President Donald Trump’s Department of Health and Human Services (HHS) is accusing Democrat-led Illinois of violating the conscience protections of pro-life doctors and pregnancy centers by requiring them to refer for abortions.
HHS issued a Notice of Violation to Illinois on Jan. 21, informing the state that the department’s Office for Civil Rights (OCR) found the state’s Senate Bill 1564 in violation of federal law. The Illinois law mandates pro-life healthcare professionals, against their moral and religious beliefs, refer patients for abortions — a law HHS contends violates the Coats-Snowe and Weldon amendments. Those amendments prohibit government entities receiving federal funds from coercing healthcare professionals and organizations into referring or facilitating abortions.
HHS said Illinois has 30 days to bring its policies into compliance or risk the potential loss of federal healthcare funding.
“If OCR does not receive sufficient assurance that Illinois will not enforce [the law] where the objected-to service is abortion, or that it is willing to negotiate in good faith towards that end, OCR will forward this Notice of Violation and the evidence supporting OCR’s findings in this matter to the appropriate HHS funding components for further action under applicable grants and contracts regulations, or take any other appropriate action to address Illinois’ violation of the Amendments,” the notice reads. “Such actions may ultimately result in suspensions, terminations, or other limitations on continued receipt of certain HHS funds in accordance with the Constitution, the laws of the United States, and applicable Supreme Court case law.”
HHS’s finding is in direct response to complaints Thomas More Society filed to the department in 2018. The conservative, pro-life public interest law firm also filed a lawsuit, Shroeder v. Treto, Jr., representing an Illinois physician and several pro-life pregnancy centers who are challenging the same state law on constitutional grounds. That case is pending in the U.S. Court of Appeals for the Seventh Circuit.
“The Land of Lincoln’s Health Care Right of Conscience Act was meant to safeguard moral and religious freedom in healthcare,” said Peter Breen, executive vice president and head of litigation at Thomas More Society. “Illinois turned it on its head, weaponizing it to punish pro-life medical professionals and pregnancy centers.”
Breen notably led opposition to SB 1564 when he was a state representative in Illinois.
“HHS has now confirmed that gutting precious conscience protections violates federal law, and the financial consequences for the state could be significant if they continue to trample conscience rights,” he added.
In the Treto case, a district court struck down one of the law’s requirements in April 2025 that physicians and pregnancy centers promote abortions. However, the court upheld the law’s abortion referral requirement. Thomas More Society appealed the district court’s abortion referral decision to the Seventh Circuit.
“These are complementary battles on different legal fronts,” Breen said. “HHS has vindicated our federal conscience law arguments. How Illinois will choose to move forward remains to be seen. Meanwhile, we are asking the Seventh Circuit to hold that Illinois compelling pro-abortion speech violates the First Amendment. Rather than correcting course, Illinois has thus far doubled down—defending a law that strips conscience protections from the very people it was designed to protect.”
A spokesperson for Illinois Gov. JB Pritzker said in a statement to Axios that the HHS’s notice is another attempt on the part of the Trump administration to “strip healthcare from Americans.”
“Illinois has led the charge to fortify fundamental reproductive rights and access to healthcare, and we will keep working to defend against these attacks. We are reviewing the letter and will respond,” the spokesperson said.
Katherine Hamilton is a political reporter for Breitbart News. You can follow her on X @thekat_hamilton.
