Read more of our coverage on the Hobby Lobby and Conestoga Wood cases here.

In a 5-4 decision Monday, the U.S. Supreme Court ruled in favor of Hobby Lobby and Conestoga Wood Specialties, holding that the contraceptive coverage requirement in the Affordable Care Act violates their religious rights.

Justice Samuel Alito delivered the majority opinion for the Court, joined by Chief Justice John Roberts and Justices Antonin Scalia and Clarence Thomas. Justice Anthony Kennedy filed a concurring opinion. Justice Ruth Bader Ginsburg led the dissenting justices, along with Justices Sonia Sotomayor, Elena Kagan, and Stephen Breyer.

According to the majority, the Religious Freedom Restoration Act (RFRA) does extend to closely held corporations under the statute’s definition of “person,” which means the businesses could challenge the law’s requirement that employers who provide health insurance to their employees not discriminate in that coverage. “A corporation is simply a form of organizing used by human beings to achieve desired ends,” the Court noted. “When rights, whether constitutional or statutory, are extended to corporations the purpose is to protect the rights of these people.”

Once the majority established that the RFRA’s definition of “person” includes closely held corporations, the Court found it possible for corporations to “exercise religion” and that although these businesses are for-profit entities, that is not a barrier to practicing those beliefs.

Having established that the RFRA covers closely held corporations and that those corporations can exercise religious beliefs, the majority then ruled that the contraceptive benefit in the Affordable Care Act did substantially burden the exercise of religious rights because it requires the owners to engage in conduct that seriously violates their sincere religious belief that life begins at conception. Furthermore, the majority held, while providing access to contraceptive coverage, the coverage rule was not the least restrictive means for the Obama administration to achieve this goal.

“This is a deeply troubling decision. For the first time, the highest court in the country has said that business owners can use their religious beliefs to deny their employees a benefit that they are guaranteed by law,” said Louise Melling, the deputy legal director of the American Civil Liberties Union, in a statement. “Religious freedom is a fundamental right, but that freedom does not include the right to impose beliefs on others. In its ruling today, the Court simply got it wrong.”

According to the Court, the government has several options to provide contraceptive coverage that would not violate religious beliefs under the RFRA. Those options include assuming the costs related to coverage or to provide closely held corporations the same accommodation to the requirement as those provided to religiously affiliated nonprofits.

To date, more than 50 lawsuits challenging the constitutionality of that accommodation have been filed, including cases by the University of Notre Dame and the Little Sisters of the Poor.

Marcia D. Greenberger, co-president of the National Women’s Law Center, said in a statement that the reach of the decision would mean many employees’ basic health-care rights are subject to the whims of their employers. “While the Court left the basic contraceptive coverage provision in place and did not question that there is a compelling need for such health care, women working at these and similar companies could be denied the basic birth control coverage they need and deserve and saddled with higher costs for essential contraceptive care.”

Kierra Johnson, executive director of Choice USA, noted the impact of the decision on young workers. “Today’s decision will have far reaching consequences for young people who have benefited greatly from no-copay birth control coverage,” she said. “For young people, who often face the greatest financial strain from healthcare costs, this decision will surely mean more will be unable to afford critical healthcare.”

The majority opinion stated specifically that the decision “concerns only the contraceptive mandate and should not be understood to hold that all insurance-coverage mandates e.g., for vaccinations or blood transfusions must necessarily fall if they conflict with an employer’s religious beliefs.” While this appears to be a limiting principle, like the Court’s holding the RFRA only belongs to closely held corporations and not all corporations like those that are publicly traded, it remains to be seen if that’s true.

Justice Ginsburg called the decision one of “startling breadth,” noting that “the Court holds that commercial enterprises, including corporations, along with partnerships and sole proprietorships, can opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.” Justice Ginsburg also criticized the majority’s insistence that the decision was narrow, noting that during oral arguments, counsel for Hobby Lobby told the Court that other religious exemptions in cases such as vaccine refusals would “have to be evaluated on its own.”

The problem, Justice Ginsburg notes, is that now courts will be in the business of evaluating the sincerity of religious claims. “There in an overriding interest, I believe, in keeping the courts ‘out of the business of evaluation the elate merits of differing religious claims’ or the sincerity with which an asserted religious belief is held,” Ginsburg wrote. “Indeed, approving some religious claims while demeaning others unworthy of accommodation could be ‘perceived as favoring one religion over another,’ the very ‘risk the Establishment Clause was designed to preclude.'”