Obamacare Can’t Order Employers to Cover HIV Drugs, Governance Rules

On the same day that former President Barack Obama returned to the White House to witness the unveiling of new presidential photosa federal judge in Texas ruled against provisions of the Affordable Care Act, also known as Obamacare.

U.S. District Judge Reed O’Connor ruled on Wednesday in favor of plaintiffs, companies and individuals who wanted to deny free coverage of the HIV drug PrEP on religious grounds.

Devin Dwyer, ABC News’ Washington correspondent, sat down with the Start Here podcast to explain Obamacare’s legacy, the latest legal challenge, and how far the fallout could go.

START HERE: Devin, I think health insurance enrollment season starts in two months, so what was that verdict?

DWYER: Yes, one of the most common judgments that come to mind when we look at our employer’s health care plans to choose from Brad are the free preventive care services and medications that insurance companies now have to cover because of Obamacare.

Things like cancer screenings and colonoscopy, vaccinations, and those things that are covered at no cost, no co-payments, of course. Well, Texas federal judge Reed O’Connor, the same person who targeted Obamacare before, gave a strike-out opinion, threatening key parts of the Preventive Services mandate.

He said that this Board of US Health Officials, which decides what insurance companies must cover for free, is unconstitutional. They are not properly appointed and confirmed by the Senate, which, in his opinion, might invalidate them in all the business which they do, we shall see. He backed off from the exact scope of his decision, which is to come a little later. But he’s also targeted, Brad, and I mentioned him, in this very popular pre-exposure preventative treatment called PrEP. It is a preventive medicine for HIV.

He said that requiring some companies to cover this property might infringe on their religious freedom. And he sided with one company, named Briarwood. It is a small company, 70 employees. They challenge this saying from their point of view, by having to cover this up, they are endorsing sexuality, [and] That they could not support sexual activity, outside of marriage, between homosexuals, and wanted to withdraw. Judge Reed O’Connor said, at least in their case, that they do not have to comply.

Image: an illustration of the PrEP (pre-exposure prophylaxis) medication.

Illustration of PrEP (pre-exposure prophylaxis) drugs.

Thom Leach / Science Photo Libra / AP, FILE

START HERE: I know this ruling can apply to a lot of drugs but while we’re at it, can you talk about the PrEP big deal? Because I feel like we don’t spend enough time dazed well, there is no cure for HIV. It has effectively allowed people to live with this disease that we thought was incurable in a more natural way than we thought possible.

Doerr: Yes. PReP Brad was in the CDC’s eyes a game-changer. I mean, it has significantly slowed the spread of HIV since it came out about a decade ago. It is 90% effective when taken beforehand in preventing HIV infection from any type of activity. Sexual activity, drug abuse, blood transfusion. You can’t, by default, have it if you do. And if you have an infection and start taking the lotion after it happens, it’s also very effective, according to experts.

So this was a drug that the Centers for Disease Control and Prevention says they want more people to take. And in fact, the most recent numbers, only about a quarter of the people at risk, of the millions of Americans at risk who should take it are doing so now. The numbers have gone up, but they need, you know, to expand.

And the CDC says access to this drug is key. Allowing more people to get it cheaply, completely free as mandated by Obamacare would help. And so they are trying to eradicate HIV and AIDS in this country using this drug, but now a relapse is likely with this ruling, if it exists, and if it is as widespread as some fear.

Start here: Well, here’s the thing, you have this company that said “We don’t want to endorse homosexuality, it’s kind of our freedom of religion. So we don’t think that should be covered under our plan. Of course, we should say that it’s not Only gays get HIV, not only men get HIV. But if future courts uphold this ruling, they’ll see what can happen next even to bypass HIV? What happens to preventive care in this Country?

Doerr: Well, there are two problems in this case. If the preparatory decision stands, it’s clearly a setback, but it’s unclear whether the judge would say the government should simply provide some mechanism to exempt religious companies or religious-minded people who simply don’t want to sign up for insurance plans like this.

Remember, there has been a similar challenge to the law’s mandate regarding contraception and similar reasons have been challenged over the years. So maybe there will be some kind of exception. Maybe he just hit her. We have to see. But this is likely to have a much broader impact. 140 million Americans are dependent and have, according to polls, free preventive services, not just drugs and vaccines, but, you know, your annual physical that’s supposed to be covered for free, no co-pay, once a year. This is a benefit from Obamacare. If the staff that sets those standards is nullified, all of that will likely disappear.

Start Here: Since they’re the ones making the call, here’s what the average person should have access to. Good. cool stuff. Devin Dwyer, thank you.

Doerr: Thank you, Brad.

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