Share and Follow
In a significant move, the Trump administration announced on Thursday the initiation of investigations into 13 states mandating abortion coverage in state-regulated health insurance plans. This action highlights the ongoing partisan debate over the interpretation of the Weldon Amendment, a provision included annually in federal spending legislation. The amendment prohibits discrimination against health entities that choose not to provide, cover, or refer for abortion services.
Under the Biden administration, the U.S. Department of Health and Human Services (HHS) civil rights office had previously clarified that the Weldon Amendment did not apply to employers or other healthcare sponsors. However, the Trump administration has adopted a different stance, asserting that it does indeed apply to them.
The administration argues that the states enforcing abortion coverage requirements could potentially be violating the federal law, as these states might not permit employers or healthcare providers to opt out of such coverage. Consequently, letters have been dispatched to these states to request further information.
The Director of the HHS civil rights office, Paula M. Stannard, explained that the investigations aim to address what the office perceives as some states’ alleged non-compliance or misunderstanding regarding the Weldon Amendment. She emphasized the necessity of these inquiries to ensure adherence to federal regulations.
The HHS civil rights office launched the investigations “to address certain states’ alleged disregard of, or confusion about, compliance with the Weldon Amendment,” office Director Paula M. Stannard said in a 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. Period,” Stannard said.
The states with the coverage requirements are California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont and Washington. All except Vermont have Democratic governors.
The Weldon Amendment is one of a series of provisions known as conscience laws, which provide legal protections for individuals and health care entities that choose not to provide abortions or other types of care because of religious or moral objections.
In the years since it was enacted in 2005, there’s been a “partisan swing” in how broadly or narrowly it is interpreted depending on which party is in office, according to Mary Ziegler, a law professor at the University of California, Davis.
Ziegler said the fact that employers and plan sponsors are not mentioned among health care entities in the text of the Weldon Amendment could give Democrats an edge with their interpretation, but the question has yet to be resolved in court.
Elizabeth Sepper, a law professor at the University of Texas at Austin, said the Heritage Foundation’s massive policy proposal known as Project 2025 called for an incoming Trump administration to withhold Medicaid funding for states found to violate the Weldon Amendment.
“What we’re seeing here is the fulfillment of a promise to the religious right,” she said.
President Donald Trump’s first administration in 2020 moved to withhold federal health care funding for California over what it interpreted as a Weldon Amendment violation, but the Biden administration entered office the next year and reversed the decision.