A fifth federal appeals court has said the Obama administration has sufficiently excused religious nonprofits from the Obamacare birth control mandate.

The U.S. Court of Appeals for the 10th Circuit ruled Tuesday that two nonprofits — the Catholic Little Sisters of the Poor and Reaching Souls International — must comply with the accommodation provided to religious charities, hospitals and schools.

While businesses must cover all types of birth control in their employee health plans under the Affordable Care Act, some employers with religious objections can get around the requirement by delegating that responsibility to a third party. But many groups, including Little Sisters and Reaching Souls, say they're still complicit in providing birth control coverage even with the accommodation.

But the Denver-based 10th Circuit disagreed, ruling that the Obama administration has sufficiently accommodated such groups' religious beliefs.

"Although we recognize and respect the sincerity of plaintiffs' beliefs and arguments, we conclude the accommodation scheme relieves plaintiffs of their obligations under the mandate and does not substantially burden their religious exercise under [the Religious Freedom Restoration Act] or infringe upon their First Amendment rights," wrote Judge Scott Matheson, an Obama appointee.

Two other justices, one a Reagan appointee and the other a Carter appointee, agreed with the decision.

Little Sisters of the Poor Director Loraine Marie Maguire said the birth control requirement constitutes "government intrusion"

"As Little Sisters of the Poor, we simply cannot choose between our care for the elderly poor and our faith," she said. "And we should not have to make that choice, because it violates our nation's commitment to ensuring that people from diverse faiths can freely follow God's calling in their lives."

Four other federal appeals courts have rebuffed similar challenges to the birth control accommodation, while none has upheld them. Two Baptist universities and a seminary have asked the Supreme Court to take up the issue.