The Department of Health and Human Services (HHS) under Donald Trump’s administration has accused Illinois, led by Democrats, of breaching conscience protections by mandating pro-life doctors and pregnancy centers to refer patients for abortions.
The HHS formally notified Illinois on January 21 through a Notice of Violation, highlighting that the state’s Senate Bill 1564 contravenes federal law. According to HHS, the Illinois statute compels pro-life healthcare providers to make abortion referrals that conflict with their moral or religious beliefs, thereby violating existing amendments aimed at protecting medical professionals from being forced to facilitate abortions.
Illinois has been given 30 days to align itself with federal policy or face the possibility of losing federal health funding.
In the notice, HHS stated, “If OCR does not have sufficient assurance that Illinois will not enforce the law… OCR will forward this Notice of Violation and supporting evidence to the appropriate HHS funding official for further action under applicable regulations.” It references the Constitution, U.S. law, and relevant Supreme Court decisions.
This situation arose partly due to a complaint filed with HHS by the Thomas More Society in 2018, alongside a lawsuit challenging the same Illinois law on constitutional grounds. This case, titled Schroeder vs. Torreto Jr., involves Illinois doctors and several pro-life pregnancy centers and is currently awaiting a decision from the U.S. Court of Appeals for the Seventh Circuit.
Peter Breen, Executive Vice President and Litigation Director of the Thomas More Institute, remarked, “Lincoln’s National Medical Rights of Conscience Act was designed to protect moral and religious freedom in medicine. However, Illinois has twisted it to punish pro-life medical professionals and facilities.” Breen, who previously opposed SB 1564 while serving in the Illinois state legislature, underscored the potential significant financial consequences for non-compliance with federal conscience protections.
In the context of this ongoing legal battle, a district court ruling in April 2025 invalidated one requirement of the law that mandated doctors and pregnancy centers to facilitate abortions, although it upheld the requirement for abortion referrals. The Thomas More Society is appealing this aspect of the ruling to the Seventh Circuit.
“These are related challenges across different legal avenues,” Breen noted. “HHS has reinforced our claims regarding federal conscience protections. It remains to be seen how Illinois will respond. Meanwhile, we’re urging the Seventh Circuit to conclude that Illinois’ mandatory pro-abortion referrals infringe on First Amendment rights. Rather than correcting course, Illinois appears intent on defending a law that undermines conscience rights.”
A spokesperson for Illinois Governor JB Pritzker commented that the HHS notice represents another effort by the Trump administration to “deprive Americans of health care.” The spokesperson added, “Illinois is committed to enhancing reproductive rights and access to healthcare and will continue to combat these attacks. We are reviewing the letter and will respond accordingly.”
