US Supreme Court Protects PrEP Access In Major Ruling
The U.S. Supreme Court on Thursday upheld a vital part of the Affordable Care Act, ruling 6–3 in Kennedy v. Braidwood that insurers must keep covering preventive services at no cost. Justice Brett Kavanaugh wrote the majority opinion, joined by Justices Roberts, Sotomayor, Kagan and Jackson. Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch dissented.
How coverage works.
Under the Affordable Care Act, any service rated A or B by the U.S. Preventive Services Task Force must be covered without copays or deductibles. That list includes pre-exposure prophylaxis (PrEP), cancer screenings, depression checks, and a suite of vaccines. The Task Force is an independent expert panel whose research guides these recommendations. The court confirmed that its members are “inferior officers,” meaning the Secretary of Health and Human Services can oversee and remove them if needed.
Why do we need PrEP?
Pre-exposure prophylaxis, or PrEP, blocks HIV transmission when taken as prescribed. Public health experts stress that access is life-saving for Black and Latin gay and bisexual men and transgender women, who face the highest new infection rates. But PrEP is used by people of all backgrounds and orientations. We celebrate this ruling as a boost for health equity right across the country.
The lawsuit began when a group of Christian business owners claimed that covering PrEP “encourages homosexual behaviour” and violated their religious beliefs. A lower court agreed, sparking fears that hundreds of preventive services might lose no-cost coverage. The Supreme Court majority rejected those arguments, emphasising that Congress gave the Secretary oversight of Task Force appointments. That oversight keeps the panel within constitutional bounds and the coverage mandate intact
Lambda Legal and PrEP4All joined forces with the Centre for HIV Law and Policy and others to praise Friday’s decision. In a joint statement, they said it “upholds essential protections for preventive services and affirms [s] that early detection of disease saves lives.” They warned that “most of the people harmed by this decision wouldn’t have been queer. They would be working-class families, Black and Brown communities, rural Americans and anyone who relies on preventive care.
Rep. Mark Takano, chair of the Congressional Equality Caucus, welcomed the ruling as a rare bit of good news this term. Skye Perryman, chief executive of Democracy Forward, said the court correctly rejected “baseless theories” that threatened millions of people’s health care. Yet both urged vigilance: anti-science groups are already lining up new court challenges.
