By: Omar Martínez González, Sr. Manager of Policy & Advocacy, AIDS Foundation Chicago 

CHICAGO, IL – On Thursday, March 30, 2023, U.S. District Judge Reed O’Connor of the United States District Court for the Northern District of Texas issued final judgement on the Braidwood v. Becerra lawsuit, striking down a key provision of the Affordable Care Act (ACA) which provides lifesaving, free preventive care to millions of Americans, ranging from cancer screenings to pre-exposure prophylaxis (PrEP) to prevent HIV.  

AIDS Foundation Chicago (AFC) calls on the Biden-Harris administration to immediately appeal this flawed decision, and on Congress to further protect the preventive health provisions of the ACA, in particular the important role of the U.S. Preventive Services Task Force (USPSTF). 

Braidwood v. Becerra sought to strike down free, mandated coverage of PrEP by private insurances and employers based, in part, on religious freedom claims. The suit made the blatantly homophobic and patently false argument that PrEP encourages gay sex, when in fact PrEP is a powerful public health tool used by Americans of all ethnic backgrounds, religious creeds, and sexual orientations, to prevent HIV. This decision goes beyond the initial scope of the lawsuit, and now threatens access to other vital prevention services for all Americans. 

Since the FDA approved PrEP to prevent HIV in 2012, hundreds of thousands of people around the world have used it to stay HIV negative, and yet, it remains out of reach for some our most vulnerable communities here in the U.S. Black and Latinx same gender-loving men, transgender women of color, people struggling with substance use disorder, and cis-gender, heterosexual Black women continue to be disproportionately impacted by HIV, and lack the same access to PrEP as cis-gender white males. This flawed judicial decision creates a new barrier for these individuals to access PrEP, and dangerously jeopardizes the progress we have made to end the HIV epidemic in the U.S. 

It is estimated that, on average, every new HIV transmission costs the U.S. over $420,000 in lifetime medical costs. By limiting access to PrEP, researchers estimate that the Braidwood v. Becerra decision will cause 1,140 new HIV cases a year among same-gender loving men for every 10% drop in PrEP coverage. These cases are entirely preventable. Not only will this decision fundamentally change the lives of thousands of Americans who will receive an HIV diagnosis, it will further strain our already overstretched and underfunded public health and safety net institutions. 

This is the latest injury to Americans in a growing list of threats to public health and health care access, which include the attack on reproductive rights, and the recent announcement by the state of Tennessee that it would reject federal grants to provide HIV and STI prevention services to individuals in that state. 

We cannot end the HIV epidemic if our most vulnerable communities cannot access safe, effective and preventive health care services. As a nation, we can and must do better.