Texas Judge Says Obamacare Can't Require Coverage for Meds That Prevent HIV

September 8, 2022
By Cara Murez and Robin Foster HealthDay Reporters

Hundreds of thousands of Americans take medications intended to prevent infection with HIV, but a federal judge in Texas ruled Wednesday that a provision in the Affordable Care Act (ACA) that requires free coverage of the drugs violates the religious beliefs of a Christian-owned company.

U.S. District Judge Reed O'Connor made the ruling Wednesday about Truvada and Descovy, commonly known as PrEP, NBC News reported.

The ruling stemmed from a lawsuit filed by Jonathon Mitchell, former Texas solicitor general and conservative activist, who filed it on behalf of the company Braidwood Management Inc.

"Defendants do not show a compelling interest in forcing private, religious corporations to cover PrEP drugs with no cost-sharing and no religious exemptions," O'Connor ruled.

Reaction to the decision was swift.

"This ruling is yet one more instance of unacceptable interference in scientific, evidence-based health care practices that must remain within the sanctity of the provider-patient relationship," Dr. Marwan Haddad, chair of the HIV Medicine Association, said in a statement. "Denying access to PrEP threatens the health of the more than 1.2 million Americans who could benefit from this potentially lifesaving intervention. Religious refusal laws allowing the personal beliefs of employers or health care providers to dictate access to prevention, care and treatment services are discriminatory and dangerous. These laws ultimately hurt everyone."

Mitchell Warren, executive director of the HIV nonprofit AVAC, noted that PrEP is a "core component" in the fight against the spread of HIV.

"This ruling is shocking on every level,"Warren said in a statement. "It defies evidence, logic, public health and human rights, and sets back enormous progress in the fight to end the HIV epidemic."

Most insurers were required to cover PrEP starting in January 2021 after it received an "A rating"by the U.S. Preventive Services Task Force in 2019. Not all insurers are following that policy, which concerns some public health experts.

Truvada reduces the risk of contracting HIV by 99% among men who have sex with men and by 90% among women. It has been used as PrEP since 2012. Descovy was approved in 2019. Both drugs are made by the company Gilead Sciences.

"Increasing PrEP access in the United States has been a key public health goal, and the requirement that private insurers provide PrEP with no cost-sharing was a key way in which access has been promoted,"Jennifer Kates, director of global health and HIV policy at the Kaiser Family Foundation, told NBC News. "However, this latest ruling would re-introduce a barrier that would result in less access, as fewer individuals would be able to afford this critical intervention."

O'Connor has called the ACA unconstitutional in the past, NBC News reported, and he has become the go-to judge when conservatives seek to challenge decisions based on the ACA or other measures such as protecting transgender students. He was appointed by former President George Bush.

More information

The U.S. Centers for Disease Control and Prevention has more information on PrEP.

SOURCE: NBC News

Sexually Transmitted Diseases: AIDS/HIV