The US Supreme Court on Wednesday released its opinions in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania. 

The Little Sisters case reversed the opinion of the US Court of Appeals for the Third Circuit. It centered on the requirement under the Affordable Care Act of 2010 for employers to provide women with “preventive care and screenings.” The Health Resources and Services Administration provided a discretionary exemption for religious organizations allowing them to opt-out of providing coverage for contraceptives. A newer rule allowing religious organizations to opt-out of coverage “by self-certifying that they met certain criteria” to exclude contraceptive coverage. In this situation, the plan would include separate payments for contraceptive services without cost-sharing requirements.

Organizations were also permitted to be exempt if they had moral objections to providing contraceptive coverage or religious reasons for objecting to it. Pennsylvania sued in response, alleging that the Departments promulgating the rules did not abide by notice and comment rulemaking requirements under the Administrative Procedure Act.

The Third Circuit allowed a preliminary nationwide injunction against these rules, but the Supreme Court, in an opinion by Justice Thomas, held that the rules were not issued with procedural defects, and the Departments were allowed to permit these exemptions. They thus reversed the Third Circuit ruling and remanded the case. Justices Ginsburg and Sotomayor dissented.