Trump administration investigates states over abortion coverage requirement

Body

The Trump administration said it has launched investigations into 13 states that require state-regulated health insurance plans to cover abortion, arguing the requirements may conflict with the Weldon Amendment, a conscience-related provision in federal spending laws. The cases are the latest step in a dispute over how to interpret the Weldon Amendment and whether its protections extend to how states structure insurance coverage rules. The administration said it is seeking information from the states as part of the inquiry.

The Weldon Amendment bars states from discriminating against health entities that don’t provide, cover or refer for abortion, according to the HHS civil rights office. The Trump administration said the states it selected for investigation have abortion coverage requirements that could put them in violation of the law because, the administration argued, the rules may not allow employers or other health care issuers to opt out.

In a statement, HHS civil rights office Director Paula M. Stannard said the investigations were launched “to address certain states’ alleged disregard of, or confusion about, compliance with the Weldon Amendment.” Stannard added that, 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.”

The states identified with the insurance coverage requirements are California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont and Washington. The administration said it was sending letters to gather more information from those states while the probes proceed.

New Jersey Gov. Mikie Sherrill said she would defend her state’s policies. Sherrill said in a statement that New Jersey requires health insurance plans to follow applicable laws, including protecting women’s reproductive freedom, and she called the Trump administration’s inquiry a “fishing expedition” that she said would waste taxpayers’ money.

The dispute dates to at least 2005, when the Weldon Amendment was enacted as part of federal spending legislation, according to legal experts cited by the Associated Press. The conflict has also shifted with political transitions: when Democrat Joe Biden was president, the U.S. Department of Health and Human Services’ civil rights office said the Weldon Amendment did not pertain to employers or other health care sponsors, but the Trump administration said this year that it does.

Mary Ziegler, a law professor at the University of California, Davis, said the “partisan swing” in how broadly or narrowly the amendment has been interpreted depends on which party is in office. Ziegler also said the language of the Weldon Amendment does not mention employers or plan sponsors by name, which she said could give Democrats an edge with their interpretation, while adding that the question has not been resolved in court.

Elizabeth Sepper, a law professor at the University of Texas at Austin, said the Heritage Foundation’s policy proposal Project 2025 called for an incoming Trump administration to withhold Medicaid funding from states found to violate the Weldon Amendment. Sepper said the administration’s actions fit a broader agenda, saying, “What we’re seeing here is the fulfillment of a promise to the religious right.”

The Trump administration’s move also follows actions from Trump’s first term. In 2020, his administration moved to withhold federal health care funding for California over what it interpreted as a Weldon Amendment violation, but the Biden administration reversed the decision after taking office.