Health Law

Insurers don't have to provide free HIV-prevention drugs, some cancer screenings as result of federal judge's ruling

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HIV PrEP pills in a bottle

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A federal judge in Fort Worth, Texas, has blocked requirements for insurers to provide some preventive-care services for free, including drugs for HIV prevention and screenings for depression, high blood pressure, sexually transmitted diseases and some kinds of cancer.

U.S. District Judge Reed C. O’Connor of the Northern District of Texas ruled Thursday in a lawsuit filed by six individuals and two businesses, including Braidwood Management Inc., a Christian for-profit corporation.

O’Connor gave nationwide effect to his former September 2022 decision on the validity of the task force that adopted the mandates under the Affordable Care Act. In that decision, he ruled that coverage mandates adopted by the U.S. Preventive Services Task Force weren’t valid because task force members were appointed in violation of the appointments clause. O’Connor also ruled in the previous decision that the mandate for HIV-prevention drugs violated the rights of religious plaintiffs under the Religious Freedom Restoration Act.

O’Connor did not decide on a remedy when he issued the September decision.

Bloomberg Law has coverage of O’Connor’s latest decision, while Slate reporter Mark Joseph Stern linked to the decision in a tweet.

O’Connor’s September decision on the validity of the task force did not invalidate preventive-care requirements formulated by two other groups created by the secretary of the Department of Health and Human Services: the Health Resources and Services Administration and the Advisory Committee on Immunization Practices.

A United States of Care fact sheet lists the preventive-service mandates that were adopted by each group.

Natalie Davis, CEO and co-founder of United States of Care, criticized O’Connor’s March 30 decision in a March 30 press release.

“This decision introduces uncertainty into an aspect of the health care system that people have benefited from for nearly a decade: access to preventive care with no out-of-pocket costs,” Davis said. “This ruling means that nearly half of Americans, over 151 million people, may lose access to free preventive services, such as mental health, weight loss measures and various cancer screenings that we have all come to depend on. Additionally, this is yet another step on the dangerous path to allowing politicians and judges to make health care decisions, overruling nonpartisan experts who have the best interests of the public in mind.”

Plaintiffs in the case wanted the option to purchase health coverage that didn’t include mandated coverage for services that they didn’t use. Religious plaintiffs also objected to HIV-prevention coverage on the ground that it promoted behavior that was against their beliefs.

The case is Braidwood Management Inc. v. Becerra.

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