Under the Affordable Care Act, health insurers are required to cover all costs associated with preventive care — including PrEP, or pre-exposure prophylactic treatment for HIV. But now all preventive care coverage is under threat, thanks to a lawsuit filed by employers who believe they shouldn’t be required to pay for care that violates their religious beliefs.
While coverage for PrEP access is largely unchanged as the court case makes its way through the legal system, Richard Hughes IV, a partner with the law firm Epstein Becker Green, says that protecting the status quo isn’t enough. For instance, currently you have to jump through extra hoops to get long-acting injectable PrEP covered by insurance.
But Hughes has a better idea for how to not only protect but also expand access to PrEP.
On this episode of the “First Opinion Podcast,” I spoke to Hughes about his proposal, why access to PrEP has never been what it should be, the Supreme Court’s current approach to health care, and more.
“If a provider has a bad experience with a previous patient experiencing non-coverage, they might say to the next patient, ‘Well, I’m not sure this is going to be covered.’ And that can be really discouraging,” Hughes said. “What we really need to create that clarity for patients is for this law to be upheld, for the recommendations to be clear, and for providers to have the assurance that they will be covered by payers.”
Our conversation was based on his recent First Opinion op-ed, “How to protect PrEP coverage, no matter what happens in Braidwood v. Becerra.”
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