Supreme Court Upholds Religious Liberty in Health Care Mandate

The fight over the Affordable Care Act's contraception coverage continues in the courts.

Mar. 18, 2026 at 7:00am by Ben Kaplan

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The Supreme Court has ruled in favor of religious liberty in a series of cases challenging the Affordable Care Act's contraception coverage mandate. The Obama administration fought to force employers, including the Little Sisters of the Poor, to provide insurance coverage for contraceptives, including abortifacients, despite their religious objections. The Trump administration later issued regulations exempting employers with religious or moral objections from the mandate, but the fight continues as some states try to reverse those exemptions.

Why it matters

The cases highlight the ongoing tension between religious freedom and government mandates, as well as the role of the courts in protecting the First Amendment rights of religious organizations and individuals. The outcome could have far-reaching implications for the ability of faith-based entities to operate according to their beliefs without government interference.

The details

In the 2014 Hobby Lobby case, the Supreme Court ruled 5-4 that the contraception mandate violated the Religious Freedom Restoration Act. The court found that closely held for-profit companies like Hobby Lobby could not be forced to provide coverage for contraceptives that violated the owners' religious beliefs. In 2020, the court ruled 7-2 that the Trump administration acted legally in establishing exemptions to the mandate for employers with religious or moral objections. However, some states are now trying to reverse those exemptions, leading to the ongoing legal battle.

  • In 2014, the Supreme Court ruled in favor of Hobby Lobby Stores in its challenge to the contraception mandate.
  • In 2017, the Trump administration issued new regulations exempting employers with religious or moral objections from the contraception mandate.
  • In 2020, the Supreme Court ruled 7-2 that the Trump administration's exemptions were legal.
  • In August 2021, a federal judge ruled against the Trump administration's exemptions, leading the Little Sisters of the Poor to appeal the decision.

The players

Hobby Lobby Stores

A family-owned business that sued the Obama administration over the contraception mandate, arguing it violated their religious beliefs.

Little Sisters of the Poor

A Catholic religious order that has been fighting the contraception mandate, arguing it violates their religious beliefs.

Kathleen Sebelius

The former Health and Human Services Secretary under President Obama who implemented the contraception mandate.

Donald Trump

The former president who issued regulations exempting employers with religious or moral objections from the contraception mandate.

Wendy Beetlestone

A federal judge who ruled against the Trump administration's exemptions to the contraception mandate.

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What they’re saying

“We hold that the regulations that impose this obligation violate RFRA, which prohibits the Federal Government from taking any action that substantially burdens the exercise of religion unless that action constitutes the least restrictive means of serving a compelling government interest.”

— Justice Samuel Alito, Supreme Court Justice (Burwell v. Hobby Lobby Stores, Inc.)

“Why must they be deprived of their God-given and constitutional right to serve the poor and with such great sacrifice, in accordance with their moral principles derived from their religious faith?”

— Archbishop Salvatore Cordileone, Archbishop of San Francisco (Religious Liberty Commission Hearing)

What’s next

The Little Sisters of the Poor have appealed the federal judge's ruling against the Trump administration's contraception mandate exemptions to the U.S. Court of Appeals for the Third Circuit.

The takeaway

The ongoing legal battles over the Affordable Care Act's contraception coverage mandate highlight the delicate balance between protecting religious liberty and ensuring access to healthcare. The outcome of these cases could have significant implications for the ability of faith-based organizations to operate according to their beliefs without government interference.