The Trump administration is launching civil rights investigations into the 13 Democrat-led states that require private health insurance plans to pay for abortions, arguing that state mandates for abortion insurance coverage violate religious and conscience rights protections.
The Department of Health and Human Services’ Office for Civil Rights sent 13 states letters late Wednesday evening, opening investigations into whether their requirements violate conscience protections under federal rules prohibiting state and local governments from discriminating against healthcare entities that refuse to facilitate abortions.
Paula Stannard, Director for HHS’ OCR, said in a press release that the investigations involve alleged violations of the Weldon Amendment, a provision of law that ties federal funding to anti-abortion conscience protections for all healthcare entities, including hospitals, doctors, and insurance companies.
Trump administration officials told reporters ahead of the announcement that the current laws in the 13 states that mandate abortion coverage mean that thousands of employers and individuals are required to either forgo health insurance or purchase plans that provide abortion coverage despite their conscientious objection.
Washington, Oregon, California, Colorado, Minnesota, Illinois, Maryland, New York, Delaware, New Jersey, Massachusetts, Vermont, and Maine are the 13 states that require all insurance plans to cover abortion.
Stannard said in her press release that the investigations aim “to address certain states’ alleged disregard of, or confusion about” compliance with the statute.
“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.
HHS’ civil rights office earlier this year disavowed a Biden administration interpretation of the Weldon Amendment, issued in 2021, that excluded employers and plan sponsors from the scope of healthcare entities protected by the conscience protection provision. Trump OCR officials viewed the Biden interpretation of the rule as “unduly narrow.”
The investigations will be welcomed by anti-abortion advocates, who have had tensions with the administration ahead of the 2026 midterm elections.
Anti-abortion advocates and Republicans in Congress have accused Trump administration officials of slow-walking an investigation from the Food and Drug Administration into the negative consequences of telehealth prescriptions for medication abortion, delaying a decision on abortion pills until after the November elections.
In early January, Trump told GOP members of Congress to “be flexible on Hyde,” referring to the Hyde Amendment’s prohibition of using federal funding to pay for abortion that has been included in all congressional appropriations bills since the 1970s. Trump was lambasted by allies within the GOP and by anti-abortion advocates when suggesting a compromise on Hyde.
The Weldon Amendment was introduced by former Rep. Dave Weldon in 2005 and, such as the Hyde Amendment, must be voted on with each congressional spending bill.
Trump administration officials said the 13 Weldon Amendment investigations are part of the ORC’s efforts to “enforce conscience rights and protect human life,” according to the press release issued Thursday.
In January, coinciding with the annual anti-abortion March for Life in Washington, D.C., OCR announced a notice of violation for Illinois after finding the state’s laws violated federal conscience protections by forcing healthcare providers to refer for abortion regardless of personal or religious beliefs.
Administration officials told reporters that the 13 new Weldon Amendment investigations were not sparked by official complaints from any of the states in question but rather were part of the agency’s compliance review authority.
