US Launches Civil Rights Probes of States Over Abortion Care (1)

The Trump administration is investigating more than a dozen states for potentially pushing health care entities to cover abortions despite legally-protected objections to the procedure.

The investigations announced Thursday by the US Department of Health and Human Services’ Office for Civil Rights will focus on 13 states that the HHS claims mandate state-regulated insurance plans cover abortion regardless of whether a plan objects to the care on religious or conscience grounds.

The HHS isn’t publicly releasing the names of the targeted states. An HHS official said in a Wednesday call with reporters that states with the type of mandate in question include California, Colorado, Illinois, Maine, Minnesota and New York. Those states are among the 13 that require abortion coverage for enrollees of Medicaid, private insurance, and plans offered on the Affordable Care Act marketplace, according to health policy research group KFF.

The official said the HHS was “initiating these investigations under authority to conduct compliance reviews” but that the OCR doesn’t “have any current complaints with respect to these states.”

The official said the HHS planned to send letters to the states Wednesday night notifying them of the investigations and requesting information on topics like how they are implementing or enforcing their insurance mandates.

The probe comes as the Trump administration escalates investigations into Democratic-led states. California, Maine, and New York are already have faced questions from HHS over allegations tied to Medicaid. The administration is also threatening to withhold billions in Medicaid funds from Minnesota.

The Trump administration has also sought to bolster religious and conscience protections in regards to abortion.

Last year, the HHS announced it would prioritize religious protections through its civil rights office, marking a shift from the Biden administration’s focus on abortion protections. Since then, the HHS has rescinded civil rights guidance for health providers on abortion.

In focusing on states, the HHS told health departments in 2025 that vaccine administrators needed to comply with religious and conscience exemptions to immunization mandates. The HHS also sent Illinois a letter in January detailing complaints involving state law requirements for counseling patients about abortions despite religious or moral objections.

President Donald Trump’s “claim that he wants to ‘leave abortion to the states’ is an absolute lie, and this latest attack on abortion access is further proof,” said Katie O’Connor, senior director of federal abortion policy at the National Women’s Law Center, in a statement.

Thursday’s actions are being taken under the Weldon Amendment, which prohibits states from discriminating against health care entities or insurers that won’t provide, cover or refer for abortions.

“The administration is weaponizing the anti-abortion Weldon Amendment to rip away affordable abortion care from people and to punish states where this care remains protected,” O’Connor said. “These investigations also follow a familiar pattern from the administration: attacking states that the president views as political threats.”

The HHS in a press release Thursday said the investigations are “based on information that the states are allegedly coercing health care entities to provide coverage of, or pay for, abortion contrary to conscience.”

“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 the 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.”

Rachel Morrison, director of the Administrative State Accountability Project at The Ethics and Public Policy Center (EPPC), said that “HHS has authority to enforce federal conscience protection laws by conducting investigations, seeking voluntary resolutions of violations, withdrawing federal health care funds, and referring cases to DOJ for litigation.”

“It’s refreshing to see HHS OCR take its statutory duty to protect and enforce health care conscience rights seriously,” Morrison said. “Because the Weldon Amendment does not have a private right of action allowing private parties to sue in federal court when their conscience rights are violated, HHS OCR investigations and enforcement actions are vital to ensuring those rights are protected.”

The OCR in the first Trump administration had issued Weldon Amendment violation findings against California. The office said in 2020 it would disallow $200 million in Medicaid funds from the state for forcing heath care plans to cover abortions without exclusion and threatened to do so on a quarterly basis if it didn’t come into compliance.

“The precedent has been set regarding penalties and consequences for breaking these laws,” said Roger Severino, who led the HHS OCR in the first Trump term. The new investigations, he said, “are more than fair” and “obvious for anyone who cares about enforcing our conscience laws.”

“OCR has ample authority to conduct compliance reviews for conscience violations just like every other civil rights law. OCR cannot turn a blind eye to such in your face law breaking by liberal states,” said Severino, who is now with the Heritage Foundation, the conservative group behind the Project 2025 policy effort for a Republican president.