Aradia clinic a pioneer in women's health

For more than 30 years, Aradia Women's Health Center has pushed through pickets and protests and changes in political power to provide women with abortion services, reproductive health and advocacy.

But try as it might, Aradia could not recover from the financial challenges of health care today, from the rising number of uninsured clients to the exploding cost of malpractice insurance, its organizers and allies say. In the end, the finances didn't pencil out.

"I always said the bean counters might get us," said Marcy Bloom, who led the clinic for 18 years.

This week's announcement that the small First Hill clinic will close Jan. 31 hit some abortion-rights advocates hard. They described the clinic as a trailblazer in its focus on women's health. Aradia was one of the city's earliest abortion clinics, founded by feminists and built on a philosophy of health care for women, by women.

Amy Luftig, deputy director of public policy, Planned Parenthood Network of Washington, said the clinic "revolutionized" standards of care for women in Washington and beyond. At Aradia, receptionists are also trained as counselors, and members of the support staff sit in on medical procedures, even holding patients' hands.

"They advocate on a client-by-client level," said Luftig, who once worked there. "And they [advocate] at the federal level."

But in the end, Aradia was unable to survive, its leaders said. The clinic's rent escalated, and malpractice-insurance premiums tripled. About 70 percent of Aradia's patients require subsidized health care. The decision to close came after several years of research and discussion among the board members and others at Aradia.

"It's a wonderful health-care model, but it's not viable as a business model," said Amie Newman, spokeswoman for the clinic.

Though all health-care providers are facing rising costs, abortion clinics are hit particularly hard because they don't qualify for certain state and federal subsidies, advocates note.

For clinics such as Aradia, the challenge can be even more acute because they often also have a political arm to fund in addition to providing medical services.

And there are more options for abortion services now than when Aradia first opened in 1972, a year before Roe v. Wade, which established a woman's right to end a pregnancy. The number of abortion providers has gone up in Seattle, even as the number of abortions nationwide has fallen.

"We were all competing for the same women to walk through our doors," said Bloom, who retired in May.

And between 1994 and 2001, abortions nationally decreased 20 percent among more affluent women, who are more likely to have insurance, according to a study by the Guttmacher Institute, a nonprofit reproductive-health organization based in New York City. But abortions increased 29 percent among poor women.

That national trend has played out at Aradia, where the percentage of patients requiring financial help for abortions went from 57 percent two years ago to 68 percent last year. Aradia charges on a sliding scale for patients who are not eligible for state subsidies.

Charissa Fotinos, family-planning director for Public Health — Seattle & King County, said Aradia's closure eliminates one of the few abortion providers for low-income women who do not qualify for subsidies.

"It's yet another piece of the safety net that has fallen apart," she said.

Though federal money won't pay for abortions, Washington is one of more than a dozen states that pay for abortions for women eligible for Medicaid. It paid for about 13,700 in fiscal 2006, up from 10,500 abortions in fiscal 1996.

Still, Aradia and other clinics say the state's reimbursement rates are too low to cover the cost of services.

And abortion-rights advocates predict the number of low-income women getting abortions will keep rising, helped by recent changes to a federal program that provides birth control and family planning for poor residents.

That program, Take Charge, gave more than 138,000 people access to birth control and other family planning services in fiscal 2006, but a rule change this summer means the state is expecting fewer people will be eligible for Take Charge.

It's the kind of change Aradia would have fought hard against.

Even so, advocates don't expect the voice of Aradia activists to disappear with the clinic's closing. "They're not going away," said Deborah Oyer, the medical director for Aurora Medical Services, another Seattle clinic that provides abortions. "They'll just do it from a different venue."

Cara Solomon: 206-464-2024 or csolomon@seattletimes.com