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‘Religious freedom’ now threatens PrEP coverage thanks to a Texas judge

PrEP/Truvada
Posed by models (Photo: Shutterstock)

A federal judge in Texas has sided with two companies that don’t want to pay toward their employees’ PrEP, the medication that, when taken daily, prevents HIV infection.

Judge Reed O’Connor, a Bush appointee for the US District Court for the Northern District of Texas, ruled yesterday that paying for PrEP via the Affordable Care Act (Obamacare) violates the Religious Freedom Restoration Act.

Christian businesses Braidwood Management and Kelley Orthodontics brought the case against the US Department of Health. The former has 70 employees and is owned by Steven Hotze, a conservative activist in Texas.

The businesses argued that PrEP conflicted with their owners’ religious beliefs. They claim paying for PrEP, “forces religious employers to provide coverage for drugs that facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.”

This is not the first time Judge O’Connor, described by The Hill as a “notorious Republican”, has taken a swipe at the ACA. He ruled in 2018 that the entire law was invalid. That judgment was later overruled by the Supreme Court.

It is unclear whether the ruling applies nationwide or just to the two businesses concerned.

“What happens next remains a wide open question as to whom it affects,” Tim Jost, emeritus professor at the Washington and Lee University School of Law, told CNN.

The White House responds to PrEP ruling

The Biden administration moved swiftly to respond to the ruling.

White House press secretary Karine Jean-Pierre tweeted, “The Administration is reviewing today’s decision by the Northern District of Texas. The Affordable Care Act has been the law of the land for over 10 years.

“In addition to making affordable health insurance available to millions of Americans, the ACA has guaranteed free access to critical preventive medical services—from cancer screenings to HIV prevention drugs like PrEP.

“That guarantee is critical to the health and wellbeing of millions of Americans, particularly LGBTQI+ Americans, people of color, pregnant women, and others.

“The Administration is committed to protecting Americans’ access to free preventive health care and building upon the successes of the Affordable Care Act.”

Decision by Texas federal judge slammed by HIV experts

PrEP has been credited with greatly reducing HIV infections since its introduction in 2012. Judge O’Connor’s ruling has been widely criticized.

“Without covering PrEP, highly at-risk populations — mostly gay and bisexual men and Black women — will continue to become infected with HIV, perpetuating this ongoing epidemic in our society,” Perry N. Halkitis, Dean of the Rutgers School of Public Health, said in a statement to Queerty.

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a statement: “To single out PrEP, FDA-approved drugs that effectively prevent HIV, and conclude that its coverage violates the religious freedom of certain individuals, is plain wrong, highly discriminatory, and impedes the public health of our nation.”