Medical groups ‘deeply disturbed’ by judge’s decision that puts ACA’s PrEP coverage at risk
September 08, 2022
2 minute read
Key points to remember
- A federal judge has ruled that the Affordable Care Act’s requirement for insurers to provide plans for free HIV prevention drugs is unconstitutional.
- The decision is another example of “unacceptable interference with science”, said Marwan Haddad, MD, MPHPresident of the HIV Medicine Association.
Medical organizations are expressing concern after a U.S. District Court judge struck down a requirement of the Affordable Care Act that requires employers to provide free plans that cover HIV prevention drugs.
Marwan Haddad, MD, MPHpresident of the HIV Medicine Association, said in a statement that the organization “is deeply troubled” by the decision, which will allow employers in Texas to deny coverage for pre-exposure prophylaxis, or PrEP, “a very effective in preventing HIV infection.
“This decision is yet another example of unacceptable interference with evidence-based, scientific health care practices that must remain within the sanctity of the provider-patient relationship. Denying access to PrEP threatens the health of more than 1.2 million Americans who could benefit from this potentially life-saving intervention,” Haddad said in the statement. “Religious denial laws that allow the personal beliefs of employers or health care providers to dictate access to prevention, care and treatment services are discriminatory and dangerous. These laws end up hurting everyone.
The ACA required employers and insurers to cover “evidence-based items or services that actually have an ‘A’ or ‘B’ rating in the current recommendations of the United States Preventive Services Task Force. United” without cost-sharing requirements. The USPSTF gave PrEP an A rating in 2019.
Steven F. Hotze, MD, the president of Braidwood Management Inc., an employer in Texas and a plaintiff in the case, argued that “these drugs facilitate behaviors such as homosexual sodomy, prostitution and intravenous drug use, all of which are contrary to Dr. Hotze’s sincere religious beliefs. ”
Hotze, also CEO of the Hotze Medical Association, also took issue with preventive care mandates such as coverage of STD screenings for people “with non-marital sexual behavior.”
Judge Reed O’Conner wrote that the defendants, who argued that reducing the spread of HIV is a “compelling governmental interest,” have failed to prove that requiring PrEP furthers that interest. He also said the government had failed to prove that PrEP “was the least restrictive way to further” that interest, adding that “the PrEP mandate significantly burdened the religious exercise of Braidwood owners.”
Sterling N. Ransone, Jr., MD, FAAFPpresident of the American Academy of Family Physicians, said in a statement that “family physicians are alarmed” by the decision.
“If today’s decision stands, it will jeopardize health outcomes by creating financial barriers to preventive testing, counseling and medication that improves the health of our patients,” Ransone said in the statement. “The AAFP calls on legislators, insurers and health plan sponsors to ensure that patients can continue to access essential, high-value preventive services without cost sharing.”