The Department of Health and Human Services announced Wednesday that its Office for Civil Rights will launch investigations into 13 states for allegedly violating the Weldon Amendment, a federal appropriations provision that prohibits governments receiving federal funds from discriminating against healthcare providers that refuse to provide or cover abortions.
The states under investigation are California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont and Washington. Each state will have 20 days to respond to letters from HHS.
Paula Stannard, Director of HHS's Office for Civil Rights, said the investigations address 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 for any reason. Period,' Stannard said in a statement.
The Weldon Amendment was first enacted in 2005 as part of a federal appropriations bill. An HHS official on a press call said the provision was created because of concerns that 'state and local governments were coercing health care entities ... both providers as well as health plans and health insurance companies, into covering or providing abortion, despite religious or conscious objections to those requirements.'
The investigations were not prompted by complaints from the states themselves. An HHS official said this was largely because 'the prior administration closed complaints.'
What the Left Is Saying
Progressive advocates and Democratic lawmakers are framing the HHS investigations as federal overreach targeting states that have enacted reproductive health protections. Reproductive rights organizations say the Weldon Amendment is being weaponized to limit access to abortion care.
The Guttmacher Institute, a research organization supporting abortion rights, has documented that states with stronger abortion protections have also enacted measures to ensure insurance coverage for the procedure. Progressive advocates argue these are legitimate policy choices by states, not coercion.
In 2021, the Biden administration withdrew a notice of violation issued to California by the Trump administration, finding that the scope of 'health care entity' under the Weldon Amendment was narrower than previously interpreted. At the time, HHS under Biden determined that churches and religious organizations did not fall under the amendment's protections.
Democratic attorneys general from several states under investigation have criticized the current administration's approach, arguing that states have the authority to set their own insurance regulations and that the Weldon Amendment was never intended to preempt state laws governing private insurance coverage.
What the Right Is Saying
Conservative groups and Republican officials are praising the HHS investigations as a necessary enforcement of federal law protecting religious liberty and conscience rights. They argue that states have been effectively compelling healthcare providers to provide abortion coverage in violation of the Weldon Amendment.
The Becket Fund for Religious Liberty, a nonprofit representing religious organizations, has long advocated for stronger enforcement of conscience protections. The organization argues that healthcare providers with religious objections should not be forced to participate in abortion coverage regardless of state mandates.
Republican lawmakers who championed the original Weldon Amendment say it was always intended to protect a broad range of healthcare entities, including health insurance issuers and religious employers. They contend that the 2021 Biden administration interpretation was a departure from congressional intent.
An HHS official said the department is 'disavowing' the 2021 legal interpretation, calling it an 'unduly narrow reading of the statute.' The official said states and other entities should no longer rely on that legal position.
What the Numbers Show
The Weldon Amendment has been included in federal appropriations bills since 2005, meaning it has been renewed annually for over two decades. The provision applies to states and local governments receiving federal healthcare funding.
In January 2026, HHS OCR announced plans to promote compliance with the Weldon Amendment and issued a notice of violation to Illinois. The current investigations expand this enforcement to 13 states representing both coasts and several midwestern jurisdictions.
All 13 states under investigation have enacted some form of abortion protection or insurance coverage mandate following the Supreme Court's 2022 Dobbs decision, which returned abortion regulation to the states. These states collectively represent approximately 35% of the U.S. population.
The 20-day response window for states is consistent with standard OCR enforcement procedures. If violations are found, potential remedies could include withholding federal healthcare funding, though such action would require extensive administrative proceedings.
The Bottom Line
The HHS investigations represent a significant escalation in federal enforcement of conscience protection provisions related to abortion. The 13 states under investigation will need to demonstrate that their insurance regulations and healthcare policies do not discriminate against providers with religious or conscientious objections to abortion.
The legal interpretation of the Weldon Amendment remains contested, particularly regarding whether it applies only to government entities or extends to private insurance companies and employers. The 2021 Biden administration interpretation that HHS is now disavowing directly addressed this question.
What to watch: How states respond to the HHS letters, whether legal challenges emerge, and how courts resolve the question of who qualifies as a 'health care entity' under the Weldon Amendment. The outcome could affect healthcare coverage regulations in states across the country.