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LITTLE SISTERS OF THE POOR SAINTS PETER 
AND PAUL HOME v. PENNSYLVANIA 
Opinion of the Court 

of  Health  and  Human  Services,  Labor,  and  the  Treasury 
(Departments)—which jointly administer the relevant ACA
provision1—exempted certain employers who have religious
and conscientious objections from this agency-created man-
date.  The  Third  Circuit  concluded  that  the  Departments
lacked statutory authority to promulgate these exemptions 
and  affirmed  the  District  Court’s  nationwide  preliminary 
injunction.  This decision was erroneous.  We hold that the 
Departments had the authority to provide exemptions from 
the  regulatory  contraceptive  requirements  for  employers 
with religious and conscientious objections.  We accordingly
reverse the Third Circuit’s judgment and remand with in-
structions  to  dissolve  the  nationwide  preliminary  injunc-
tion. 

I 

The ACA’s contraceptive mandate—a product of agency 
regulation—has existed for approximately nine years.  Lit-
igation surrounding that requirement has lasted nearly as
long.  In light of this extensive history, we begin by summa-
rizing the relevant background. 

A 
The  ACA  requires  covered  employers  to  offer  “a  group
health plan or group health insurance coverage” that pro-
vides  certain  “minimum  essential  coverage.”    26  U. S. C. 
§5000A(f )(2);  §§4980H(a),  (c)(2).    Employers  who  do  not
comply  face  hefty  penalties,  including  potential  fines  of 
$100 per day for each affected employee.  §§4980D(a)–(b); 
see also Burwell v. Hobby Lobby Stores, Inc., 573 U. S. 682, 
696–697 (2014).  These cases concern regulations promul-
gated under a provision of the ACA that requires covered 
employers  to  provide  women  with  “preventive  care  and 
screenings”  without  “any  cost  sharing  requirements.”  42 

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1 See 42 U. S. C. §300gg–92; 29 U. S. C. §1191c; 26 U. S. C. §9833.