A federal appeals court ruled Thursday that President Barack Obama's health care law unjustly burdens religiously affiliated employers by forcing them to help provide insurance coverage for certain contraceptives, even though they can opt out of directly paying for it.

The ruling by a three-judge 8th U.S. Circuit Court of Appeals panel in St. Louis upheld lower court decisions that sided with plaintiffs who included three Christian colleges in Missouri, Michigan and Iowa.

The 25-page opinion conflicts with all other federal appellate courts, which have found in the U.S. government's favor.

As religiously affiliated entities, those colleges victorious with Thursday's ruling don't have to pay directly for their workers' birth control. Instead, they can seek an accommodation that requires their insurance providers to pay for it. But the groups still say the scheme makes them complicit in the providing of contraception and subjected them to possible fines for noncompliance.

Circuit Judge Roger Wollman, writing the ruling on the panel's behalf, wrote that the contraceptive mandate and accommodation process of the Affordable Care Act substantially burdens the plaintiffs' exercise of religion.

Those plaintiffs included Heartland Christian College in Newark, Missouri, Dordt College in Sioux Center, Iowa, and Cornerstone University in Grand Rapids, Michigan, as well as Bethel, Missouri-based CNS International Ministries Inc., a nonprofit provider of addiction services.

The Justice Department, which has called the lawsuits meritless and an attempt to prevent female employees from obtaining coverage, defended the federal government in the cases but directed The Associated Press' questions Thursday to the White House, where a statement called the rulings disappointing.

"As all of the other seven U.S. courts of appeals to address this issue have held, the contraceptive accommodation process strikes the proper balance between ensuring women have equal access to health care and protecting religious beliefs," that statement read.

The Obama administration did not indicate whether it would appeal, including asking the full 8th Circuit to consider the matter.

Messages left with many of the attorneys for the plaintiffs were not immediately returned.

Lawsuits over the contraceptive mandate have been part of the lengthy political and legal battle over the health-care law Obama signed in 2010, with roughly 100 lawsuits from businesses and religiously affiliated colleges, hospitals and other not-for-profit organizations challenging the contraceptives requirement.

Federal appeals courts largely have ruled that informing the government of a religious objection does not interfere with the groups' religious rights. Several appeals already are pending at the Supreme Court.

In 2014, the Supreme Court ruled in favor of family-controlled businesses with a religious objection to paying for some or all of the approved contraceptives. Their employees still could receive the birth control, but through an arrangement with the businesses' insurers or third-party insurance administrators. The government covers the cost of the contraceptives in those circumstances.