PrEP Advocates Convene Virtual Town Hall Responding to Braidwood v. Becerra

Hundred gather to discuss concerns, plans for long-term advocacy

Hundreds of HIV prevention advocates nationwide convened on Tuesday to discuss the implications of Judge Reed O’Connor’s ruling in the Texas Braidwood v. Becerra case that could impact access to PrEP and other preventive health interventions for millions of Americans. The ruling states private insurers are no longer required to cover certain preventive care services under the Affordable Care Act, including PrEP.  

Advocates called on public and private insurers to maintain coverage to prevent HIV and other conditions no matter the ultimate outcome of the case. Experts from Lambda Legal, the Center for HIV Law and Policy, and the Center for Health Law and Policy Innovation provided preliminary analyses and shared their thoughts on strategies moving forward, including steps in the appeal process. Attendees vowed to take action to raise awareness of this threat to PrEP access, connect with other affected healthcare communities, and get organized for what will likely be a prolonged process to try and preserve preventive health services. 

Thirteen leading advocacy organizations sponsored the convening, including the speakers’ organizations, PrEP4All, the PrEP in Black America Coalition, AVAC, HIVMA, NASTAD, Public Citizen, My Brother’s Keeper, Inc, the International Community of Women living with HIV in North America, NMAC, and AIDS Action Baltimore. 

“We need to turn the fear, anger, and sadness of this decision into informed action,” explained PrEP4All Executive Director Jeremiah Johnson. “It is heartbreaking to see basic healthcare needs in our communities being litigated once again, and even worse to see PrEP–an essential and powerful HIV prevention tool–uniquely singled out in a twisted attempt to undermine a huge array of preventive healthcare in our nation, including cancer screenings, diabetes screenings, and key medications intended to prevent complications from cardiovascular disease.” 

“We are grateful to the Biden Administration for quickly appealing this irresponsible decision by Judge O’Connor,” added Leisha McKinley-Beach, Founder and CEO of the Black Public Health Academy, and co-facilitator for the event. “In case anyone needed more evidence of the clear and pressing need for a National PrEP Program, this case spotlights the extraordinary vulnerability of PrEP access for those who most need it.”  

Attendees shared ideas and resources regarding short, medium, and long-term advocacy strategies. Registrations for the town hall ballooned to over 500, reflecting intense concern from HIV advocates across the nation.  

“It’s important to let individuals using PrEP know there is no reason to panic at this time. As of now, coverage has not changed, and we believe it is unlikely that insurance plans will stop covering preventive health services mid-year. The Affordable Care Act has survived attacks on it before, but we also can’t take such a threat lightly. We will fight to ensure it endures for our communities,” said Jose Abrigo, HIV Project Director of Lambda Legal. 

“We are angry and frustrated by this decision, but we are not powerless,” said Elizabeth Kaplan, Director of Health Care Access for the Center for Health Law and Policy Innovation. “We have an opportunity to come together with partners and stakeholders both within and beyond the HIV advocacy community to ensure life-saving preventive services including PrEP are accessible and affordable for all who need them.” 

Recent analysis out of Yale and Harvard has found that for every 10% decline in PrEP coverage caused by the ruling, HIV infections will increase by over 1,140 per year among gay and bisexual men. With lifetime HIV costs estimated by CDC to be $501,000 per each new infection, such an outcome would likely contribute significantly to out-of-control healthcare expenses in the US. 

“This decision is the Right’s latest move in their long-term strategy to quell our intersectional movements for justice. Enemies of trans and queer rights, access to healthcare, sexual health literacy, and reproductive justice have been playing a long game and our basic rights are constantly under attack,” said S. Mandisa Moore-O’Neal, Executive Director at the Center for HIV Law and Policy. “But we will be ready and we will not give up. As the litigation unfolds, now is the moment for us to fortify our strategies for continued access, including legislative avenues and engaging invested policymakers.” 

“This ruling expands on last year’s shocking decision on PrEP and religious freedom and further undermines the right to health for an even larger group of Americans. It is the latest blow in a campaign to roll back bodily autonomy and human rights for a wide swathe of the population and will degrade the quality of life for all Americans by denying life-saving preventive care,” said Mitchell Warren, AVAC’s Executive Director.