SAN FRANCISCO (KRON) – House Speaker Nancy Pelosi (D-San Francisco) is blasting a federal court ruling that the Affordable Care Act mandate that insurers and employers cover HIV prevention medications for free is unconstitutional.

“Today, a radical, Republican-appointed federal judge ruled that employers can deny coverage for PrEP: a drug proven to save lives from HIV/AIDS and a key strategy for ending the epidemic,” Pelosi stated in a press release Wednesday. “This disturbing decision amounts to open homophobia: unleashing unthinkable suffering and death specifically among the LGBTQ community. This decision also threatens vital preventative health services guaranteed under the Affordable Care Act, including birth control, vaccinations and routine health screenings.”

PrEP, standing for pre exposure prophylaxis, refers to either Truvada or Descovy when taken to prevent infection with the human immunodeficiency virus. PrEP was first approved by the United States Food and Drug Administration (FDA) in 2012 for prevention of HIV infection, and the Patient Protection and Affordable Care Act had required it to be covered under the aegis of preventative care.

About 25% of the 1.2 million Americans who the U.S. Centers for Disease Control and Prevention recommends for PrEP were prescribed it in 2020, up from 3% in 2015. Without insurance it can cost up to $21,000 annually.

A group of business owners challenged the PrEP coverage mandate, alongside the mandate to cover contraception and the vaccine for human papillomavirus, arguing that covering PrEP made them “complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.” Most HIV diagnoses in the U.S. have been among men who have sex with men and intravenous drug users.

In the ruling in the case of Braidwood Management vs. Xavier Becerra, Judge Reed O’Connor of the Northern District of Texas agreed.

KRON ON is streaming live

“The mandates force Braidwood [the plaintiff] to underwrite coverage for services to which it holds sincere religious objections,” he ruled. “This injury is distinct from the pocketbook injury Braidwood would incur in paying for the objectionable services.”

O’Connor had ruled in the past that all of the Affordable Care Act was unconstitutional; he has not yet ruled on the contraception mandate. The HPV challenge was dismissed.

In her statement, Pelosi tied the ruling to the recent U.S. Supreme Court ruling that there is no right to an abortion in the U.S. Constitution.

“This extreme MAGA ruling comes just months after the Republican-controlled Supreme Court discarded precedent and privacy in overturning Roe v. Wade,” Pelosi stated. “Since then, House Republicans have plotted an unhinged, dangerous campaign to punish our most personal decisions, from abortion care to birth control and more. With the GOP’s utter disdain for our health, safety and freedom, it is only a matter of time that another drug, treatment, vaccine or health service becomes the next target of their extremism.”