CHRISTOPHER KANE | Washington Blade
Reprinted Courtesy of the National LGBT Media Association
The U.S. Supreme Court has upheld a portion of the Affordable Care Act requiring private health insurers to cover the cost of preventative care, including PrEP, which significantly reduces the risk of transmitting HIV.
Conservative Justice Brett Kavanaugh authored the majority opinion in the case, Kennedy v. Braidwood Management, which originated in Texas in 2020. Kavanaugh was joined by two conservatives, Chief Justice John Roberts and Justice Amy Coney Barrett, along with the three liberal justices, Sonia Sotomayor, Elena Kagan and Ketanji Brown-Jackson.
The plaintiffs, including the Christian company Braidwood Management, argued that the ACA’s mandate requiring health plans to cover preventive services without cost-sharing violates their constitutional and religious rights. The plaintiffs specifically objected to coverage of pre-exposure prophylaxis for HIV prevention — or PrEP citing religious objections to facilitating behavior they oppose, such as homosexual conduct and drug use.
United States District Judge Reed O’Connor of the United States District Court for the Northern District of Texas, who was nominated by President George W. Bush in 2007, ruled in favor of the plaintiffs in 2022, and in 2024 The U.S. Fifth Circuit Court of Appeals upheld his ruling.
The Supreme Court’s decision today, however, rejected the plaintiffs’ challenge to the Affordable Care Act’s reliance on the U.S. Preventative Services Task Force to “unilaterally” determine which types of care and services must be covered by payors without cost-sharing.
An independent all-volunteer panel of nationally recognized experts in prevention and primary care, the 16 task force members are selected by the secretary of the U.S. Department of Health and Human Services to serve four-year terms.
They are responsible for evaluating the efficacy of counseling, screenings for diseases like cancer and diabetes, and preventative medicines — like Truvada for PrEP, drugs to reduce heart disease and strokes, and eye ointment for newborns to prevent infections.
Parties bringing the challenge objected especially to the mandatory coverage of PrEP, with some arguing the drugs would “encourage and facilitate homosexual behavior” against their religious beliefs.