Federal judge rules against ObamaCare coverage of HIV prevention drugs

A federal judge in Texas struck down a key provision of the Affordable Care Act that requires insurers and employers to cover HIV prevention drugs, ruling that the requirement violates the religious freedom of a Christian-owned company.

The ruling by Judge Reed O’Connor — who previously struck down the entire ObamaCare law before it was upheld by the Supreme Court — was a partial victory for the challengers.

It was not immediately clear what kind of impact the ruling would have beyond the employers challenging the provision, but it could determine whether the rest of the law’s preventive care coverage requirements will remain.

The Texas employers who challenged the provision argued it violates the Religious Freedom Restoration Act by forcing people to pay for coverage that conflicts with their faith and personal values.

Specifically, they said paying for health plans that cover HIV prevention drugs, known as PrEP, makes them “complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.”

PrEP reduces the risk of getting HIV by 99 percent when taken as recommended, according to the Centers for Disease Control and Prevention. There are two pills approved for use as PrEP: Truvada and Descovy. 

O’Connor also ruled against the broader preventive services covered under the U.S. Preventive Services Task Force, including colorectal and other cancer screenings, depression screenings and hypertension screenings, among many others. O’Connor said the task force’s system for deciding which services should be fully covered was unconstitutional. 

O’Connor upheld some requirements for immunizations as well as for certain services for women and children. 

O’Connor did not rule on the scope of relief or remedy, and asked the parties for additional briefs by Friday, including how to proceed on the law’s contraceptive mandate.

The lawsuit was led by Jonathan Mitchell, the architect of Texas’s six-week abortion law that offers a $10,000 bounty to private citizens who successfully sue abortion providers.

An analysis by the Robert Wood Johnson Foundation in July found that overturning the preventive services requirement could threaten access to life-saving care for nearly 168 million Americans covered under private employer health plans as well as the ACA’s individual market plans.