The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), is investigating 13 Democrat-run states for allegedly forcing employers' health insurance plans to cover abortions. Officials say these rules trample the Weldon Amendment's federal conscience protections.
The Weldon amendment blocks states from punishing health insurers, plans, or providers who refuse to pay for, provide, or refer for abortions on moral or religious grounds, and has appeared in every HHS spending bill alongside the Hyde Amendment since 2005.
“OCR launches these investigations to address certain states’ alleged disregard of, or confusion about, compliance with the Weldon Amendment,” Paula M. Stannard, HHS Director of the Office for Civil Rights, said in a statement. “Under the Weldon Amendment, health care entities, such as health insurance issuers and health plans, are protected from state discrimination for not paying for, or providing coverage of, abortion contrary to conscience. Period.”
The states targeted in the investigation are California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont, and Washington, all of which require state-regulated plans to include abortion coverage without any exceptions.
HHS framed the investigation as the Trump administration delivering on a core promise. “Today’s announcement advances an Administration promise, corrects misguided legal interpretations of laws that OCR enforces, and builds on HHS’ recent efforts to enforce conscience rights and protect human life.” The office sent letters this week demanding details from the states. Non-compliance could result in billions of dollars in Medicaid funds being withheld.
This isn’t the Trump administration’s first rodeo either.
During his first term, Trump’s HHS Department hit California with a Notice of Violation over its abortion mandate, threatening to withhold $200 million per quarter in Medicaid funding. In 2021, the Biden administration quietly reversed course, claiming in a letter that the Weldon Amendment’s definition of a “health care entity” was narrower than Trump officials had interpreted, saying churches and religious groups didn’t count—effectively gutting federal conscience protections.
Now, Trump’s HHS has disavowed the Biden-era interpretation.
“We believe that it reflected an unduly narrow reading of the statute. We also disavowed downstream impacts of the legal position taken in 2021, which imposed certain requirements on complainants of protected parties that were not grounded in the state statute,” an HHS official said. “And by publicly repudiating that 2021 letter, we informed states and other entities, including those protected by this by the Weldon amendment, that they should no longer rely on this now repeated legal position.”
Blue-state governors are furious. “This is the latest effort by President Trump and Secretary Kennedy to take away women's reproductive rights,” Massachusetts Gov. Maura Healey said in a statement. “In Massachusetts, we're focused on making sure everyone can access and afford the health care services they need, including abortion care. We're not going to be intimidated by this investigation, and we are going to continue protecting women's access to reproductive health care.”
New Jersey's Rep. Mikie Sherrill branded it “nothing but a fishing expedition wasting taxpayers’ money.” She insisted, “New Jersey requires health insurance plans to follow all applicable laws, including protecting women’s reproductive freedom.”