#prep access

The U.S. Supreme Court on Friday upheld a key provision of the Affordable Care Act, ruling in Kennedy v. Braidwood that health insurance companies must continue covering preventive services recommended by a federal task force — including HIV prevention medication, cancer screenings, and vaccines. The case challenged the United States Preventive Services Task Force’s preventive care ratings that require health insurance plans to cover recommended preventive services under the ACA. At issue was whether insurers could be compelled to cover services such as pre-exposure prophylaxis, or PrEP, which prevents HIV transmission. Public health experts say PrEP access is especially vital for Black and Latine gay and bisexual men and transgender women, who are disproportionately impacted by HIV.

A lower court had ruled that requiring PrEP coverage was akin to supporting homosexuality and, therefore, a violation of religious rights. However, advocates are concerned about further legal challenges that may appear. PrEP access has been maintained for most Americans after an appeals court ruling ended a lawsuit that challenged the medication’s coverage. In a ruling that upholds crucial components of the Affordable Care Act, the Fifth Circuit Court of Appeals ruled on Friday in Braidwood Management, Inc. v. Becerra, mandating that most insurance providers continue to cover preventive services, including PrEP medication. The Advocate was first to report in 2022 that the plaintiffs, led by Jonathan Mitchell, an ultraconservative Texas lawyer with a history of challenging LGBTQ+ rights, argued that the ACA’s requirement for insurance plans to cover preventive services violated their religious freedom. They specifically objected to covering PrEP, pre-exposure prophylaxis, a medication that prevents HIV transmission, citing their Christian beliefs against homosexuality. Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas, who has also been allergic to LGBTQ+ causes, initially sided with the plaintiffs, ruling that the ACA mandate infringed on their religious freedom. The Department of Justicequickly appealed to the Fifth Circuit Court of Appeals, which has jurisdiction over Texas, Louisiana, and Mississippi. In its ruling, the Fifth Circuit upheld the lower court’s decision but limited the scope of the exemption to the plaintiffs in the case. This means that the broader mandate requiring most insurance providers to cover preventive services, including PrEP, remains in effect for the rest of the nation.

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