Judge rules state cannot compel anti-abortion health providers to discuss benefits of abortion to retain legal immunity
On April 4, 2025, a federal judge ruled that Section 6.1(1) of Illinois’ Health Care Right of Conscience Act violates the First Amendment by compelling anti-abortion health care providers to discuss abortion’s benefits. The court held that the law, part of a 2016 amendment, improperly conditioned civil immunity on providers delivering state-mandated speech. While striking down this provision, the judge upheld another section that requires referrals or provider lists upon patient request. The ruling permanently enjoins the state from enforcing Section 6.1(1). No appeal has yet been announced.
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A federal judge has struck down a portion of Illinois\’ Health Care Right of Conscience Act, ruling that the law unconstitutionally compels speech in violation of the First Amendment. The April 4, 2025, ruling in Schroeder v. Treto bars enforcement of Section 6.1(1) of the Act, which required health care professionals with conscience-based objections to discuss both the risks and benefits of abortion and childbirth with patients.
The decision, issued by U.S. District Judge Iain D. Johnston, grants declaratory and injunctive relief to Dr. Ronald Schroeder and affiliated pro-life pregnancy centers. The judge ruled that compelling anti-abortion providers to discuss what the state believes are abortion’s benefits as a condition for retaining civil immunity violates the Freedom of Speech Clause.
The case is part of a years-long legal challenge to 2016 amendments to the Illinois Health Care Right of Conscience Act (HCRCA) passed in Public Act 99-690. Plaintiffs argued that the amended Section 6.1(1) forced them to engage in speech contrary to their beliefs, infringing on their constitutional rights. The court agreed, holding that the state cannot require such speech in exchange for a liability shield.
At issue were new provisions in the HCRCA that conditioned civil and criminal immunity on compliance with “access to care and information protocols,” including a mandate to inform patients of “legal treatment options, and the risks and benefits of the treatment options.” The judge found this requirement constituted compelled speech, noting that plaintiffs do not believe abortion has any benefits and that the law forces them to adopt and deliver the state’s viewpoint.
Judge Johnston distinguished this provision from others that regulate professional conduct, such as Section 6.1(3) of the same statute, which requires providers—upon patient request—to refer, transfer, or provide a list of alternative providers. The court upheld that section as constitutional, reasoning it did not compel speech but regulated conduct and did not violate either the Speech or Free Exercise clauses.
In a detailed 58-page opinion, the court emphasized that the state cannot require speech from those who are not offering the underlying medical procedure—in this case, abortion—especially when the compelled message conveys a government-favored viewpoint. The ruling declined to accept the state’s broader interpretation of informed consent and rejected arguments that the requirement was incidental to medical practice.
The ruling ends nearly a decade of litigation that began with a preliminary injunction in 2017. Despite the state’s claim that the law was necessary to protect women’s health, the court found no evidence over the intervening years that any woman’s health had been endangered due to the injunction. The court noted that emergency care obligations under the HCRCA remained unaffected regardless of conscience objections.
The court formally entered judgment on April 4, 2025, denying all other relief. There was no indication in the ruling whether the state will appeal.