Adam Polaski

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Federal Judge Bars ACA Mandate for Insurance Coverage of PrEP, a Critical HIV Prevention Medication

U.S. District Judge Reed O’Connor ruled in Braidwood Management v. Becerra that the federal government cannot enforce many of the preventative care coverage requirements in the Affordable Care Act, notably including a requirement that employers provide insurance coverage for PrEP (Pre-exposure prophylaxis), a medication that prevents the transmission of HIV. The judge ruled that the ACA mandate violates employers’ rights under the Religious Freedom Restoration Act. Read the ruling in the case, the final judgment after he granted a motion for summary judgment in September. 

Adam Polaski (he/him pronouns), Communications Director at the Campaign for Southern Equality, said today: 

“This is yet another example of blatant judicial overreach that targets the LGBTQ community, which already experiences significant health disparities. PrEP is a medication that keeps people safe and prevents the transmission of HIV. This ruling is an attack on privacy and science and, if it’s allowed to stand, will drastically limit Americans’ ability to protect themselves from HIV.”

“Whether it’s access to abortion, gender-affirming care, birth control, or PrEP, we are seeing dangerous action from rogue activist judges forcing themselves into Americans’ private health care decisions. Particularly here in the South, rulings like this restrict access to essential health care for precisely those communities already experiencing the greatest disparities in access to care. We must push back – and we will – to ensure that people have access to life-saving medications like PrEP and the health care they need and deserve.” 

PrEP is a daily pill used widely for HIV prevention by individuals who are HIV-negative but at high risk for exposure, including men who have sex with men, people who are in a sexual relationship with an HIV-positive partner, and people who have recently injected drugs. Daily PrEP use can reduce the risk of HIV infection from sex by more than 90%.

PrEP is an especially critical strategy for HIV prevention in the South, the epicenter of the modern HIV crisis in the United States. According to 2016- 2017 CDC data, one-half of all HIV diagnoses occur in the South, 47% of HIV related deaths happened in the South, and 46% of people living with HIV live in the South. In the Campaign for Southern Equality’s Report of the 2019 Southern LGBTQ Health Survey(direct link to HIV data), we found that respondents’ reported rates of living with HIV more than 15 times higher than the national rate, with 5% of respondents saying they are living with HIV and 10.4% saying that they don’t know their status. Recent research published this month in Open Forum Infectious Diseases found that if such a ruling were to stand in this case, more than 2,000 otherwise-preventable HIV infections could develop within a year.

Judge O’Connor has a long, infamous history, of ruling against the Affordable Care Act, and a history of rulings that specifically harm the LGBTQ community, including on denying federal benefits to same-sex couples and a decision on anti-LGBTQ workplace discrimination that blatantly violated the U.S. Supreme Court’s ruling in Bostock v. Clayton County. 

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Based in Asheville, NC, the Campaign for Southern Equality promotes full LGBTQ equality across the South. Our work is rooted in commitments to equity in race, gender and class. www.southernequality.org

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Judge Rules Against Federal Mandate for Coverage of HIV Prevention Medication PrEP, Signaling New Attack on LGBTQ Health in the South

Today U.S. District Judge Reed O’Connor ruled in Braidwood Management v. Becerra against a provision of the Affordable Care Act that requires employers to provide insurance coverage for PrEP (Pre-exposure prophylaxis), a medication that prevents the transmission of HIV. The judge ruled that the ACA mandate violates employers’ rights under the Religious Freedom Restoration Act. Read the ruling in the case (courtesy of Chris Geidner) here. 

Ivy Hill (they/them pronouns), Community Health Program Director of the Campaign for Southern Equality, said today: 

“This ruling is about imposing extreme religious beliefs – not, as it purports, about protecting religious freedom: Far right extremist judges are attacking privacy and access to health care.” 

“We must be increasing access to life-saving medications like PrEP, not using it as the latest political wedge to attack LGBTQ people in the South. Whether it’s access to abortion, trans-affirming care, birth control, or PrEP, we are seeing dangerous action from activist courts intervening in Americans’ healthcare decisions – and we must push back.” 

PrEP is a daily pill used widely for HIV prevention by individuals who are HIV-negative but at high risk for exposure, including men who have sex with men, people who are in a sexual relationship with an HIV-positive partner, and people who have recently injected drugs. Daily PrEP use can reduce the risk of HIV infection from sex by more than 90%. 

PrEP is an especially critical strategy for HIV prevention in the South, the epicenter of the modern HIV crisis in the United States. According to 2016- 2017 CDC data, one-half of all HIV diagnoses occur in the South, 47% of HIV related deaths happened in the South, and 46% of people living with HIV live in the South. In the Campaign for Southern Equality’s Report of the 2019 Southern LGBTQ Health Survey(direct link to HIV data), we found that respondents’ reported rates of living with HIV more than 15 times higher than the national rate, with 5% of respondents saying they are living with HIV and 10.4% saying that they don’t know their status. 

Judge O’Connor has a long history of ruling against the Affordable Care Act, and a history of rulings that harm the LGBTQ community, including opinions that overreached on marriage rights for same-sex couples and a decision on anti-LGBTQ workplace discrimination that blatantly violated the U.S. Supreme Court’s ruling in Bostock v. Clayton County. 

This summer the Campaign for Southern Equality launched a new campaign, Meeting the Moment in the LGBTQ South to mobilize responses to growing anti-LGBTQ attacks, such as this ruling. Learn more about Meeting the Moment here. 

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Based in Asheville, NC, the Campaign for Southern Equality promotes full LGBTQ equality across the South. Our work is rooted in commitments to equity in race, gender and class. www.southernequality.org