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LITTLE SISTERS OF THE POOR SAINTS PETER 
AND PAUL HOME v. PENNSYLVANIA 
Syllabus 

U. S. ___, the Court opted to remand without deciding the RFRA ques-
tion in cases challenging the self-certification accommodation so that
the  parties  could  develop  an  approach  that  would  accommodate  em-
ployers’ concerns while providing women full and equal coverage.

Under Zubik’s direction and in light of Hobby Lobby’s holding, the 
Departments  promulgated  two  interim  final  rules  (IFRs).    The  first 
significantly expanded the church exemption to include  an employer 
that  “objects  . . .  based  on  its  sincerely  held  religious  beliefs,”  “to  its 
establishing, maintaining, providing, offering, or arranging [for] cov-
erage or payments for some or all contraceptive services.”  82 Fed. Reg.
47812.  The second created a similar “moral exemption” for employers
with sincerely held moral objections to providing some or all forms of 
contraceptive  coverage.    The  Departments  requested  post-promulga-
tion comments on both IFRs. 

Pennsylvania  sued,  alleging  that  the  IFRs  were  procedurally  and 
substantively invalid under the Administrative Procedure Act (APA). 
After the Departments issued final rules, responding to post-promul-
gation  comments  but  leaving  the  IFRs  largely  intact,  New  Jersey 
joined Pennsylvania’s suit.  Together they filed an amended complaint,
alleging  that  the  rules  were  substantively  unlawful  because  the  De-
partments lacked statutory authority under either the ACA or RFRA 
to promulgate the exemptions.  They also argued that the rules were
procedurally defective because the Departments failed to comply with 
the APA’s notice and comment procedures.  The District Court issued 
a preliminary nationwide injunction against the implementation of the
final rules, and the Third Circuit affirmed.  

Held: 

1. The Departments had the authority under the ACA to promulgate 

the religious and moral exemptions.  Pp. 14–22.

(a) As  legal  authority  for  both  exemptions,  the  Departments  in-
voke §300gg–13(a)(4), which states that group health plans must pro-
vide women with “preventive care and screenings . . . as provided for 
in  comprehensive  guidelines  supported  by  [HRSA].”  The  pivotal
phrase, “as provided for,” grants sweeping authority to HRSA to define
the  preventive  care  that  applicable  health  plans  must  cover.    That 
same grant of authority empowers it to identify and create exemptions 
from its own Guidelines.  The “fundamental principle of statutory in-
terpretation  that  ‘absent  provision[s]  cannot  be  supplied  by  the 
courts,’ ” Rotkiske v. Klemm, 589 U. S. ___, ___ applies not only to add-
ing terms not found in the statute, but also to imposing limits on an 
agency’s discretion that are not supported by the text, see Watt v. En-
ergy  Action  Ed.  Foundation,  454  U.  S.  151,  168.  Concerns  that  the 
exemptions thwart Congress’ intent by making it significantly harder