Federal Court Vacates Trump Contraceptive Mandate Exemptions (1)

The Trump administration can’t enforce religious and moral exemptions to an Obamacare rule that requires employee health plans to cover birth control and related services at no cost to an employee.

The US Department of Health and Human Services and two other agencies didn’t engage in reasoned decisionmaking when they adopted the rules in 2017, during Trump’s first term in office, the US District Court for the Eastern District of Pennsylvania said Wednesday. The court granted summary judgment for Pennsylvania and New Jersey, which had challenged the exemptions as arbitrary, capricious, and an improper exercise of the agency’s authority.

The case is unusual, as the US Supreme Court previously decided that the agencies had complied with notice-and-comment rulemaking and had statutory authority to issue the rules, but left open the question of whether the agency complied with an Administrative Procedure Act requirement that its rules be the result of reasoned decisionmaking.

It’s part of a litigation trend dating back to the signing of the Affordable Care Act, when religious organizations argued that they shouldn’t be required to pay for contraception because its use violates their beliefs.

A majority of the justices held in 2014 that the contraceptive mandate violated the Religious Freedom Restoration Act rights of a closely held company whose owners shared certain religious beliefs.

The agencies tried to develop an accommodation for such entities but reached an impasse after several subsequent lawsuits.

President Donald Trump’s administration subsequently adopted the exemptions, which extended protections to any entity that held sincere religious or moral convictions against contraception.

The states sued, and the case eventually returned to the district court in 2020. The court stayed the case after Trump left office and the new administration said it would amend the rules. The agencies never issued the amendments, and the Trump rules remained in place.

In March, the states urged the court to end the case in their favor, saying the rules were arbitrary and capricious because they “sweep well beyond” the problem they were intended to address.

The Little Sisters of the Poor, a religious group that appeared in the suit, joined the federal government in also asking for summary judgment.

Here, Judge Wendy Beetlestone said the religious exemption didn’t reasonably address the problem it was intended to resolve. The agencies claimed the exemptions resolved a conflict between the contraceptive mandate and RFRA, but agencies expanded the exemption to those who couldn’t and wouldn’t object on religious grounds, she said.

The agencies considered improper factors in adopting the moral exemption, the court added. Nothing in the ACA provides that moral objections could be a factor in creating the exemptions, Beetlestone said.

Additionally, the agencies didn’t provide a “satisfactory explanation” for their “change in course” regarding the mandate and didn’t adequately address reasonable alternatives, the court said.

The Becket Fund for Religious Liberty and Conrad O’Brien PC represent the Little Sisters. The Pennsylvania and New Jersey attorneys general represent the states.

The case is Pennsylvania v. Trump, E.D. Pa., No. 17-cv-4540, 8/13/25.