PrEP Health Insurance Coverage to Remain Intact - For Now

After lawyers in a case about the Affordable Care Act reached a deal on Monday, health plans will continue to cover preventive care for free.

A Texas district court ruled one part of that requirement unconstitutional earlier this year: that companies were no longer required to cover certain types of preventive care, such as HIV prevention medications or PrEP.

However, the Fifth Circuit Court of Appeals granted a temporary stay last month, allowing the health law’s provisions to resume. Texas residents and businesses challenging the law and the Biden administration defending it were asked by the appeals court to reach a compromise over the suspension.

The deal they reached will continue to provide preventive care free of charge for most health plans. According to the agreement, small businesses and individuals who challenge the requirement can use an insurer that does not cover all preventive services, The New York Times reports.

There is expected to be a ruling by the appellate court later this year on the constitutionality of the preventive care mandate.

Among Obamacare’s most transformative features is the mandate, which prevents worsening disease and higher costs in the future. It is also supported by the public, with 62 percent stating that maintaining it is “very important.”

As a result of the Affordable Care Act, passed in March 2010, preventive care like colonoscopies and birth control became more affordable. Several studies have shown that Americans are getting more blood pressure and cholesterol tests, along with influenza vaccinations, due to the mandate.

Earlier this year, Judge Reed O’Connor ruled parts of the mandate unconstitutional since independent panels advising the government on which benefits to cover did not have the proper authority.

In his opinion, O’Connor said prevention services should not be covered, although the US Preventive Service Task Force had recommended them since 2010.

PrEP coverage was contested in this case by opponents who claimed it would “encourage homosexual behavior or intravenous drug use.”

This is false, as viruses do not select their hosts based on their sexual orientation or any other factor related to their identity.

The deal may be insignificant to most Americans. As a result of the district court’s first ruling, health plans announced they would not change their coverage.

There is little likelihood of a health plan changing its members’ benefits during the policy year, as policies typically last a year.