March 30, 2023
Today a federal judge in Texas issued an order in Braidwood v. Becerra blocking a long-standing requirement under the Affordable Care Act that all preventive healthcare services given an A or B rating by United States Preventive Services Task Force, including a drug that reduces the risk of HIV transmission by close to 100%, must be covered by health insurance plans without cost sharing.
“This broad and dangerous order will impact critical preventative care services that millions of Americans rely on, including cancer screenings, pregnancy-related screenings and preventative mental health care,” said Ben Klein, GLBTQ Legal Advocates & Defenders (GLAD) Senior Director of Litigation and HIV Law. “Today’s order in Braidwood v. Becerra will have direct and devastating consequences for efforts to combat the HIV epidemic. We have a safe, approved therapy PrEP (Preexposure Prophylaxis), that is nearly 100% effective at preventing transmission of HIV but that remains underutilized, particularly among Black and Latinx communities. Ending the requirement that insurers cover PrEP with no cost-sharing will increase new HIV diagnoses and exacerbate racial health disparities when what we need is to be ensuring more people have access to PrEP. Copays and deductibles deter people from accessing healthcare. Make no mistake, we will see more HIV transmission as a result of this ruling.”
According to researchers at Yale and Harvard, ending the prohibition of cost sharing for PrEP will increase HIV transmission among men who have sex with men by at least 17% in the first year alone.
The CDC reported in 2019 that only 23% of people eligible for PrEP were prescribed it, and that only 8% of Black people and 14% of Latinx people eligible for PrEP received it compared to 63% of white people.
“States must take action now to address the glaring danger presented by today’s ruling in Braidwood v. Becerra,” added Klein who is working to enact legislation to create a state mandate requiring insurers to cover PrEP with no cost sharing. “In Massachusetts today, only 9,113 of the 24,900 Massachusetts residents at high risk for HIV have been prescribed PrEP. We must do better. We urge the legislature to pass an Act to Address Barriers to HIV Medication that will fix this problem for Massachusetts.”