Federal District Court rules employers can refuse to purchase health insurance that covers PrEP

Federal District Court rules employers can refuse to purchase health insurance that covers PrEP

Truvada for PrEP is an antiretroviral medicine taken to prevent HIV infection (courtesy of Tony Webster)

In the post-Dobbs climate of right-wing reaction to what should be established as human rights protections, many people were concerned about the overturning of Supreme Court precedents protecting marriage equality, same-sex relationships and contraception . But we also have to worry about new poisonous weeds springing up from the Federalist Societyheap of dung and stifling new signs of progress in the legal cradle.

For example, earlier this month, some of the worst people in Texas prevailed in Federal District Court in Ft. Valid against the US Department of Health and Human Services, as a judge Reed O’Connor reigned in Braidwood Management c. Becerra that plaintiffs could refuse to take out health insurance that covers pre-exposure prophylaxis (PrEP) medicines taken to prevent HIV infection. This means that HHS cannot require that everything plans sold in the US cover PrEP, as it has since 2020, following a recommendation from its medical experts. This rule has now been placed under what could become a permanent injunction.

Why would the plaintiffs want to do this? Because PrEP entices young men into sodomy, of course! (Maybe women too? Complainants didn’t really say; they were more concerned that girls would be pressured into sex by HPV vaccination, which is a source of long-standing conservative moral panic that is also somehow wrapped up in this matter.) Apparently allowing people to avoid death from terrible plagues is too high a price to pay for maintaining anti- sex and especially anti-LGBTQ. coded. It is therefore a violation of the sincere religious beliefs of these conservative plaintiffs.

At first it looks like hobby hall and little sisters of the poor cases that interfered with the Affordable Care Act’s contraceptive coverage guarantee. But in these cases, brought, as is Braided woodto obtain exemptions under federal law Religious Freedom Restoration Act, there is no doubt that contraception itself contradicts the sincere religious beliefs of many people; for good or for bad. The Obama White House knew that with the ACA mandate, it was choosing to provoke conflict; no one was shocked that a convent wouldn’t just accept it even though it literally meant ticking a box. It was not clear until it happened how much SCOTUS would sympathize and align with these plaintiffs, but it was not a pretense dispute.

These plaintiffs – various individuals and two companies, including Braidwood Managementa company owned by the disgusting sociopath and homophobe from Houston Steven Hotze for its various Christian crusades and side hustles – are more concerned with messages and vibes. They are not asked to sin; PrEP (and HPV) meds come with the package, and they can skip them if they don’t want to catch cooties. Hotze has already publicly stated that he will not employ gay people, which suits this judge, so it’s unclear what damage they can claim here.

What’s really under fire is the power of HHS to enforce coverage of preventative care treatments proven to save lives, including those that protect against diseases that the can be contracted through sex. But it’s not a political fight that’s going to be won with the Biden White House, so instead we’re getting religious objections to…reality as it exists around them? Sounds like the top of a really slippery slope, doesn’t it?

Defendants argued that since Hotze et al. make empirical claims – more young men will have sinful sex if they have access to PrEP – they should have to prove them to counter the evidence on the other side that led to the rule being passed. But O’Connor, who once tried to strike the ACA in its entirety from its bench only to get fired at SCOTUS, was broadly sympathetic to the plaintiffs’ argument that asking them to show their work was unnecessary and inappropriate. Because their beliefs are “sincerely held”, it doesn’t matter how absurd they are, and now employers and other busy people can drop religious bubbles on anything they’d rather not see changed. A call is certain, but no deadline has yet been set.

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