Supreme Court to Hear Case Challenging Free PrEP Distribution
Two Christian-led companies are challenging the Affordable Care Act (ACA) mandate requiring insurance providers to cover the cost of pre-exposure prophylaxis (PrEP) medication used to prevent the spread of HIV—and as of January 10, the Supreme Court has elected to take on the case.
Kelley Orthodontics and Braidwood Management Inc., both employers that unsurprisingly hail from Texas, originally sued the federal government over the mandate in 2020 alongside some individual Texas residents. They were first represented by the same former solicitor general that helped to draft up the state’s six-week abortion ban, which was effectively the first of it’s kind being conceptualized pre-fall of Roe v. Wade—Jonathan Mitchell. Mitchell said of his clients’ justification for their lawsuit that the inability to select an insurance provider for their company policy that doesn’t cover preventative care for HIV “violates their religious beliefs by making them complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.”
The plaintiffs argue that this is in violation of the Religious Freedom Restoration Act, and said that the U.S. Preventative Services Task Force (who helped put the mandate in place) is an unconstitutionally appointed body. The case has naturally progressed through the judicial system, gaining a ruling in favor of the plaintiffs in 2022 from a federal judge in Texas and a similar result last June from the Fifth Circuit Court of Appeals. The Circuit Court said that no-cost coverage of PrEP is a violation of the Appointments clause of the U.S. Constitution, as members of the Preventative Services Task Force are not presidentially appointed with Senate confirmation.
Overall, this outcome allows employers to deny coverage of PReP on company insurance policies, which is not only horrifically discriminatory in multiple ways, but also harrowing to consider the future effects of. It hearkens back to the AIDS crisis, which is an almost-certainly-fatal disease that evolves from contraction of HIV and the fifty thousand deaths AIDS has caused in the United States since 1987, with a large chunk taken out of our own queer community. The World Health Organization, which the new president has bullheadedly withdrawn the United States from, still classifies HIV as a global epidemic, as literally anybody can contract HIV and subsequently develop AIDS regardless of their sexual orientation. However, certain states, such as Rhode Island, have enshrined access to PReP into their legislature.
Finally, it’s worth noting that if this ruling was overturned, people outside of those taking PReP would be vastly affected as well. It would roll back the entire preventative care measure outlined in the ACA mandate, which would allow insurance companies to deny colorectal cancer screenings, breast cancer screenings, and heart disease screenings as well. The outlook for an overturn is quite grim, regardless of your status within the queer community.
