In defense of the Affordable Care Act, the Texas Supreme Court ruled that PrEP was unconstitutional in the absence of a prescription drug coverage

The judge in Texas said that some of the Affordable Care Act mandates, such as requiring insurers to cover a wide array of preventative care services at no cost to the patient, could not be enforced nationwide.

While the case does not pose the existential threat to the Affordable Care Act that previous legal challenges posed, legal experts say that O’Connor’s ruling nonetheless puts in jeopardy the access some Americans will have to a whole host of preventive treatments.

There is an option for the Justice Department to put O’Connor’s ruling on hold while the appeal is taken care of.

Andrew Twinamatsiko is an associate director of the O’Donnell Institute for National and Global Health Law at Georgetown University. Poor people and marginalized communities will go without people who are sensitive to cost.

The Biden administration had told the court that the outcome of the case “could create extraordinary upheaval in the United States’ public health system.” It’s likely to appeal.

In September of this year, O’Connor ruled that the plaintiffs’ religious beliefs were violated when it came to the requirement of coverage of the HIV prevention pill, known as PrEP.” That decision also undercut the broader system that determines which preventive drugs are covered in the U.S., ruling that a federal task force that recommends coverage of preventive treatments is unconstitutional.

Employers’ religious objections have been a sticking point in past challenges to former President Barack Obama’s health care law, including over contraception.

The Biden administration and more than 20 states, most of which are controlled by Democrats, had urged O’Connor not to rule that the preventive care coverage requirement should be abolished.

“Over the last decade, millions of Americans have relied on the preventive services provisions to obtain no-cost preventive care, improving not only their own health and welfare, but public health outcomes more broadly,” the states argued in a court filing.

The lawsuit is among the attempts by conservatives to chip away at the Affordable Care Act — or wipe it out entirely — since it was signed into law in 2010. The attorney who filed the suit was an architect of the Texas abortion law that was the nation’s strictest before the Supreme Court overturned Roe v. Wade in June and allowed states to ban the procedure.