By maintaining Obamacare pillar, Supreme Court hands win to HIV advocates

The Supreme Court on Friday granted the HIV-prevention field a historic win — yet with a major caveat — as it upheld a federally appointed health task force’s authority to mandate no-cost insurance coverage of certain preventive interventions, but clarifying that the health and human services secretary holds dominion over the panel.

The Supreme Court on Friday granted the HIV-prevention field a historic win — yet with a major caveat — as it upheld a federally appointed health task force’s authority to mandate no-cost insurance coverage of certain preventive interventions, but clarifying that the health and human services secretary holds dominion over the panel.

The 6-3 decision in Kennedy v. Braidwood Management, Inc. essentially leaves in place a popular pillar of the Affordable Care Act, which mandates that most insurers cover various task force-recommended preventive screenings, therapies and interventions, with no out-of-pocket costs imposed on patients. The case reached the high court after a group of Christian businesses in Texas objected to being compelled to cover certain drugs used for HIV prevention, known as PrEP, given their claims that it “promotes homosexuality.”

“Since our efforts to address HIV in the U.S. are under attack on so many levels, preserving insurers’ requirement to cover preventive services, including PrEP, will help ensure access to people who need it,” said Carl Schmid, executive director of the HIV + Hepatitis Policy Institute, a patient advocacy group in Washington, D.C.

But the court clarified the scope of the task force’s independence, thus potentially compromising its impact. Addressing concerns that the 16-member volunteer task force’s power over insurers was unconstitutional, the justices asserted that the health secretary holds the authority to appoint and dismiss the panelists and to block their new recommendations from mandating insurance coverage. The secretary could also possibly direct the panel, including one stocked with his or her own hand-picked members, to revisit previous recommendations that have already gone into effect.

Given the unpredictable nature and unconventional approach to health policy of the current health secretary, Robert F. Kennedy Jr., HIV advocates are concerned that he might undermine the task force’s current or future endorsements of HIV-prevention medications, known as PrEP.