Texas rules to remove PrEP from healthcare plans for 'religious reasons'

A ruling by a Texas judge to remove PrEP from the Affordable Care Act could have nationwide implications.

PrEP has been removed from the Affordable Care Act by a Judge in Texas. The image shows a PrEP drug called Truvada being emptied from a white container onto a glass plate. The pills are blue.
Image: @ajplus via Twitter

A conservative federal judge in Texas has ruled in favour of two companies permitting them to remove PrEP from their employees’ healthcare plans.

Braidwood Management and Kelley Orthodontics brought a case in front of the US District Court for the Northern District of Texas on the grounds that the requirement to pay for PrEP contravened the owners’ Christian beliefs. 

They argued it, “forces religious employers to provide coverage for drugs that facilitate and encourage homosexual behavior, [sic] prostitution, sexual promiscuity, and intravenous drug use.”

On Wednesday, Judge Reed O’Connor, who has a record of ruling against the Affordable Care Act (ACA) also known as ‘Obamacare’, ruled that the inclusion of PrEP in the ACA violated the Religious Freedom Restoration Act.

In a tweet, legal affairs editor Chris Geidner highlighted Judge O’Connor’s previous anti-LGBTQ+ decisions. “O’Connor also has a history of anti-LGBTQ rulings, both as to marriage and Title IX’s sex discrimination ban.”

He continued by questioning the validity of O’Connor’s rulings saying, “He also has a history of overstepping, even in this era, and his rulings have repeatedly been reversed on appeal or effectively overturned by contrary SCOTUS opinions.”

In 2018, O’Connor, who was appointed as a federal judge by President Bush in 2007, ruled the ACA to be “invalid”, this judgment was later overruled by the Supreme Court.

Unless challenged in the Supreme Court, Wednesday’s ruling means that neither company will be expected to cover the costs of two PrEP drugs, Truvada and Descovy, irrespective of their employees’ sexual orientation.

It is uncertain as to whether on not the ruling will have a nationwide impact or whether it will just affect Braidwood Management and Kelley Orthodontics.

Responding to the ruling, the Biden administration responded in a tweet saying they were reviewing the decision. 

Defending the White House press secretary Karine Jean-Pierre wrote, “In addition to making affordable health insurance available to millions of Americans, the ACA has guaranteed free access to critical preventive medical services—from cancer screenings to HIV prevention drugs like PrEP.”

She continued, “That guarantee is critical to the health and wellbeing of millions of Americans, particularly LGBTQI+ Americans, people of colour, [sic] pregnant women, and others.”

She concluded, “The Administration is committed to protecting Americans’ access to free preventive health care and building upon the successes of the Affordable Care Act.”

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