A recent court ruling in Texas has put the insurance coverage of preventative healthcare services in jeopardy, including a drug that reduces the risk of HIV transmission by close to 100%.
On March 30, a federal judge in Texas issued an order in Braidwood v. Becerra, blocking a requirement under the Affordable Care Act that all preventive healthcare services must be covered by health insurance plans without cost sharing.
Those healthcare services include PrEP (Pre-exposure Prophylaxis), a drug that is nearly 100% effective at preventing the transmission of HIV.
The plaintiffs in the case argued that requiring insurance companies to pay for PrEP violated their religious beliefs.
Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas agreed, and ruled that such coverage would force the plaintiffs to be “complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.”
O’Connor is widely known to be one of the most conservative justices in the country, notably ruling in 2018 that the Affordable Care Act was unconstitutional, a decision that was reversed by the Supreme Court.
Swift Response
LGBTQ+ and healthcare organizations were quick to decry the ruling.
Make no mistake, we will see more HIV transmission as a result of this ruling.
Ben Klein, GLAD Senior Director of Litigation and HIV Law.
“[The] order in Braidwood v. Becerra will have direct and devastating consequences for efforts to combat the HIV epidemic,” said Ben Klein, GLAD Senior Director of Litigation and HIV Law. “We have a safe, approved therapy, PrEP (Preexposure Prophylaxis), that is nearly 100% effective at preventing transmission of HIV but that remains underutilized, particularly among Black and Latinx communities.
“Ending the requirement that insurers cover PrEP with no cost-sharing will increase new HIV diagnoses and exacerbate racial health disparities when what we need is to be ensuring more people have access to PrEP,” Klein added. “Copays and deductibles deter people from accessing healthcare. Make no mistake, we will see more HIV transmission as a result of this ruling.”
In a recent study led by the Yale School of Public Health, researchers found a ruling like this could potentially result in more than 2,000 cases of HIV in the upcoming year.
In Ohio, the ruling could have far-reaching effects.
“Cuyahoga, Franklin and Hamilton, were deemed to have HIV rates worthy of being included in the federal ‘End the HIV Epidemic’ initiative launched in 2018,” said Kenyon Farrow, board president of the LGBT Community Center of Greater Cleveland and one of the architects of the End the HIV Epidemic initiative.
“This decision, if upheld by higher courts, will make accessing PrEP harder and more expensive for most people, undermine the goals toward ending the epidemic, and could actually gut many of the Affordable Care Act provisions requiring insurance companies to cover a range of preventative health care services and screenings at no cost to patients,” Farrow said. “Even people not using PrEP should be worried about the outcome of this lawsuit.”
Dr. Rhea Debussy, Director of External Affairs at Equitas Health, extolled the life-saving benefits of PrEP and noted Judge O’Connor’s problematic history.
“This ruling from Texas is absolutely disappointing,” Debussy said. “However, this specific judge has issued similarly problematic rulings about PrEP and the ACA in the past. Even so, higher courts have not affirmed his so-called legal logic.”
The question now becomes whether this ruling will be upheld.
“Nothing’s going to happen right away because insurance will probably stay the same until open enrollment period,” A. David Paltiel, a professor at the Yale School of Public Health, told Salon there will likely be a gap in legal action until the open enrollment period.
“But if insurers are no longer required to cover these things completely, no cost sharing, no deductibles, no copays, many of them are going to scale back,” Paltiel said. “And if they do, access will be curtailed.” 🔥
Ignite Action:
- Read the profiles created by The Body about the three Ohio counties targeted by the “Ending the HIV Epidemic Plan”: Cuyahoga County, Franklin County and Hamilton County.
- Learn more about TelePrEP, an Equitas Health program in which you can meet with a medical provider and pharmacist through Zoom. If PrEP is a good match for you, medication can be delivered within 24 hours.
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