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On June 30 2014 the Supreme Court decided Burwell v Hobby Lobby Stores, Inc, in a deeply divided judgment that engaged religious freedom, women’s health, and corporate personhood. Three closely held for-profit organizations challenged the Affordable Care Act’s contraceptive mandate, objecting to four contraceptive methods that they believe acted as abortifacients, in violation of their Christian beliefs.

The Court held that the contraceptive mandate violated the Religious Freedom Restoration Act of 1993, ruling that the Act’s protections extended to closely held corporations, with the mandate substantially burdening their religious freedoms. The Court acknowledged the federal government’s compelling interest in ensuring reproductive services, but said that the government could achieve this objective less restrictively, for example by directly funding the four contraceptive methods or by offering corporations the same accommodation given to non-profit religious organizations.

The Court’s judgment privileges corporate rights and religious freedoms, while burdening women’s health and reproductive autonomy. The Court failed to recognize the role of reproductive services in women’s equal participation in social and economic life, and deferred to companies’ subjective beliefs that the four contraceptive methods can prevent a fertilized egg from attaching to the uterus, for which there is no scientific evidence. The Supreme Court also created significant ambiguity around the definition of a ‘closely-held’ corporation, the extent to which large companies have religious freedoms, and whether Hobby Lobby applies to medical services beyond contraception. As well as undermining women’s reproductive health, the case solidifies a jurisprudential trend towards broadening corporate rights, which is constraining public health regulation in a wide range of areas including marketing of junk food, tobacco, and alcohol.

Publication Citation

Lawrence O. Gostin, The ACA’s Contraceptive Mandate: Religious Freedom, Women’s Health, and Corporate Personhood, JAMA Online (July 11, 2014),