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

to that same authority, the Departments provided the an-
ticipated  accommodation  for  eligible  religious  organiza-
tions,  which  the  regulation  defined  as  organizations  that 
“(1) [o]ppos[e] providing coverage for some or all of the con-
traceptive  services  . . .  on  account  of  religious  objections;
(2) [are] organized and operat[e] as . . . nonprofit entit[ies]; 
(3) hol[d] [themselves] out as . . . religious organization[s];
and (4) self-certif[y] that [they] satisf[y] the first three cri-
teria.”  Id., at 39874.  The accommodation required an eli-
gible organization to provide a copy of the self-certification
form to its health insurance issuer, which in turn would ex-
clude  contraceptive  coverage  from  the  group  health  plan
and provide payments to beneficiaries for contraceptive ser-
vices separate from the health plan.  Id., at 39878.  The De-
partments  stated  that  the  accommodation  aimed  to  “pro-
tec[t]”  religious  organizations  “from  having  to  contract, 
arrange, pay, or refer for [contraceptive] coverage” in a way
that was consistent with and did not violate the Religious
Freedom Restoration Act of 1993 (RFRA), 107 Stat. 1488,
42  U. S. C.  §2000bb  et  seq.  78  Fed.  Reg.  39871,  39886–
39887.  This accommodation is referred to as the self-certi-
fication accommodation. 

B 
Shortly after the Departments promulgated the 2013 fi-
nal rule, two religious nonprofits run by the Little Sisters
of the Poor (Little Sisters) challenged the self-certification
accommodation.  The  Little  Sisters  “are  an  international 
congregation of Roman Catholic women religious” who have 
operated  homes  for  the  elderly  poor  in  the  United  States
since  1868.    See  Mission  Statement:  Little  Sisters  of  the 
Poor,  http://www.littlesistersofthepoor.org/mission-statement.  

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people of different religious faiths.”  78 Fed. Reg. 39874.  But see post, at 
12–13  (GINSBURG,  J.,  dissenting)  (arguing  that  the  church  exemption 
only covered houses of worship).