Making PrEP Free: A Battle Against HIV in the US
Making PrEP free to all those with insurance has been a key provision in the battle against HIV in the US. However, a Texas judge has struck down the provision of the Affordable Care Act that requires health insurers to cover preventive interventions, tests or therapies, including PrEP.
Benjamin Ryan
🔬Health & science reporter | Contributor to: @NYTimes @NBCNews @Guardian @TRF | Other bylines: @WashingtonPost @TheAtlantic | Cancer Survivor | Columbia grad
-
BREAKING: A Texas judge has struck down the provision of the Affordable Care Act that grants a task force the authority to recommend preventive interventions, tests or therapies & require health insurers to cover them. This includes PrEP, cancer screenings, HIV testing, etc 1/ pic.twitter.com/yv6zd7QOvI
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
The fed govt will likely immediately request a stay of Texas District Court Judge Reed O'Connor ruling as it appeals to the 5th circuit. Plaintiffs tend to shop cases to this judge, who is predictably very conservative. So for now, PrEP will remain free to insured people. 2/
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
Making PrEP in particular free to all those with insurance--that means no out of pocket costs for the medication, the clinic visits or the lab tests--has been a fundamentally important provision in the battle against HIV in the US. 3/
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
Without the US Preventive Services Task Forces' authority, which the Texas judge has sought to decimate, it is very unlikely that insurers will ever cover long-acting injectable PrEP, called Apretude. I covered the issue here for @NBCOUT: 4/https://t.co/7pHQwDg5is
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
Here is the Texas judge's decision vacating the authority of the US Preventive Services Task Force to compel insurers to cover various preventive therapies, interventions and tests. 5/ https://t.co/oCmg9F2K2L
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
People went wild when I reported in 2021 for @NBCOUT that PrEP is now totally free for insured people thanks to the authority of the US Preventive Services Task Force: https://t.co/H1nD1Ad94p
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
I covered the Texas judge's initial ruling regarding PrEP in the fall for @NBCNews: https://t.co/tngfTtfMC4
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
Note that even before the US Preventive Service Task Force granted oral PrEP an “A” rating in 2019, leading to a requirement that as of Jan 1, 2021, PrEP must be covered and with no cost sharing, PrEP was already widely covered by insurance and copay cards minimized costs. 1/2
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
The TX ruling today if it becomes a matter of law would wipe out the requirement, in place since July 2021, that the lab tests and clinic visits for PrEP lead to no out of pocket costs. Also, newer forms of PrEP could not receive an A rating and get guaranteed insurance coverage.
— Benjamin Ryan (@benryanwriter) March 30, 2023 -
Without the US Preventive Services Task Force, it is unlikely many insurers will ever cover injectable Apretude as PrEP or Gilead’s injectable lenacapavir, given every six months and currently in clinical trials. They will cost too much compared with generic Truvada.
— Benjamin Ryan (@benryanwriter) March 30, 2023