Defenders of women’s health and reproductive freedom are reacting with anger to the U.S. Supreme Court’s decision on Monday which ruled that an employer with religious objection can opt out of providing contraception coverage to their employees under the Affordable Care Act.

Writing for the majority side of the 5-4 decision in Burwell v. Hobby Lobby, Justice Samuel Alito argued that the “the HHS mandate demands that they engage in conduct that seriously violates [employers’] religious beliefs.”

Rights advocates were quick to condemn the court’s decision.

“Today’s decision from five male justices is a direct attack on women and our fundamental rights. This ruling goes out of its way to declare that discrimination against women isn’t discrimination,” said Ilyse Hogue, president of NARAL Pro-Choice America.

“Allowing bosses this much control over the health-care decisions of their employees is a slippery slope with no end,” Hogue continued. “Every American could potentially be affected by this far-reaching and shocking decision that allows bosses to reach beyond the boardroom and into their employees’ bedrooms. The majority claims that its ruling is limited, but that logic doesn’t hold up. Today it’s birth control; tomorrow it could be any personal medical decision, from starting a family to getting life-saving vaccinations or blood transfusions.”

Ninety-nine percent of sexually active women in the U.S. use birth control for a variety of health reasons, according to research by women’s health organizations.

“The fact of the matter is that birth control is a wildly popular and medically necessary part of women’s health care,” said Nita Chaudhary, co-founder of UltraViolet, a national women’s advocacy organization.Chaudhary adds that despite its clear necessity for the reproductive health of the majority of women, one in three women have struggled at some point to afford birth control.

Monday’s ruling focuses specifically on companies that are “closely-held,” which analysts report covers over 90 percent of businesses in the United States.

The dissenting opinion, penned by Justice Ruth Bader Ginsburg and supported by Justice Sonia Sotomayor and mostly joined by Justices Elena Kagan and Stephen Breyer, acknowledges that the decision was of “startling breadth” and said that it allows companies to “opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.”

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