The Department of Health and Human Services is accusing Democrat-led Illinois of violating federal law by forcing doctors and pregnancy centers that oppose abortion to refer patients for abortions against their moral and religious beliefs.
In a Jan. 21 notice of violation, HHS informed Illinois officials that the agency's Office for Civil Rights found the state's Senate Bill 1564 in conflict with federal conscience protections.
The law requires healthcare professionals who object to abortion to provide abortion referrals — a mandate HHS says violates the Coats-Snowe and Weldon amendments, which bar government entities receiving federal funds from coercing medical providers to facilitate or refer for abortions.
HHS warned Illinois it has 30 days to bring its policies into compliance or face possible enforcement action, including the 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 toward that end," the notice states, HHS could move to suspend, terminate, or limit federal funding tied to the violation.
The federal finding stems from complaints filed in 2018 by the Thomas More Society, a conservative public interest law firm. The group also represents plaintiffs in an ongoing lawsuit, Dr. Ronald L. Schroeder v. Mario Treto Jr., challenging the Illinois law on constitutional grounds.
That case is before the 7th Circuit U.S. Court of Appeals.
"The Land of Lincoln's Health Care Right of Conscience Act was meant to safeguard moral and religious freedom in healthcare," Peter Breen, executive vice president at Thomas More Society, said in a statement. "Illinois turned it on its head, weaponizing it to punish pro-life medical professionals and pregnancy centers."
Breen, a former Illinois state representative, also led opposition to SB 1564 when it was debated in the legislature.
"HHS has now confirmed that gutting conscience protections violates federal law," Breen added. "The financial consequences for the state could be significant if Illinois continues down this path."
In April 2025, a federal district court struck down part of the law requiring doctors and pregnancy centers to promote abortions but upheld the abortion referral requirement — a ruling the Thomas More Society has appealed.
"These are complementary battles," Breen said. "Illinois has doubled down on a law that strips conscience protections from the very people it was designed to protect."
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