When an order of nuns providing service to the elderly decided to challenge a provision in the Affordable Care Act, the one which requires employers to provide insurance policies including contraceptives, their appeal was turned down by a federal appeals court based in Denver, Colorado.

The Little Sisters of the Poor, together with four Christian colleges in Oklahoma, argued that the Affordable Care Act, better known as Obamacare, violates their beliefs about childbirth, especially since they would have a hand in providing contraceptives.

However, the 10th Circuit Court of Appeals disagreed, saying there is no way the Obamacare mandate hinders the nuns from exercising their religious freedom.

"Although we recognise and respect the sincerity of plaintiffs' beliefs and arguments, we conclude the accommodation scheme does not substantially burden their religious exercise," the three-judge panel wrote in their verdict.

Under Obamacare, the US government allows religious groups, such as the Little Sisters of the Poor, to fill out a form notifying the Department of Health and Human Services of their religious objection to providing such contraception coverage.

With this notification, the government will then require insurers and third-party administrators to provide the mandated Obamacare coverage to employees at no cost to the religious objectors.

However, many religious organisations object to this alternative way of providing contraceptive coverage to their employees, saying this does not address their moral objections.

The Little Sisters of the Poor said agreeing to this alternative makes it complicit in the facilitation of potentially life-ending drugs and devices, thus curtailing its free exercise of religion.

But the 10th Circuit Court of Appeals disagreed, arguing that the accommodation provided to religious objectors "relieves [the Little Sisters] of their statutory obligation" to provide the objectionable coverage.

After the ruling, Sister Loraine Marie Maguire told Fox News that "we simply cannot choose between our care for the elderly poor and our faith."

Maguire said forcing the Little Sisters of the Poor to make that choice only "violates our nation's commitment to ensuring that people from diverse faiths can freely follow God's calling in their lives."

The nuns' lead attorney Mark Rienzi believes that there are several ways people could get access to contraceptives without involving the nuns, so there was absolutely "no reason the government cannot run its programs without hijacking the Little Sisters and their health plan."

"The government demands that the Little Sisters of the Poor sign a permission slip for abortion drugs and contraceptives, or pay of millions in fines," Rienzi said. "The Sisters believe that doing that violates their faith, and that they shouldn't be forced to divert funds from the poor elderly and dying people they've devoted their lives to serve."

Even though the nuns have lost, Daniel Blomberg, a lawyer at the Becket Fund who is also representing the Little Sisters of the Poor, vowed to continue fighting for their beliefs. He said in an e-mailed statement: "We will keep on fighting for the Little Sisters, even if that means having to go all the way to the Supreme Court."

The Little Sisters of the Poor is an international congregation of Roman Catholic women religious founded in 1839 by Saint Jeanne Jugan. Together with a diverse network of collaborators, its members serve the elderly poor in over 30 countries around the world.