On July 7, 2026, a federal appeals court examined whether the Trump administration's 2017 expansion of religious exemptions to the Affordable Care Act's contraception mandate was excessive. The U.S. Court of Appeals for the Third Circuit heard arguments from Pennsylvania and New Jersey, which contend that the administration's rules improperly allow religious employers to opt out of providing contraceptive coverage.
The panel included Judges Cheryl Ann Krause, Jane Roth, and Arianna Freeman. The case follows a 2020 Supreme Court ruling that affirmed the federal government's authority to create such exemptions, but left open questions regarding compliance with the Administrative Procedure Act.
During the hearing, Judge Krause questioned the sincerity of religious objections from employers and the broad scope of the exemptions. Counsel for Pennsylvania and New Jersey, Amy Thompson, argued that the exemptions could affect approximately 126,000 women by limiting their access to contraceptive coverage. She claimed the exemptions were unnecessarily broad and not justified by existing religious objections.
Mark Rienzi, representing the Little Sisters of the Poor, countered that the states were relying on speculative claims and emphasized that the exemptions protect religious organizations while maintaining the mandate for most employers. He also noted that Pennsylvania could implement its own contraceptive mandate if it chose to do so.
A Justice Department attorney defended the regulations, stating that federal agencies acted within their authority to create religious exemptions. The judges are expected to issue a decision in the coming months.