Abortion Coverage Mandates: State Probes & Insurance News

The Trump administration said Thursday that it has launched investigations into 13 states that require state-regulated health insurance plans to cover abortion.

The probes are the latest in a long-running dispute between the political parties on how to interpret a provision, known as the Weldon Amendment, that’s included in federal spending laws each year. It bars states from discriminating against health entities that don’t provide, cover or refer for abortion.

When Democrat Joe Biden was president, the U.S. Department of Health and Human Services’ civil rights office said the provision didn’t pertain to employers or other health care sponsors. The Trump administration said this year that it does.

The administration says that potentially puts states with abortion coverage requirements in violation of the law, because they may not allow employers or other health care issuers to opt out. It said it was sending out letters to gather more information from those states.

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 Zieglera 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 Seppera law professor at the University of Texas at Austinsaid 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.