In a significant legal development with far-reaching effects on reproductive rights and religious liberty, a federal judge has struck down Trump-era regulations that allowed employers to opt out of providing contraceptive coverage under the Affordable Care Act (ACA) on the basis of religious or moral objections. The ruling, handed down on August 13, 2025, by Judge Wendy Beetlestone of the Eastern District of Pennsylvania, vacates the controversial exemptions in their entirety, marking the latest chapter in a legal battle that has spanned nearly a decade and reached the U.S. Supreme Court.
Judge Beetlestone’s decision, as reported by New Jersey Monitor and Straight Arrow News, was unambiguous. She described the rules as “arbitrary and capricious,” asserting that the Departments of Health and Human Services, Labor, and Treasury failed to engage in the rigorous analysis required by law and did not properly consider alternatives. In her 55-page opinion, Beetlestone wrote, “Indeed, in the face of prior, contradictory findings that contraception is safe and effective, and without evidence to refute said conclusions, the Agencies’ change-in-position ‘runs counter to the evidence.’”
The regulations in question originated during President Donald Trump’s first term. At that time, the administration expanded exemptions to the ACA’s contraceptive mandate, which previously required most employer health plans to provide cost-free contraceptive services for women. While the original law included narrow exemptions primarily for churches, the Trump administration broadened these to cover nearly any for-profit or nonprofit employer citing religious or moral objections, and even created a new “moral exemption.”
New Jersey and Pennsylvania quickly challenged the move, filing suit in 2017. Their argument was straightforward: the expanded exemptions would increase costs for publicly funded contraceptive programs and undermine access to basic reproductive health care. The litigation wound its way through the courts, ultimately reaching the U.S. Supreme Court in 2020. In a 7-2 decision, the justices ruled that the Trump administration did, in fact, have the authority to issue such exemptions. However, they sent the case back to Judge Beetlestone’s court for further proceedings—a crucial step that set the stage for this latest ruling.
Judge Beetlestone’s decision this month focused on two key aspects. First, she found that the so-called moral exemption was based on a factor that Congress never intended the relevant agencies to consider. Second, she determined that the religious exemption could not be justified under the Religious Freedom Restoration Act (RFRA) of 1993, a federal law designed to protect religious minorities. Notably, Beetlestone pointed out that Congress had previously rejected an amendment to the ACA that would have allowed for moral objections, precisely because it would have circumvented the judicial scrutiny required by RFRA for religious-based objections.
For the states that brought the lawsuit, the decision was a clear victory. New Jersey Attorney General Matt Platkin expressed his satisfaction, stating, “We are proud to stand up for access to contraceptive care in New Jersey, and we will continue to fight back against the federal government’s callous attempts to make it harder for women to access basic reproductive health care.” According to New Jersey Monitor, Platkin emphasized the importance of the ruling, which comes eight years after the initial complaint was filed against the Trump administration.
However, the case is far from over. The Little Sisters of the Poor, a Catholic religious order, intervened as defendants, arguing that the ACA’s contraceptive mandate is unconstitutional. Judge Beetlestone rejected their arguments as “well outside the scope of the matter,” noting that the Little Sisters could not raise those points unless a party directly challenged the mandate itself. Mark Rienzi, the lead attorney for the Little Sisters, told Catholic Standard that the group plans to appeal: “The district court blessed an out-of-control effort by Pennsylvania and New Jersey to attack the Little Sisters and religious liberty.”
The impact of the ruling is immediate and sweeping. The Trump-era rules that allowed broad religious and moral exemptions are now vacated, meaning most employers must once again comply with the ACA’s requirement to provide contraceptive coverage, with only the original, narrow exemptions remaining in place. As Straight Arrow News noted, the judge found that the scope of the Trump administration’s exemption was far too broad compared to the relatively small number of employers actually affected, and that the agencies had not provided sufficient justification for such a sweeping change.
Groups affected by the decision, particularly religious organizations that had relied on the exemptions, are expected to appeal. This sets the stage for yet another round of legal wrangling, and possibly another trip to the Supreme Court. The White House has not commented on the ruling as of press time.
To understand the broader significance of this decision, it’s worth recalling the contentious history surrounding the ACA’s contraceptive mandate. Since its inception, the mandate has been a flashpoint in the culture wars, pitting advocates of women’s reproductive health against those who argue for robust protections of religious liberty. The Obama administration initially crafted the rules with narrow exemptions for houses of worship, but subsequent legal challenges—most famously the Hobby Lobby case in 2014—forced the federal government to accommodate certain for-profit businesses with religious objections.
The Trump administration’s expansion of exemptions was cheered by religious conservatives, who viewed it as a necessary protection against government overreach. At the same time, reproductive rights advocates decried the move as a thinly veiled attempt to roll back women’s access to essential health services. The legal back-and-forth has left employers, employees, and insurers in a state of uncertainty for years.
Judge Beetlestone’s ruling is likely to be seen as a restoration of the status quo ante, returning the law to its original intent and framework. For women in New Jersey, Pennsylvania, and across the country, the decision means that access to contraceptive care through employer health plans is once again safeguarded—at least for now. Yet, with appeals looming and political winds ever-shifting, the future of the contraceptive mandate remains anything but settled.
As the legal battle continues, all eyes will be on the appellate courts—and perhaps, once again, the Supreme Court. For now, though, the message from federal courts is clear: exemptions to the ACA’s contraceptive mandate must be narrowly tailored and firmly grounded in the law, not in shifting political winds or unsubstantiated claims.
