A federal court has ruled that the Little Sisters of the Poor must once again comply with the Affordable Care Act’s contraceptive mandate or risk facing steep fines.

According to Breitbart, the U.S. District Court for the Eastern District of Pennsylvania revoked religious exemptions granted during the Trump administration, despite prior Supreme Court wins by the Little Sisters of the Poor that appeared to settle the long-standing legal matter.

On Wednesday, Judge Wendy Beetlestone, presiding in Philadelphia, vacated the Trump-era religious exemption rule in a lawsuit brought by the states of Pennsylvania and New Jersey. The judge, appointed by President Barack Obama, stated the exemption violated the Administrative Procedure Act by being “arbitrary and capricious.”

The Affordable Care Act, enacted under President Obama, included a mandate requiring employers to provide contraceptive coverage through health insurance. No religious exemption was included in the original legislation, leading to years of legal challenges by religious groups.

The Little Sisters of the Poor, a Catholic nonprofit organization that provides care to the elderly poor, became one of the most prominent challengers to the mandate. Their legal journey began in earnest after the ACA went into effect, with their first major victory coming in 2016 when the U.S. Supreme Court ruled in their favor.

States challenge Trump-era exemption rule

In 2017, following the Supreme Court decision, the Trump administration implemented a broader religious exemption allowing groups like the Little Sisters to opt out of the contraceptive mandate. The exemption generated pushback from several states, including Pennsylvania and New Jersey.

Those states sued the federal government, arguing the Trump policy exceeded administrative authority and harmed women’s access to healthcare. The case, known as Pennsylvania v. Trump, began in the U.S. District Court for the Eastern District of Pennsylvania and has since made its way to the Supreme Court.

In 2020, the Supreme Court once again ruled in favor of the Little Sisters, upholding the Trump-era exemption. However, Pennsylvania and New Jersey returned to the district court with legal arguments that remained unresolved by earlier decisions.

Judge overturns federal religious exemption

This week’s ruling by Judge Beetlestone invalidated the religious exemption entirely, siding with the states’ claim that the Trump administration’s rules lacked sufficient justification. The court did not conduct a hearing before delivering its decision and did not weigh in on constitutional claims raised by the Little Sisters’ attorneys.

Mark Rienzi, president of the Becket Fund for Religious Liberty and attorney for the Little Sisters, criticized the decision. He argued that the district court had failed to address crucial constitutional issues, opting instead to strike down the exemption without allowing a public hearing.

“It’s bad enough that the district court issued a nationwide ruling invalidating federal religious conscience rules,” Rienzi said. “But even worse is that the district court simply ducked the glaring constitutional issues in this case, after waiting five years and not even holding a hearing.”

Little Sisters vow to continue legal battle

Rienzi expressed frustration that the case may return to the Supreme Court once more. He noted the Little Sisters have spent over a decade in litigation trying to secure religious protections regarding the contraceptive mandate.

“It is absurd to think the Little Sisters might need yet another trip to the Supreme Court to end what has now been more than a dozen years of litigation over the same issue,” he stated. “We will fight as far as we need to fight to protect the Little Sisters’ right to care for the elderly in peace.”

Mother Loraine Marie Maguire, a spokesperson for the Little Sisters, also responded, affirming their commitment to continue challenging the ruling. She emphasized that their work is rooted in faith and serving the vulnerable elderly.

“As Little Sisters of the Poor, we dedicate our lives to caring for the elderly poor until God calls them home,” she said. “We will continue to fight for the right to carry out our mission without violating our faith, and we pray Pennsylvania and New Jersey will end this needless harassment.”

Appeal expected to follow recent court decision

The Little Sisters of the Poor have announced plans to appeal the district court’s ruling in the coming weeks. Legal analysts expect the case to revisit questions the Supreme Court has already touched upon in 2016 and 2020.

Although the religious exemption provided temporary relief in the past, this latest decision reopens legal uncertainty for religious nonprofits subject to federal health mandates. The outcome of the expected appeal could reshape how administrative law interacts with religious liberty claims under the ACA.

As the legal battle continues, the case underscores unresolved tension between government healthcare regulations and the rights of faith-based organizations. The next phase of litigation will likely determine whether groups like the Little Sisters can continue to operate without conflicting with their core religious beliefs.