When I was a young woman, private insurers did not have to cover contraception, which was a hardship for me as a single mother working a minimum-wage job while putting myself through community college. Since the Affordable Care Act (ACA) mandated that private health plans cover many preventive services, from cancer screenings to pre-exposure prophylaxis (PrEP), this was not something today’s young people had to worry about.
And I applaud this idea. It makes sense. This is not complicated: Prevention is a lot cheaper than cure.
But not everyone agreed. On March 30, a U.S. District Court judge in Texas issued a final ruling in Braidwood Management v. Becerra, which challenged the legality of the preventive care mandates on constitutional grounds, and specifically, the requirement to cover PrEP on religious grounds.
About 100 million people in the United States have private insurance requiring preventive services to be covered, so this ruling will affect many people, both in and outside the LGBTQ+ community, according to the Kaiser Family Foundation (KFF). Vaccinations, cancer screenings and more have all been covered, which turned out to be pretty popular among most Americans, according to the Kaiser Family Foundation..
Several organizations, including the Infectious Diseases Society of America and the HIV Medicine Association, objected to the ruling, calling it “a major setback to ending HIV as an epidemic and for improving the health of Americans by preventing the spread of other infectious diseases in the United States.”
The American Academy of Family Physicians had a similar view, saying the AAFP was “alarmed and disappointed” by the ruling, which the organization said will create “insurmountable barriers to screenings, counseling, and preventive medications that improve individual patient and population health, including pre-exposure prophylaxis (PrEP) medications for the prevention of HIV.”
Although the KFF called the ruling “sweeping,” it will not immediately stop all preventive services from being covered “because the ruling applies specifically to services recommended by the U.S. Preventive Services Task Force (USPSTF) that were made after 2010.” Screenings like mammograms will still be covered because the recommendation occurred before 2010.
Unfortunately, PrEP, which is 99% effective in preventing HIV, and is a cornerstone of ending HIV in this country, will not. KFF has a nice summary of which services will be affected here: bit.ly/3HgFxT5-IDSE.
The federal government is appealing the decision.
In the meantime, if you think all preventive services should be covered, contact your state and federal representatives and tell them what you think. And vote. Recent events aside, voting, supporting candidates and letting your representatives know what you think can still create change.
—Marie Rosenthal, MS
The views expressed here belong to the author and do not necessarily reflect those of the publisher.
This article is from the May 2023 print issue.