Federal Judge Rules That Employers Can Refuse to Cover HIV Prevention Drugs on Religious Grounds

The Affordable Care Act requires insurance plans to cover PrEP, but a judge in Texas decided that violates employers' religious freedom.

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Federal Judge Rules That Employers Can Refuse to Cover HIV Prevention Drugs on Religious Grounds
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A conservative federal judge in Texas ruled Wednesday that requiring employers to cover PrEP HIV prevention drugs in their health insurance plans, as the Affordable Care Act does, violates their right to religious freedom.

U.S. District Judge Reed O’Connor, a George W. Bush appointee, decided in favor of Braidwood Management, a Christian-owned, Texas-based company. He ruled that it shouldn’t have to cover the cost of Truvada and Descovy—drugs that hundreds of thousands of Americans take daily to prevent HIV transmission—because Braidwood’s owners have religious objections to gay sex. O’Connor cited the 1993 Religious Freedom Restoration Act, the same law that the Supreme Court ruled in 2014 protects employers’ right to refuse to cover birth control.

Journalist and legal expert Chris Geidner noted in a Twitter thread about the ruling that O’Connor “has a history of anti-LGBTQ rulings, both as to marriage and Title IX’s sex discrimination ban,” as well as a “history of overstepping” with his decisions. Slate legal reporter Mark Stern added that gutting the prevention coverage requirements of the Affordable Care Act could free “private insurers from the obligation to provide so much basic coverage—again, we’re talking vaccines, pregnancy care, cancer screening and treatment … The list is nearly endless.”

O’Connor’s decision comes during a massive wave of right-wing homophobic and anti-trans panic. Republicans have been railing against drag brunches and sex ed; are trying to criminalize doctors and parents who provide gender-affirming care to trans teens and kids; want to pull LGBTQ-related books off library shelves and out of classrooms; and have not-so-subtly hinted since the Supreme Court overturned Roe v. Wade in June that they’re also coming for same-sex marriage. A federal judge ruling that employers have no obligation to cover drugs that save lives, simply because the employer hates gay people, is just the latest escalation in this war.

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