Attorneys for the Little Sisters of the Poor, a Catholic order that provides long-term and hospice care, appeared before the U.S. Court of Appeals for the Third Circuit on Tuesday, asking the court to restore a federal religious exemption from the Affordable Care Act’s contraceptive coverage mandate.

The dispute dates back more than a decade, after the ACA required many employer health plans to cover contraceptives. The nuns of the order argued that complying with the mandate would violate their religious beliefs.

The Supreme Court ruled twice in the order’s favor, most recently in 2020, finding that federal agencies had authority to grant religious and moral exemptions from the mandate. But in 2025, U.S. District Judge Wendy Beetlestone of the Eastern District of Pennsylvania struck down the exemption rule, prompting the Little Sisters to appeal.

The Third Circuit is expected to issue a ruling later this year.

“This is our God-given mission,” said Mother Loraine Marie Maguire of the Little Sisters of the Poor. “For nearly 200 years, we have welcomed the elderly, poor and dying into our homes, and with the population of seniors rapidly growing, we cannot allow a government lawsuit to stop us from carrying out our mission.”

Mark Rienzi, president of Becket and lead counsel for the order, said he was confident the appeals court would uphold the exemption.

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