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NYC health providers warn ‘HIV cases will go up’ if Texas ruling curbs access to PrEP
By
Caroline Lewis
Published Apr 7, 2023
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By
Caroline Lewis
Published Apr 7, 2023
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Health care providers and advocates for LGBTQ+ New Yorkers are speaking out about how a recent federal court ruling in Texas could affect patients’ access to a range of preventive health services. That includes PrEP, or pre-exposure prophylaxis, a pill that helps block the spread of HIV.
Representatives of Housing Works, the Gay Men’s Health Crisis and Callen-Lorde Community Health Center joined other advocates and elected officials at a virtual panel Thursday to discuss the potential fallout from a decision last week in the case Braidwood Management v. Becerra. On March 30, Judge Reed O’Connor of the U.S. District Court in the Northern District of Texas struck down a provision of the Affordable Care Act requiring most health plans to cover preventive health services at no cost to their members.
“Although we live in a state with more robust [health care] protections, we can’t take anything for granted,” Peter Meacher, chief medical officer at Callen-Lorde, said at Thursday’s panel.
The ruling specifically applies to preventive services that were recommended for coverage by the U.S. Preventive Services Task Force after the ACA was enacted in 2010. That includes PrEP as well as screenings for substance use disorders, HIV and certain types of cancer.
“Surely, HIV cases will go up if this is permitted to go through,” Dr. Archie Jao, the medical director at Housing Works, said at the panel. “Surely, morbidity and mortality will also go up in our patients.”
Meacher of Callen-Lorde worried the decision could affect public health in the city overall. “We finally have a path to end the [HIV/AIDS] epidemic,” he said. “Why on earth would this progress be threatened now?”
Reducing insurance coverage for PrEP could result in 2,000 more HIV infections per year nationwide among men who have sex with men, according to a Yale study on the potential effects of the lawsuit. The researchers found that PrEP currently prevents about 3,200 HIV transmissions per year among that population.
The Biden administration is appealing the Texas decision.
But even if it’s upheld, it’s still unclear how big of an impact it will have on New York. The state has its own laws around insurance coverage for preventive care that will minimize some of the fallout. For instance, Gov. Kathy Hochul signed legislation at the end of last year requiring New York health plans to cover PrEP. Panelists said they would advocate for more robust state insurance rules, given the threat to federal protections posed by the lawsuit. In a similar way, the Supreme Court’s decision to overturn Roe v. Wade last year led New York to reinforce its own laws promoting abortion access.
But state insurance requirements don’t apply to the large, self-insured health plans offered by some employers – meaning this ruling could erode preventive health coverage for New Yorkers on those plans and result in out-of-pocket fees for services that were once free.
The Texas case was first filed in 2020 by the health care employer Braidwood Management and other Christian-owned businesses. They argued that the U.S. Preventive Services Task Force – a national panel of experts disease prevention – doesn’t have the authority to determine which services should be covered under the ACA. They also argued that coverage requirements for PrEP and other HIV services, in particular, violate the Religious Freedom Restoration Act.
This particular Texas court district has recently been in the news for a separate case that could impact health care in New York. The judge in that case is weighing whether to block access to the abortion medication mifepristone nationwide.
Eric Linzer, president and CEO of the New York Health Plan Association, said in an interview on Thursday that his organization doesn’t support the decision to roll back coverage requirements for insurance companies.
“It’s important to ensure that individuals have the ability to get the screenings they need to prevent more serious conditions,” Linzer said, adding that the ruling could create confusion for patients.
He added that health plans are still awaiting more federal and state guidance on what the ruling means for them.
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new york city
health care
Health and Science
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
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