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NYC health providers warn ‘HIV cases will go up’ if Texas ruling curbs access to
PrEP
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NYC HEALTH PROVIDERS WARN ‘HIV CASES WILL GO UP’ IF TEXAS RULING CURBS ACCESS TO
PREP



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By
Caroline Lewis

Published Apr 7, 2023

41 comments

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By
Caroline Lewis

Published Apr 7, 2023

41 comments

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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.



Tagged

Health and Science
health care
new york city

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Caroline Lewis


Caroline Lewis is on the health care beat for WNYC and Gothamist — and also
covers cannabis, both with an eye towards equity and accountability. She was
previously a health care reporter for Crain’s New York Business. Lewis has a
degree from the CUNY Graduate School of Journalism and is a native New Yorker,
although she has left occasionally. She did a Fulbright in Chile in 2011 and is
fluent in Spanish. She now resides in Brooklyn.

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