A Texas judge on Wednesday ruled that mandatory free coverage of HIV preventive medication known as PrEP violates the Religious Freedom Restoration Act.
U.S. District Judge Reed O’Connor issued a summary judgment siding with Braidwood Management, a Christian for-profit company with nearly 70 employees. Braidwood’s owner Steven Hotze believes providing coverage of PrEP “facilitates and encourages homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman,” according to the complaint.
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Judge O’Connor ruled that Braidwood showed that the PrEP mandate, outlined in the Affordable Care Act, “substantially burdens” its religious exercise. He said that the government must show that the PrEP mandate furthers a “compelling governmental interest and is the least restrictive means of furthering that interest.” PrEP prescriptions can be expensive, costing as much as $20,000 per year.
Six individuals and two businesses brought the lawsuit against the Secretary of the Department of Health and Human Services, Xavier Becerra and other government officials, challenging the legality of the preventive care mandates for several health benefits. That includes STD screenings, contraception, and PrEP coverage under the Constitution and the Religious Freedom Restoration Act (RFRA). So far, Judge O’Connor has only ruled on the section of the complaint pertaining to PrEP.
The judge’s ruling mentioned the Supreme Court decision in Burwell v. Hobby Lobby multiple times, which said that the chain of stores did not have to cover contraception since it violated the RFRA.
The case involving PrEP will likely head to the Supreme Court, too, according to David Stein, co-founder and CEO of at-home diagnostics platform Ash Wellness that specializes in STIs and HIV diagnostics. Stein takes PrEP and started the company because he felt accessing care as someone in the LGBTQ+ community was challenging.
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“This isn’t the first ruling that attacks our communities and it definitely is not the last. But in a time where HIV is still a pandemic and 22% of new cases of HIV in the US are in heterosexual people, this is dangerous and will lead to an increase in HIV cases and ultimately more stigma and shame in seeking out PrEP which dramatically reduces the spread of HIV,” Stein said in an emailed statement.
According to O’Connor’s summary judgment decision, the parties have until Friday to outline what other issues remain to be decided and provide a schedule for the remaining briefing.
Lawyers for Braidwood and for the government did not immediately reply to requests for comment.
Photo: MarcBruxelle, Getty Images
