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The Department of Health and Human Services, Office for Civil Rights today announced it is investigating 13 states under a federal healthcare conscience law called the Weldon Amendment.
The investigation is based on information that the states are allegedly "coercing" insurers to cover abortion services, contrary to conscience and religious objections, according to HHS.
These states have a mandate for health plans to cover abortions in their insurance policies, according to an HHS official who spoke during a press call Wednesday afternoon.
The states, not publicly named in information released by HHS are California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Oregon and Washington.
People in these states are forced into purchasing a plan that covers abortion, and they cannot purchase abortion-free coverage, the official said.
WHY THIS MATTERS
The OCR said it expected to release letters to the states informing them on Wednesday night of the investigation. Each state will have 20 days to respond.
If the OCR identifies concerns of states' compliance with the Weldon Amendment, it will try to resolve the issue by means of coming into compliance, the HHS official said. If compliance is not made, the federal government may withhold relevant funding or refer the matter to the Department of Justice.
The HHS official said there could be no speculation as to what compliance looked like.
The Weldon Amendment, named after physician and former Representative David Weldon, R-Florida, is a federal healthcare conscience law included in annual HHS spending bills since 2005. According to the amendment, any state or local government that receives federal funds cannot discriminate against healthcare providers that refuse to cover, pay for, refer or provide an abortion. This includes physicians, hospitals and insurance plans.
The National Women's Law Center called Weldon an "anti-abortion extremist." What the Weldon Amendment really does is allow healthcare providers to discriminate against patients by denying them the care they need, the National Women's Law Center said. "There are no provisions in the Weldon Amendment to protect patient access to abortion services," the center said.
OCR said it clarified its best reading of the Weldon Amendment earlier this year when it repudiated a 2021 case-specific letter that excluded employers and plan sponsors from the scope of healthcare entities that the Weldon Amendment protects.
"OCR launches these investigations to address certain states' alleged disregard of, or confusion about, compliance with the Weldon Amendment," HHS OCR Director Paula M. Stannard said by statement. "Under the Weldon Amendment, healthcare 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 LARGER TREND
The announcement advances an administration promise, corrects misguided legal interpretations of laws that OCR enforces and builds on HHS' recent efforts to enforce conscience rights and protect human life, most recently in Illinois, the OCR said.
The OCR's Notice of Violation to Illinois explained that Illinois law unlawfully tied healthcare provider conscience protections to referral requirements in the case of abortion.
OCR said it initiated investigations last year to protect healthcare workers, support whistleblowers and reinforce adherence to religious and conscience exemptions in the Vaccines for Children Program.
OCR also enforces federal religious nondiscrimination provisions in grant and block grant programs that prohibit discrimination against individuals on the basis of religion.
Email the writer: SMorse@himss.org