In 2022, the Supreme Court, in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, holding that abortion care is not a fundamental right under the Constitution. Therefore, access to abortion care is now left up to the states. However, the Trump Administration has also signaled that the current United States Department of Health and Human Services’ (HHS) priorities must protect the right of religious exercise and has expressed a goal to reevaluate programs to ensure enforcement of the Hyde Amendment, which prevents federal funds from being used for elective abortions. The Administration’s statements have created questions about whether future abortion care policies will actually be left to the states.
On March 19, 2025, HHS’s Office of Civil Rights announced that it plans to investigate thirteen states, including California, Colorado, Illinois, Maine, Minnesota, New York, Maryland, and Massachusetts, for allegedly compelling health care providers to provide abortion care. While the full list of the states under investigation has not been released, the states included are those that mandate state-regulated health insurance plans to cover abortion care. The actions are being taken under the Weldon Amendment that prohibits states from discriminating against health care providers that refuse to cover abortion. The Biden Administration interpreted the amendment not to apply to healthcare sponsors, but this administration believes that interpretation is too limited. While the Trump Administration had previously rescinded civil rights guidance issued by the Biden Administration that largely sought to protect abortion access, this investigation has escalated efforts to limit abortion care.
Maryland Governor Wes Moore and Massachusetts Governor Maura Healey have publicly responded to the letters they received from HHS and both made clear that their priorities are to continue ensuring access to reproductive health care in their states. While it remains unclear what the outcome of these investigations will be, they indicate a potential threat to states that have decided to continue ensuring access to abortion. Reproductive health care advocates have expressed a concern that this investigation indicates that the Trump Administration does not truly intend to “leave abortion to the states” and that further federal interference with states that have protected abortion access post-Dobbs may be imminent. In addition, concerns have arisen that the investigations do not have weight under law, as they did not arise out of any complaints of the states, and advocates have expressed fear that they have merely arisen to advance the Administration’s political agenda, rather than out of a genuine concern of violation of the law. For citizens, abortion care post-Dobbs has been uncertain, with access largely depending on geography and an increase in travel for abortion access. This investigation indicates the potential that the Trump Administration plans to take action to further limit abortion access, particularly meaning that low-income citizens with less ability to travel may experience further difficulty in access.