Document ID: ./input/supremecourt_opinions/opinions/19pdf/19-431_5i36.pdf
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LITTLE SISTERS OF THE POOR SAINTS PETER 
AND PAUL HOME v. PENNSYLVANIA 
GINSBURG, J., dissenting 

[HRSA].”  §300gg–13(a)(4).  Pursuant  to  this  instruction, 
HRSA  undertook,  after  consulting  the  Institute  of  Medi-
cine,3 to state “what preventive services are necessary for
women’s health and well-being and therefore should be con-
sidered in the development of comprehensive guidelines for 
preventive services for women.”4  The resulting “Women’s 
Preventive  Services  Guidelines”  issued  in  August  2011.5 
Under these guidelines, millions of women who previously
had  no,  or poor  quality,  health  insurance  gained  cost-free
access, not only to contraceptive services but as well to, in-
ter alia, annual checkups and screenings for breast cancer, 
cervical cancer, postpartum depression, and gestational di-
abetes.6  As to contraceptive services, HRSA directed that,
to implement §300gg–13(a)(4), women’s preventive services 
encompass  “all  [FDA]  approved  contraceptive  methods, 
sterilization  procedures,  and  patient  education  and  coun-
seling for all women with reproductive capacity.”7 

Ready  access  to  contraceptives  and  other  preventive
measures  for  which  Congress  set  the  stage  in  §300gg–
13(a)(4)  both  safeguards  women’s  health  and  enables 

—————— 

3 “The  [Institute  of  Medicine]  is  an  arm  of  the  National  Academy  of
Sciences, an organization Congress established for the explicit purpose 
of furnishing advice to the Government.”  Id., at 742, n. 3 (internal quo-
tation marks omitted).

4 HRSA, U. S. Dept. of Health and Human Services (HHS), Women’s 
Preventive  Services  Guidelines,  www.hrsa.gov/womens-guidelines/
index.html. 

5 77 Fed. Reg. 8725 (2012). 
6 HRSA, HHS, Women’s Preventive Services Guidelines, supra. 
7 77 Fed. Reg. 8725 (alterations and internal quotation marks omitted). 
Proponents of the Women’s Health Amendment specifically anticipated
that HRSA would require coverage of family planning services.  See, e.g., 
155  Cong.  Rec.  28841  (2009)  (statement  of  Sen.  Boxer);  id.,  at  28843 
(statement of Sen. Gillibrand); id., at 28844 (statement of Sen. Mikulski); 
id.,  at  28869  (statement  of  Sen.  Franken);  id.,  at  28876  (statement  of 
Sen. Cardin); ibid. (statement of Sen. Feinstein); id., at 29307 (statement 
of Sen. Murray).