Texas Judge Ruled Against Mandate Requiring Employers to Offer HIV Prevention Drug Coverage

By Lou Portero - Last Updated: January 3, 2023

A federal judge in Texas ruled in September against the mandate requiring that employers provide health insurance coverage for drugs that prevent transmission of HIV, stating that the requirement is unconstitutional and infringes on the religious right of the employers.

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The 2020 mandate is a part of the Affordable Care Act, which requires that employers offer insurance plans that cover HIV-prevention pills, known as PrEP drugs. Following the mandate, some Texas business owners and residents filed a lawsuit, arguing that it forced them to sponsor health care coverage violating the Religious Freedom Restoration Act.

According to the lawsuit, this mandate required them to go against their religious beliefs, stating that providing coverage for PREP drugs would “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use,” 

HIV Activists, however, dismissed that notion. According to Gary McCoy, an HIV-positive advocate in San Francisco, “Limiting and prohibiting a preventative medication … will not prohibit homosexual behavior, drug use or sexual activity”. But, he also added, “Those are things that are going to happen regardless of one’s religious beliefs.”

Furthermore, HIV/AIDS advocates say the ruling would create financial hurdles for access to drugs preventing HIV and increasing HIV infections, with the virus already disproportionately affecting marginalized communities.

Austin Attorney Jonathan Mitchell, who also drafted Texas’s six-week abortion ban, served as the suit’s lead counsel. The judge, Reed O’Connor, who delivered the ruling, has previously dismantled Obamacare with several decisions, including one declaring the entire Affordable Care Act unconstitutional, which the US Supreme Court later overturned. 

“This was not a surprising ruling, given the individuals behind bringing this case and the jurisdiction in which they brought it,” Kenyon Farrow, managing director for advocacy and organizing at PrEP4ALL, told USA TODAY.

Several others found the judge’s decision disturbing. “Today’s decision basically says you could subject your employees to a higher risk of HIV transmission simply because you just have a disdain for their identity,” Anthony Michael Kreis, assistant professor of constitutional law at Georgia State University, told USA TODAY in an interview. “That is just noxious, not only to the American Civil Rights tradition but to basic tenants of public health as well,” he added.

According to the National Minority AIDS Council, employer-provided insurance is often the only way for those at high risk for HIV to access PrEP medications.

“While not a surprise, this decision is deeply disappointing and could cripple HIV prevention efforts, particularly among communities of color and communities of poverty,” the organization wrote in a statement. 

Following the judge’s decision, the ruling could be appealed by the Department of Health and Human Services, the defendant in the case.

Source: USA Today

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