OCTOBER TERM, 2019
NOTE: Where it is feasible, a syllabus (headnote) will be released, as is
being done in connection with this case, at the time the opinion is issued.
The syllabus constitutes no part of the opinion of the Court but has been
prepared by the Reporter of Decisions for the convenience of the reader.
See United States v. Detroit Timber & Lumber Co., 200 U. S. 321, 337.
SUPREME COURT OF THE UNITED STATES
LITTLE SISTERS OF THE POOR SAINTS PETER AND
PAUL HOME v. PENNSYLVANIA ET AL.
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR
THE THIRD CIRCUIT
No. 19–431. Argued May 6, 2020—Decided July 8, 2020*
The Patient Protection and Affordable Care Act of 2010 (ACA) requires
covered employers to provide women with “preventive care and screen-
ings” without “any cost sharing requirements,” and relies on Preven-
tive Care Guidelines (Guidelines) “supported by the Health Resources
and Services Administration” (HRSA) to determine what “preventive
care and screenings” includes. 42 U. S. C. §300gg–13(a)(4). Those
Guidelines mandate that health plans provide coverage for all Food
and Drug Administration approved contraceptive methods. When the
Departments of Health and Human Services, Labor, and the Treasury
(Departments) incorporated the Guidelines, they also gave HRSA the
discretion to exempt religious employers, such as churches, from
providing contraceptive coverage. Later, the Departments also prom-
ulgated a rule accommodating qualifying religious organizations that
allowed them to opt out of coverage by self-certifying that they met
certain criteria to their health insurance issuer, which would then ex-
clude contraceptive coverage from the employer’s plan and provide
participants with separate payments for contraceptive services with-
out imposing any cost-sharing requirements.
Religious entities challenged the rules under the Religious Freedom