Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania

The Little Sisters of the Poor, an order of Catholic nuns, challenged the Affordable Care Act's contraceptive mandate, which required employers to provide insurance coverage for contraceptives. The nuns argued that compliance would violate their religious beliefs. The Trump administration issued rules in 2017 expanding exemptions for employers with religious or moral objections. Pennsylvania and New Jersey sued, arguing the departments lacked statutory authority and violated the Administrative Procedure Act. The Third Circuit affirmed a nationwide injunction against the rules. The Supreme Court consolidated the case with Trump v. Pennsylvania and heard oral arguments in May 2020. On July 8, 2020, the Court ruled 7-2 in favor of the Little Sisters, holding that the departments had the authority to create the exemptions.

The Supreme Court reversed the Third Circuit's judgment in a 7-2 decision. The Court held that the departments had the authority to provide exemptions from the regulatory contraceptive requirements for employers with religious and conscientious objections, and that the rules were procedurally valid. The case was remanded with instructions to dissolve the nationwide preliminary injunction.

Whether the U.S. Departments of Health and Human Services, Labor, and the Treasury had the statutory authority under the Affordable Care Act to promulgate rules exempting employers with religious and moral objections from the contraceptive coverage mandate, and whether those rules complied with the Administrative Procedure Act's notice-and-comment requirements.

The decision was celebrated by religious liberty advocates as a victory for free exercise rights, while critics argued it jeopardized access to birth control for tens of thousands of women. The ruling highlighted the ongoing tension between religious freedom and reproductive healthcare access in the United States and was part of a broader trend of the Supreme Court prioritizing religious rights. Litigation over the contraceptive mandate continued in lower courts after the decision.