The Supreme Court said Wednesday that it would allow companies to opt out of the federal mandate to provide paid sick leave for their employees.
The court, however, said that the requirement would apply only to employees working at large companies.
The ruling, which is the latest in a string of court decisions to weaken the federal requirement for paid sick time, came in a case brought by employees of a Connecticut-based nursing home.
The nursing home had sought to get the court to rule that it is immune from paying sick leave because it does not provide benefits under the Fair Labor Standards Act.
The Supreme Court rejected the argument.
The court said that employees at large employers would still be required to take sick leave.
The case has generated a flood of lawsuits challenging the Affordable Care Act, which President Donald Trump has said is a failure.
The federal government has argued that the ACA provides a free-market health care system, which would not be affected by a court ruling.