Federal Government Probes 13 States Over Abortion Insurance Coverage Mandates

The Trump administration has initiated investigations into 13 states, including Delaware, that require health insurance plans to cover abortion services. Officials claim these state mandates may violate federal conscience protection laws that allow healthcare entities to refuse abortion coverage based on religious or moral objections.

Federal officials announced Thursday they are conducting investigations into 13 states, including Delaware, over requirements that health insurance plans provide abortion coverage.

These investigations represent the most recent chapter in an ongoing political battle over how to interpret the Weldon Amendment, a federal provision included annually in spending legislation since 2005. This amendment prohibits states from discriminating against healthcare organizations that refuse to provide, cover, or make referrals for abortion services.

During Joe Biden’s presidency, the Department of Health and Human Services’ civil rights division determined this provision did not apply to employers or healthcare plan sponsors. However, the current Trump administration has reversed this interpretation.

Federal officials now argue that states requiring abortion coverage may be breaking the law by failing to provide opt-out options for employers and healthcare plan issuers. The administration is requesting additional information from affected states through formal letters.

Paula M. Stannard, who heads the HHS civil rights office, explained the investigations aim “to address certain states’ alleged disregard of, or confusion about, compliance with the Weldon Amendment.”

“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,” Stannard said.

The targeted states include California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont and Washington. Vermont is the only state among them with a Republican governor.

The Weldon Amendment belongs to a category of legislation called conscience laws, designed to protect individuals and healthcare organizations from being forced to provide abortions or related services that conflict with their religious or moral beliefs.

Mary Ziegler, who teaches law at the University of California, Davis, noted that since the amendment’s passage in 2005, its interpretation has shifted based on “partisan swing” depending on which political party controls the White House.

Ziegler observed that Democrats might have a stronger legal position since the amendment’s text doesn’t specifically mention employers and plan sponsors among protected healthcare entities, though courts have not yet settled this question.

Elizabeth Sepper, a law professor at the University of Texas at Austin, pointed out that Project 2025, the Heritage Foundation’s comprehensive policy blueprint, recommended that a Trump administration should cut Medicaid funding from states found violating the Weldon Amendment.

“What we’re seeing here is the fulfillment of a promise to the religious right,” she said.

During Trump’s previous term in 2020, his administration attempted to cut federal healthcare funding from California over alleged Weldon Amendment violations, but the Biden administration reversed that decision upon taking office in 2021.