Federal Contraceptive Mandate Exemptions for Little Sisters of the Poor Persist Through Court Battles

The Little Sisters of the Poor continue their legal battle to maintain exemption from the federal contraceptive mandate established under the Affordable Care Act (ACA). This mandate requires employers to cover contraceptives, including some that can cause abortion, in their health insurance plans. Although the Sisters secured protections twice at the U.S. Supreme Court, states like Pennsylvania and New Jersey have persisted in challenging these exemptions in lower courts. The federal government issued a 2017 rule granting religious exemptions to groups like the Little Sisters following the Supreme Court's initial decision in 2016, but multiple states then sued to remove these exemptions. In 2020, the Supreme Court again upheld the Little Sisters' exemption rights, yet these states continue to pursue legal actions against them. The case remains pending with oral arguments expected in early 2026. This ongoing litigation highlights complex intersections of religious liberty, federal mandate compliance, and state-level regulatory challenges affecting religious organizations within the healthcare insurance framework.