Texas judge rules that forcing businesses to provide HIV preventative drugs is unconstitutional

In the case of Braidwood Management v. Becerra, a Christian business owner had brought a case to court in which he objected to part of the Affordable Care Act (ACA). The business owner had to cover the cost of his employee’s HIV prevention drug, PrEP, and his objection to this act was that it has certain provisions within it which encourage homosexual behavior, sexual relations between men and women before marriage and intravenous drugs. He claimed that doing so would go against his Christian beliefs and values and if he upheld the act, he would be complicit to all these acts.

While government judges did argue that it was incorrect to assume that PrEP encourages said behaviours, the court was not concerned with the rightness of the belief but the sincerity of them.  

Associate dean of academics at the Indiana University Kelley School of Business, Josh Perry said that the court eventually decided that forcing a small business owner to fulfil this obligation would place an unnecessary burden on his religious freedom that the Religious Freedom Restoration (RFRA) Act does not stand for.

This judge, in this case, was U.S. District Judge Reed O’Conner. The federal judge located in Fort Worth, Texas, elaborated that his reasoning behind the decision was that fulfilling the ACA requirement under which employers and insurance companies provide free HIV medication to employees is a violation of the Christain business owner’s freedom of religion. He also called the law unconstitutional on the basis that the system which the government uses for deciding which preventive care services should be covered under the healthcare law is unconstitutional itself.

It is also not the first time that Judge O’Conner has objected to the ACA. In the past the same judge had termed the act unconstitutional as well. However, the verdict did not hold up in the Supreme Court, therefore, it is a possibility that this decision might also be overturned.

Nancy Neilson, the Senior Associate Dean for Health Policy at Jacobs School of Medicine and Biomedical Sciences, commented on the judgement and stated that prevention and early detection of diseases make healthcare less costly. This ruling will cause overall healthcare costs to increase and individuals will most likely experience poor health.

Public health experts are also concerned that this ruling could weaken the capacity of the ACA to provide preventive care to a large set of Americans, around 49% of whom rely on employer-sponsored health insurance.

Organisations such as Protect Our Care have also highlighted how the ruling threatens other health services provided under the ACA. These include, but are not limited to, health screenings, contraceptives, vaccinations and prenatal care.

Pre-Exposure Prophylaxis or PrEP, the drug that is used to treat HIV, is fairly expensive and not covered by insurance, Neilson has raised concerns that with the following laws in place, a lot of Americans will no longer have access to the drug.

“Prep prescriptions can cost as much as $20,000 annually”, Perry further explained.”But they are also extremely effective, it can reduce the chances of getting HIV from sex around 99% and 74% from  intravenous drugs.”