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Summary judgment hearing slated in suit over PrEP drug coverage

SOUTHEAST TEXAS RECORD

Thursday, November 21, 2024

Summary judgment hearing slated in suit over PrEP drug coverage

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Mitchell

Former Texas solicitor general Jonathan F. Mitchell

FORT WORTH -  A summary judgment hearing has been slated for later this month in a lawsuit seeking to permanently enjoin the federal government from enforcing a mandate against any individual or employer who objects to the health insurance coverage of drugs that help prevent the spread of HIV. 

Court records show that numerous Texas residents brought a complaint against the U.S. and several officials on March 29, 2020.

The plaintiffs argue that The Affordable Care Act empowers several government agencies to unilaterally determine the preventive care that private health insurance must cover, enabling them to issue pronouncements that force health insurance issuers and self-insured plans to cover preventive care measures without any cost-sharing arrangements. 

On June 11, 2019, the U.S. Preventive Services Task Force recommended that health insurance cover pre-exposure prophylaxis (PrEP) drugs, such as Truvada and Descovy. 

Some of the plaintiffs in the case contend that the mandate makes it impossible for them to purchase health insurance unless they agree to pay for preventive-care coverage that they do not want or need. Other plaintiffs in the case object to the mandate on religious grounds. 

The plaintiffs argue that the court should declare that preventive-care mandates based on a rating, recommendation, or guideline issued by the U.S. Preventive Services Task Force, the Advisory Committee on Immunization Practices, or the Health Resources and Services Administration after March 23, 2010 (the date on which the Affordable Care Act was signed into law) are unconstitutional and unenforceable, and should also permanently enjoin the defendants from enforcing them. 

Court records show that the plaintiffs filed a motion Nov. 15 seeking summary judgment on several claims, including the claim that the PrEP mandate violates the Religious Freedom Restoration Act.

“It is a ‘substantial burden’ to close off the entire health insurance market to individuals who are unwilling, for religious reasons, to purchase insurance that is used to subsidize other people’s PrEP drugs, the HPV vaccine, and the screenings and behavioral counseling for STDs and drug use,” a brief in support of the plaintiffs’ motion states.

Court records further show that the defendants filed a cross-motion for summary judgment on Jan. 28, requesting that the action be dismissed with prejudice. 

In their brief, the defendants assert that the plaintiffs lack standing to challenge the preventive services provision and that the plaintiffs have failed to establish a violation of the Religious Freedom Restoration Act.

“Plaintiffs’ contention that there is no compelling governmental interest in ensuring coverage of PrEP is without merit,” the brief states. “There can be no dispute that the government has a compelling interest in inhibiting the spread of fatal infectious diseases.

“PrEP is by far one of the most effective measures to counter the spread of HIV infection. Therefore, to advance the government’s compelling interest in reducing HIV infection, it is essential to eliminate barriers to PrEP access and uptake, including by eliminating cost-sharing hurdles for medications and associated services for those who need PrEP.” 

The motions on summary judgment are slated to be heard on July 26, court records show. 

The plaintiffs are represented by Austin attorney Jonathan F. Mitchell, along with Fort Worth attorneys H. Dustin Fillmore III and Charles Fillmore. 

The defendants are represented by Christopher Lynch of the U.S. Department of Justice and Brian Stoltz of the U.S. Attorney’s Office for the Northern District of Texas.

Filed in the U.S. District Court for Northern Texas, Fort Worth Division. Civil action No. 4:20-cv-00283-O

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