Login
West Virginia could lose $1.37 billion in federal health funding if the state’s health departments don’t follow laws recognizing religious freedom — including religious exemptions to childhood vaccination — the U.S. Department of Health and Human Services (HHS) said.
In an Aug. 21 letter, HHS’ Office for Civil Rights (OCR) issued the warning to West Virginia health departments participating in the federal Vaccines for Children Program (VFC) — a Centers for Disease Control and Prevention (CDC) program that requires doctors to administer all vaccines on the childhood immunization schedule to Medicaid patients.
In a statement provided to The Defender, an HHS spokesperson said, “The letter to the West Virginia health departments is not a notice of investigation, and it makes no finding on compliance,” adding:
“The letter describes the HHS Office for Civil Rights’ portfolio for enforcing conscience and religious freedom provisions. The letter focuses on one of the conscience protections in OCR’s jurisdiction: the conscience protection in the Vaccines for Children Program. The letter reminds the health departments throughout the state of their obligations for participating in the program.”
The letter could have implications for states that don’t allow religious exemptions, said Children’s Health Defense (CHD) CEO Mary Holland, who called the letter “unprecedented.”
Holland said the letter “may well show a path forward in states like Connecticut that have religious equal protection laws in place but that deny the right to religious exemption from vaccination,” she said.
According to the letter, OCR enforces federal statutes that contain “religious non-discrimination provisions” and conscience statutes that “protect the exercise of conscience from discrimination by federal programs” and which are tied to government funding, including for the Vaccines for Children Program.
Rick Jaffe, a constitutional and healthcare attorney representing plaintiffs in multiple federal lawsuits challenging CDC vaccine policies, called the letter a “significant development.” He said:
“HHS has been under pressure from Congress and public interest groups to clarify its position on religious exemptions under the Vaccines for Children program. The letter is short, but it sends a very clear signal: religious belief is a valid basis for declining participation in vaccination, even under a federally funded program like VFC. That’s long overdue.”
‘HHS isn’t just expressing an opinion here. It’s giving notice.’
In its letter, the OCR specifically addresses the ongoing legal and legislative battle over childhood religious exemptions in West Virginia.
In January, Republican Gov. Patrick Morrisey signed an executive order recognizing religious exemptions for school attendance. The order, which cites the state’s Equal Protection for Religion Act of 2023 (EPRA), allows parents to request a religious exemption for their children by providing a written statement explaining why they object to the vaccines.
Ιn June, West Virginia’s Department of Education voted unanimously to require school systems to follow the state’s compulsory vaccination law for schoolchildren, which went into effect in 2015 and doesn’t allow religious exemptions.
In calling on the state to recognize religious exemptions, the OCR cites the executive order and the two state laws in question.
“West Virginia is obligated to ensure that its [Vaccines for Children] providers comply with applicable state laws like EPRA, which requires recognition of religious exemptions from West Virginia’s Compulsory Vaccination Law,” the letter states.
Attorney Greg Glaser said HHS has “zeroed in on a legal mechanism to incentivize West Virginia’s public school system to restore religious exemptions,” based on the federal Religious Freedom Restoration Act of 1993.
Jaffe said the letter isn’t legally enforceable, but serves as a warning that West Virginia risks being found non-compliant with federal law. He said:
“VFC providers operate under agreements with the federal government. If those agreements require compliance with federal non-discrimination laws — including those protecting religious freedom — then a refusal to honor religious exemptions could constitute a breach of contract or even trigger enforcement under federal civil rights statutes.
“HHS isn’t just expressing an opinion here. It’s giving notice.”
HHS letter potentially a ‘prelude to broader action’
The letter from HHS comes amid an ongoing court battle over religious exemptions in West Virginia.
Last month, a West Virginia court dismissed a lawsuit by the American Civil Liberties Union (ACLU) that challenged Morrisey’s executive order. The ACLU has since refiled the lawsuit.
In a separate ruling last month, a West Virginia court granted a preliminary injunction to three families challenging the county board of education’s decision to deny their children the right to attend public school with a religious exemption.
Several legal and educational experts suggested that the HHS letter to West Virginia may hint at future actions targeting the four states that currently do not recognize religious or philosophical exemptions — California, Connecticut, Maine and New York.
“This may be a prelude to broader action,” Jaffe said.
Writing on Substack, Dr. Meryl Nass, founder of Door to Freedom, said the stakes are high for those states following HHS’ warning to West Virginia.
“California has over 20 times the population of West Virginia, which could lose $1.37 billion in Medicaid funding. How many $billions does California stand to lose? Or Connecticut, New York or Maine?” Nass asked.
Jaffe said this may be the first time HHS “has sent a letter like this to a state agency explicitly addressing religious exemptions in the VFC context,” likely reflecting “growing concern that some states … are imposing their own mandates on federal programs where those mandates don’t legally belong.”
HHS’ spokesperson said the department cannot comment on possible future enforcement actions, and that anyone who believes that their conscience or religious freedom rights were violated may file a complaint with OCR through its online portal.
This article was funded by critical thinkers like you.
The Defender is 100% reader-supported. No corporate sponsors. No paywalls. Our writers and editors rely on you to fund stories like this that mainstream media won’t write.
Support for religious exemptions gaining momentum nationally
Michael Kane, CHD director of advocacy, said the HHS letter reflects growing national momentum in favor of religious exemptions. He credited organizations like CHD for helping to raise public awareness.
“CHD has been working with a small but impactful group that has been to over 50 offices in Washington, D.C., talking about states denying religious exemptions,” Kane said.
Legislation that will likely be introduced in Congress later this week — the GRACE Act, or Guaranteeing Religious Accommodation in Childhood Education Act — addresses the issue of religious exemptions.
Drafted by Rep. Greg Steube (R-Fla.), the GRACE Act would strip federal funding from schools that don’t allow parents to apply for religious exemptions from vaccination requirements for their children. The legislation targets elementary and secondary schools, as well as local and state educational agencies.
CHD is one of several organizations supporting the legislation.
In Wisconsin, a proposed bill would require schools, childcare centers and nurseries to inform parents and legal guardians about their right to request a vaccine exemption for their children, in addition to being told what vaccinations the school requires.
CDC data released last month show the percentage of children granted religious exemptions from school immunization requirements reached a record high during the 2024-2025 school year.
A survey conducted in January by the Annenberg Public Policy Center at the University of Pennsylvania found that public support in the U.S. for religious exemptions nearly doubled over the last six years.
Kane said these developments show that support for legislation and other actions protecting religious exemptions is gaining momentum.
“It’s a boulder that I see at the top of a hill. It is rolling slowly right now, but I think the speed is about to pick up drastically,” he said.
Related articles in The Defender- Advocates for Religious Exemptions Notch Victories in West Virginia, Massachusetts
- West Virginia Schools Ordered to Defy Governor on Religious Exemptions
- ‘Huge Win’: West Virginia Governor Issues Executive Order Allowing Religious Exemptions
- ‘Right This Wrong’: GRACE Act Would Strip Federal Funding From Schools That Ban Religious Exemptions
- Vaccination Rates Hit Record-Breaking Low for Third Year in a Row as Religious Exemptions Reach Record High
