HHS investigates Maryland for abortion discrimination under conscience law

Ben Mause, The Baltimore Sun on Mar 19, 2026

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WASHINGTON — The U.S. Department of Health and Human Services is investigating Maryland for potential violations of a federal abortion discrimination law, the department said Thursday.

The investigation will examine whether the state violated the Weldon Amendment, a federal conscience law that prohibits states or local governments that receive federal funds from discriminating against health care providers who choose not to cover, pay for, refer to, or provide an abortion.

HHS’ Office of Civil Rights or known as OCR, will carry out the investigation, which is based on information that states are allegedly “coercing” health care providers to act contrary to their conscience regarding abortions, according to the department’s announcement.

During a press call on Wednesday, an HHS official said the Trump administration launched the investigation after learning that 13 states require state-regulated insurance plans to cover abortion, even with objections on religious or moral grounds. As part of the investigation, OCR will request information from Maryland about its insurance mandates and how they’ve been implemented and enforced. The state will have 20 days to respond. Should OCR find that Maryland is not complying with the Weldon Amendment, the state would have an opportunity to resolve the issue voluntarily. If unresolved, HHS could withhold funding or refer the issue to the Department of Justice.

“OCR launches these investigations to address certain states’ alleged disregard of, or confusion about, compliance with the Weldon Amendment,” OCR Director Paula M. Stannard said in a statement on Thursday. “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.”

Maryland is one of 13 states under investigation. The state’s department of health did not immediately respond to a request for comment.

The Weldon Amendment is a federal statute that was first enacted in 2004 due to concerns that state and local governments were coercing health care entities into covering or providing abortions, despite religious or conscience objections. It states that federal funds will not be made available to any federal, state, or local government or agency that discriminates against hospitals, doctors, health insurance plans, or any kind of health care facility based on their refusal to provide or facilitate abortions.

The HHS official did not clarify what constitutes a violation of the Weldon Amendment, or what specific infractions the states allegedly committed, but said that OCR was concerned that employers — such as churches or private citizens who oppose abortions — would prefer their health plans to not cover it, but are not able to purchase abortion-free coverage in the marketplace.

Maryland is one of 20 states that use state funds to cover abortion through Medicaid.

Earlier this year, OCR repudiated the Biden administration’s understanding of the Weldon Amendment, expanding it to protect employers and plan sponsors.

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