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HHS announces enforcement action against California for mandated abortion coverage

January 27, 2020

Today, the Office of Civil Rights at the U.S. Department of Health and Human Services announced a “Notice of Violation” against the state of California over its mandate that health insurance in the state cover elective abortions. This California state policy went into effect in 2014 and has been challenged by religious organizations in the courts.

The Notice of Violation states that California’s abortion insurance mandate is a violation of the Weldon Amendment, first passed in 2005, which states that no federal funds appropriated for health care “may be made available to a Federal agency or program, or to a state or local government, if such agency, program, or government subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.”

The Weldon Amendment establishes the civil rights principle that the state cannot discriminate against those who have sincerely held, good-faith conscience objections to participating in abortion. These objections do not have to be religious, recognizing the long-held principle that abortion is a morally divisive issue about which Americans disagree for a variety of reasons. 

California’s abortion insurance mandate requires all health care plans to cover elective abortions, even if the organization has sincere objections to paying for or covering abortion. This abortion mandate even requires health care plans covering a group of Catholic nuns serving the poor to include coverage for elective abortions. Such an overwhelming state fiat on such a sensitive and contested issue is well outside the bounds of both federal law and common decency. Thankfully, HHS responded to stand on behalf of conscience rights.

This notice of violation from HHS in Washington, D.C. is the start of the enforcement action process against the state of California. The state now has 30 days to respond and provide the HHS Office of Civil Rights information whether the state plans to continue to enforce the abortion mandate.

If California refuses to modify its abortion mandate policy, the HHS Office of Civil Rights has the discretion to pursue a number of remedies against the state, including the revocation of federal funds. 

The ERLC stands firmly on the principle that no American should be forced to participate in, pay for, or be complicit in abortion against their will. We are grateful for and support this significant action by the HHS Office of Civil Rights and HHS Secretary Alex Azar.