Little Sisters of the Poor v. Commonwealth of Pennsylvania
Case Snapshot
For over a decade, the Little Sisters of the Poor have been prevailing in court against a federal mandate that would force them to either provide contraceptives in their healthcare plan or pay tens of millions of dollars in fines. That winning streak features two Supreme Court victories, including a 2020 ruling that upheld a federal conscience rule shielding them from the mandate. But Pennsylvania and New Jersey keep fighting in court to strip the Little Sisters of that protection. They should expect to keep losing.
Status
On August 13, 2025, a federal district court sided with the states, issuing a nationwide ruling invalidating the religious conscience rule. The Little Sisters have appealed the ruling to the U.S. Court of Appeals for the Third Circuit.
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Case Summary
The Little Sisters keep handing hostile governments new defeats
In the fall of 2017, Health & Human Services issued a new rule with an updated, broad religious exemption that finally protected religious non-profits like the Little Sisters of the Poor, a group of Catholic nuns who care for the elderly poor. In its new rule, the government admitted that it broke the law by trying to force the Little Sisters and others to provide services like the week-after pill in their health plans. That result should mean that the end is near for the Little Sisters’ lawsuit.
But instead of accepting defeat, Pennsylvania sued the federal government to take away the Little Sisters’ hard-won religious exemption. Pennsylvania admits that it already has and already uses many government programs to provide contraceptives to women who need them. Pennsylvania never challenged the Obama Administration for creating much larger exceptions for secular corporations—exceptions that covered tens of millions more people than the religious exemption. Additionally, Pennsylvania does not even have its own contraceptive mandate at all, and its lawsuit does not identify a single real person who previously had contraceptive coverage but will lose it because of the new tule.
Despite all this, Pennsylvania—joined by New Jersey—asked a judge to order that the protection for the Little Sisters was against the law, meaning religious groups must comply with the federal mandate or pay tens of millions of dollars in fines.
The Little Sisters strike back
In November 2017, Becket intervened on behalf of the Little Sisters of the Poor in California and Pennsylvania. The Pennsylvania court refused to let the Little Sisters intervene in the case, or even argue in court. A week later, the Pennsylvania court temporarily blocked the new rule that gave the Little Sisters a religious exemption. Becket immediately appealed both rulings.
A federal appeals court ruled that the Little Sisters could participate in the lawsuit, but then ruled against the Little Sisters. Becket has argued all along that the government has many ways to provide services to women who want them as well as protect the Little Sisters. Neither the federal government nor the state governments need nuns to help them give out contraceptives. On October 1, 2019, the Little Sisters asked the Supreme Court to protect them from the HHS contraceptive mandate again. On January 17, 2020, the Supreme Court agreed to review the Third Circuit’s decision. Oral argument took place on May 6, 2020.
The Little Sisters wallop the government, again
On July 8, 2020, the Supreme Court ruled 7-2 in favor of the Little Sisters of the Poor, allowing them to continue serving the elderly poor and dying without threat of millions of dollars in fines. Writing for the Court, Justice Thomas said that “For over 150 years, the Little Sisters have engaged in faithful service and sacrifice, motivated by a religious calling to surrender all for the sake of their brother. . . . But for the past seven years, they—like many other religious objectors who have participated in the litigation and rulemakings leading up to today’s decision— have had to fight for the ability to continue in their noble work without violating their sincerely held religious beliefs.” The Court held that the federal government was right to protect those beliefs.
Every time the government attacks the Sisters, religious freedom gets stronger
Despite losing at the Supreme Court, Pennsylvania and New Jersey have kept pushing in the lower courts to strip away the Little Sisters’ protection. On August 13, 2025, in a nationwide ruling against a Trump Administration religious conscience rule, a federal district court in Philadelphia sided with Pennsylvania and New Jersey. The Little Sisters have once again appealed to the federal court of appeals for the Third Circuit.
Importance to religious liberty
- HHS Mandate cases: Winning the HHS mandate cases sets an important precedent, confirming that federal agencies cannot unnecessarily force religious people to violate their beliefs in order to further a government goal.
- Religious communities: Religious communities have the right to organize and operate according to their beliefs without the government discriminating among sincere religious beliefs.
- Individual freedom: Religious individuals and organizations are free to follow their faith in all aspects of their lives, including in the workplace and not just in houses of worship.