A federal judge in Texas ruled on Wednesday against an Affordable Care Act (ACA) requirement that employers must cover the cost of common HIV/AIDs medications.
"Defendants do not show a compelling interest in forcing private, religious corporations to cover PrEP drugs with no cost-sharing and no religious exemptions," US District Judge Reed O’Connor wrote in his ruling.
Public health advocates called the ruling “shocking,” arguing that by striking down the Obamacare regulation, the courts had taken away vital tools in making the disease far less lethal.
“This ruling is shocking on every level,” Mitchell Warren, executive director of the HIV nonprofit AVAC, told NBC News. “It defies evidence, logic, public health and human rights and sets back enormous progress in the fight to end the HIV epidemic."
The lawsuit, which will likely be appealed by the federal government, challenged a decision by the US Preventitive Services Task Force. The body in 2020 held that most employer health plans must offer HIV medications like Truvada and Descovy, commonly known as PrEP, for free as preventitive care under the ACA.
A group of self-described Christian business owners and employers launched the suit challenging the requirement with the help of Jonathan Mitchell, the former Texas solicitor general and conservative activist known for helping craft the state’s controversial bounty-style abortion restriction law.
One of the plaintiffs, Dr Steven Hotze, of Katy, Texas, argued that covering the drugs went against his religious beliefs because “these drugs facilitate or encourage homosexual behavior, which is contrary to Dr. Hotze’s sincere religious beliefs.”
Public health officials said this view of HIV treatment is incomplete, noting that the disease doesn’t discriminate based on gender or sexual orientation. One in five new cases of HIV are in women, according to the CDC.
“The virus doesn’t choose who to infect, it can infect anyone,” Dr Satish Mocherla, an infectious disease specialist at Legacy Community Health Services in Dallas. told The Texas Tribune. “So why a particular demographic is being targeted is a mystery to us.”
Medical providers also worried the ruling could open the door to further religious challenges against common preventative medical procedures that are facially neutral when it comes to religious practice.
“With an adverse ruling, patients would lose access to vital preventive health care services, such as screening for breast cancer, colorectal cancer, cervical cancer, heart disease, diabetes, preeclampsia, and hearing, as well as access to immunizations critical to maintaining a healthy population,” wrote the American Medical Association, as part of a statement from a group of 60 medical associations, in response to the original lawsuit.
The medications at issue have dramatically lowered the risk of individuals contracting the disease, which has killed more than 700,000 people in the US since 1981.
Roughly 35,000 people are infected with HIV each year, according to the Kaiser Family Foundation.
PrEP reduces the risk of contracting HIV by more than 90 per cent.
Judge O’Connor’s court has long been the venue for challenges to the ACA.
In 2018, the George W Bush appointee ruled the entire healthcare law unconstitutional, a decision ultimately overturned in the US Supreme Court.
Since then, the judge has been the go-to magistrate for conservatives seeking to challenge provisions of Obamacare.
