The agency says it will take enforcement action if states refuse to comply with federal conscience protections.
President Donald Trump’s Department of Health and Human Services (HHS) is launching an investigation into 13 states for allegedly violating federal conscience protections for those who hold moral or religious objections to abortion.
The HHS Office of Civil Rights (OCR) announced March 19 that its investigation relies on information that those states have allegedly coerced health care entities to provide coverage of or pay for abortions as a condition of offering health coverage in those states.
States that either have laws or regulations that conflict with federal conscience protection mandates are: California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont, and Washington.
According to a news release, the states may be in violation of the Weldon Amendment, which is routinely added to health care spending bills annually. It prohibits state and local discrimination against health entities that do not provide, pay for, provide coverage of, or refer for abortions.
“OCR launches these investigations to address certain states’ alleged disregard of, or confusion about, compliance with the Weldon Amendment,” HHS OCR Director Paula M. Stannard said in a statement.
“Under the Weldon Amendment,” she added, “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 for any reason. Period.”
An HHS official said in a conference call that the OCR is investigating every state with “some type of mandate” that requires insurance plans to “cover abortion, regardless of whether or not [an entity] … objects on the basis of religious belief or conscience.”
The HHS official said OCR sent letters to relevant states March 18, requesting information to help determine whether the policies violate the Weldon Amendment. If OCR determines that a state is in violation, the office will seek to solve the matter informally, the official said. If this fails, OCR will withhold funding or request action from the Department of Justice, the official said.
In January, OCR strengthened its interpretation of the Weldon Amendment. It disavowed a legal opinion under former President Joe Biden that had previously excluded employers and plan sponsors from protection under Weldon.
Although OCR determined in January that those entities were covered under Weldon, the HHS official said states did not amend laws or regulations to comply with the current interpretation.
A 2026 report from the U.S. Conference of Catholic Bishops’ (USCCB) Committee on Religious Liberty urged Congress to pass the Conscience Protection Act to broadly expand conscience protections for all Americans.
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