Litte Sisters v. Pennsylvania - Case Summary

University / Undergraduate
Modified: 25th Feb 2024
Wordcount: 619 words


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Legal Case Summary

Summary: US Supreme Court upheld rule allowing employers with religious or moral objections to opt out of no-cost contraceptive coverage.


The Patient Protection and Affordable Care Act required employers to provide women with preventative care, including contraceptives, without cost sharing. Due to several religious or moral objections, the Trump administration implemented two interim final rules expanding the exemptions to include employers with ‘religiously or morally based objections.’. The Pennsylvania and New Jersey state governments sued to block the interim rules, alleging violation of the Administrative Procedure Act (APA). The case went to the US Supreme Court after a series of legal proceedings


The main issue was whether the Departments had the statutory authority to promulgate the religious and moral exemptions. This was questioned under the Affordable Care Act (ACA) and the Administrative Procedure Act (APA). The States also expressed concern that the exemptions would impose costs on them by increasing the number of women who use state-funded services.


The Court's decision now enables more employers, including publicly traded companies, to opt out of providing no-cost contraceptive services to employees. They can simply claim violation of religious or moral objections. The decision has significant reverberations for the understanding and application of both the ACA and the Religious Freedom Restoration Act (RFRA). It stirs debates about the government's role in protecting religious liberties versus an individual's right to preventive healthcare.


In a 7-2 decision, the Supreme Court upheld the Trump administration's regulations, finding the Departments had the statutory authority to craft religious and moral exemptions. Justice Thomas delivered the opinion of the Court. He affirmed that the ACA grants the Departments broad discretion to define within parameters what counts as preventative care and screenings. Thus, they had the authority to develop the challenged exemptions.


  • Supreme Court of the United States (2020). Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania.
  • Moncrieff, A. (2020). 'The Alliance of Health Care and Religious Freedom', Yale Law Journal, 129, pp. 196-226.
  • Rovner, J. (2020). 'Supreme Court Upholds Trump Administration Regulation Letting Employers Opt Out of Birth Control Coverage', Kaiser Health News.

Journalist Brief

In simpler terms, this Supreme Court case centred on the issue of who pays for women’s contraceptives. The Affordable Care Act mandates employers to provide contraceptive services to their employees. This was challenged by the Trump administration, which intended to widen the exemption pool to include employers with religious or moral objections. The Supreme Court sided with the Trump administration permitting a broader range of employers to opt out of this mandate. The decision sparked a debate between preserving religious freedom and ensuring access to preventive healthcare for women.


What was the Supreme Court's decision in the Little Sisters v. Pennsylvania case?

Answer: The Court upheld the Trump administration's rules, allowing many more employers to opt out of providing contraceptive services on grounds of moral or religious objections.

What were the objections to providing contraceptive services?

Answer: Certain employers objected to this mandate, citing religious or moral objections to contraception.

What implications does this decision have?

Answer: The decision expands the rights of employers to refuse contraceptive coverage, sparking a debate between protecting religious freedom and guaranteeing women's preventive healthcare rights.

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