually help to protect people in those situations. And I don't think anyone should ever be afraid of knowing about their body or seeking out medical care that they need. I think that's really crucial. And I think that we may well see more attempts to protect that type of information in these types of laws moving forward. And I think they'll probably become more important because it's not something that we've seen a ton of precedent for in terms of prosecutions, but that's all changing right now because we no longer have the legal backstop of Roe. And so I think that means there are a lot of questions that we're gonna see play out over the next decade.

[00:36:50] Crystal Fincher: Yeah, absolutely. And some attempted prosecutions happening right now involving some of that data, so we will certainly see how this plays out. Thank you so much for spending this time with us today, for helping to educate us about the state of reproductive access in Washington state right now. And we'll continue to follow this. Thank you very much, Megan.

[00:37:11] Megan Burbank: Thank you, Crystal. This has been great.

[00:37:12] Crystal Fincher: Thank you for listening to Hacks & Wonks, which is co-produced by Shannon Cheng and Bryce Cannatelli. You can follow Hacks & Wonks on Twitter @HacksWonks. You can catch Hacks & Wonks on iTunes, Spotify, or wherever you get your podcasts - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to the podcast to get the full versions of our Friday almost-live shows and our midweek show delivered to your podcast feed. If you like us, leave a review wherever you listen. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the episode notes.

Thanks for tuning in - talk to you next time.