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WASHINGTON – The Supreme Court on Wednesday sided with the Trump administration on the question of whether groups with religious or moral objections can decline to provide contraceptive coverage to their employees under the 2010 Affordable Care Act.

In a 7-2 decision, the nation’s highest court determined that administration officials acted properly in 2018 when they issued rules expanding on the types of employers allowed to cite religious or moral objections to the contraception mandate. Lower courts had previously blocked the Trump administration’s changes.

In the court’s majority opinion, Justice Clarence Thomas wrote that the Health Resources and Services Administration “has virtually unbridled discretion to decide what counts as preventive care and screenings” under the ACA and said that discretion extends into “the ability to identify and create exemptions from its own Guidelines.”

The government had previously estimated that the rule changes would cause about 70,000 women, and at most 126,000 women, to lose contraception coverage in one year.

In a dissenting opinion joined by Justice Sonia Sotomayor, Justice Ruth Bader Ginsburg wrote that with the ruling, the court “leaves women workers to fend for themselves.”

>> Read the Supreme Court’s opinion

“In accommodating claims of religious freedom, this Court has taken a balanced approach, one that does not allow the religious beliefs of some to overwhelm the rights and interests of others who do not share those beliefs,” she wrote. “Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree.”

Birth control has been a topic of contention since the health care law was passed. Initially, churches, synagogues and mosques were exempt from the contraceptive coverage requirement. The Obama administration also created a way by which religiously affiliated organizations, including hospitals, universities and charities, could opt out of paying for contraception, but women on their health plans would still get no-cost birth control.

Some groups complained the opt-out process itself violated their religious beliefs.

That opt-out process was the subject of a 2016 Supreme Court case, but the court, with only eight justices at the time because of the death of Justice Antonin Scalia, didn’t decide the issue. It instead sent both sides back to see if they could work out a compromise.

The Associated Press contributed to this report.