Reconsidering the Authority of the Department of Veterans Affairs to Provide Abortion Services

CourtDepartment of Justice Office of Legal Counsel
DecidedDecember 18, 2025
StatusPublished

This text of Reconsidering the Authority of the Department of Veterans Affairs to Provide Abortion Services (Reconsidering the Authority of the Department of Veterans Affairs to Provide Abortion Services) is published on Counsel Stack Legal Research, covering Department of Justice Office of Legal Counsel primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reconsidering the Authority of the Department of Veterans Affairs to Provide Abortion Services, (olc 2025).

Opinion

(Slip Opinion)

Reconsidering the Authority of the Department of Veterans Affairs to Provide Abortion Services The Department of Veterans Affairs may not provide abortion services under any provi- sion of chapter 17 of title 38 of the U.S. Code. The portions of our opinion in Intergovernmental Immunity for the Department of Veter- ans Affairs and Its Employees When Providing Certain Abortion Services, 46 Op. O.L.C. __ (Sept. 21, 2022), that held to the contrary are withdrawn and superseded by this opinion.

December 18, 2025

MEMORANDUM OPINION FOR THE SECRETARY DEPARTMENT OF VETERANS AFFAIRS

In 2022, this Office advised that federal law authorizes the Department of Veterans Affairs (“VA”) and its employees to provide abortion ser- vices. See Intergovernmental Immunity for the Department of Veterans Affairs and Its Employees When Providing Certain Abortion Services, 46 Op. O.L.C. __, at *4 (Sept. 21, 2022) (“Abortion Services”). Our opinion, which memorialized and expanded on earlier advice, interpreted federal law as conferring “broad discretion” on the Secretary of Veterans Affairs in this area. Id. at *9 (citation omitted). And its logic suggested the unprecedented conclusion that VA could lawfully provide taxpayer- funded abortions for any reason and at any stage of pregnancy—including after fetal viability and until birth. See id. at *7–9. In response to our advice, VA issued an interim final rule that departed from longstanding practice. For the first time, it expressly authorized VA to provide abortions to veterans and certain other VA beneficiaries as part of its medical authority under chapter 17 of title 38 of the U.S. Code. See Reproductive Health Services, 87 Fed. Reg. 55,287, 55,296 (Sept. 9, 2022) (codified as amended at 38 C.F.R. § 17.38(c)(1)(i)–(ii)). It also enabled VA to provide abortion counseling. See id. at 55,288. Although VA exercised its newfound authority to provide abortions sparingly, the scope of the rule and our Office’s subsequent opinion supporting it swept more broadly. See Abortion Services at *9. In August 2025, VA proposed a new rule “to reinstate the full exclusion on abortions and abortion counseling from the medical benefits package, which was removed in 2022.” Reproductive Health Services, 90 Fed. Reg.

1 49 Op. O.L.C. __ (Dec. 18, 2025)

36,415, 36,415 (Aug. 4, 2025). That proposed rule observed that the 2022 interim final rule “was legally questionable.” Id. at 36,416. You have now asked us to reconsider whether federal law authorizes VA to provide abortion services under any provision of chapter 17 of title 38 of the U.S. Code. It does not, so we withdraw in part our prior opinion. 1

I.

Federal law requires VA to “furnish” qualifying veterans with “hospital care and medical services which the Secretary determines to be needed.” 38 U.S.C. § 1710(a)(1). VA implements this treatment scheme through regulations defining the contours of its “medical benefits package.” 38 C.F.R. § 17.38(a). VA also “is authorized to provide medical care” to certain spouses, children, and caregivers of veterans as part of the Civilian Health and Medical Program of the Department of Veterans Affairs— commonly known as “CHAMPVA” beneficiaries. See 38 U.S.C. § 1781(a). Medical care provided to CHAMPVA beneficiaries must be provided “in the same or similar manner,” and is “subject to the same or similar limita- tions,” as medical care furnished to family members of active-duty per- sonnel and others under the Department of War’s TRICARE (Select) program. Id. § 1781(b). VA regulations implementing CHAMPVA specif- ically limit the provision of abortion. See 38 C.F.R. § 17.272(a)(58). In 1992, Congress amended title 38 “to improve health care services for women veterans” and for other purposes. Veterans Health Care Act of 1992, Pub. L. No. 102-585, 106 Stat. 4943, 4943 (“VHCA”). With respect to VA’s authority to furnish hospital care and medical services, sec- tion 106 of the VHCA made clear that VA could provide “[g]eneral re- productive health care” to women. Id. § 106(a)(3), 106 Stat. at 4947. But Congress carved out from that authority “infertility services, abortions, or pregnancy care (including prenatal and delivery care), except for such care relating to a pregnancy that is complicated or in which the risks of complication are increased by a service-connected condition.” Id. This

1 Our earlier opinion also offered advice about federal immunity derived from the Su-

premacy Clause. See Abortion Services at *1–4, *9–10. While we now reconsider VA’s statutory authority to provide abortions, you did not ask us to, and therefore we do not, reconsider the portions of the opinion relating to intergovernmental immunity.

2 VA Authority to Provide Abortion Services

statutory language thus barred VA’s provision of abortions and limited its provision of pregnancy care to situations that were “complicated.” Consistent with section 106 of the VHCA, VA’s regulations for dec- ades provided that “the ‘medical benefits package’ does not include . . . [a]bortions and abortion counseling” for veterans. 38 C.F.R. § 17.38(c) (2008); accord id. (2011); id. (2019); id. (2021); see also 87 Fed. Reg. at 55,288 (explaining that the abortion exclusion had existed since 1999, the year during which VA first established the medical benefits package). VA regulations applicable to CHAMPVA beneficiaries likewise consistently excluded abortion services and clarified that physicians could perform an abortion only if they “certifie[d] that the life of the mother would be endangered if the fetus were carried to term.” 38 C.F.R. § 17.272(a)(67) (2008); see also id. § 17.272(a)(68) (excluding “[a]bortion counseling”); accord id. § 17.272(a)(67)–(68) (2022). That life-of-the-mother exception was substantially similar to federal law governing TRICARE, which prohibits the use of Department of War funds for abortions “except where the life of the mother would be endangered if the fetus were carried to term.” 10 U.S.C. § 1093(a). 2 VA changed course in 2022. When promulgating an interim final rule, VA explained that it was amend[ing] its medical regulations to remove the exclusion on abor- tion counseling and establish exceptions to the exclusion on abor- tions in the medical benefits package for veterans who receive care set forth in that package, and to remove the exclusion on abortion counseling and expand the exceptions to the exclusion on abortions for [CHAMPVA] beneficiaries.

2 VA had never understood the VHCA or its regulations “to prohibit providing care to

pregnant women in life-threatening circumstances, including treatment for ectopic pregnancies or miscarriages, which were covered under the VA’s medical benefits package prior to the 2022 [regulation].” 90 Fed. Reg. at 36,416. VA’s 2025 proposed rule “make[s] clear that the exclusion for abortion [for CHAMPVA beneficiaries] does not apply ‘when a physician certifies that the life of the mother would be endangered if the fetus were carried to term.’” Id.

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