Supreme Court Case on ACA Could Undermine HIV Care and Preventative Health Policies
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A pending Supreme Court case targeting the Affordable Care Act (ACA) may not dismantle the law’s core provisions but could have severe implications for HIV care in the United States, according to Charlotte Kilpatrick in The New Republic.
If the litigants succeed, it would hand President-elect Donald Trump a tool to reshape preventative healthcare policies, potentially cutting vital treatments. The case challenges the authority of the U.S. Preventative Services Task Force, which mandates insurance coverage for key preventative measures, including HIV prevention medication PrEP.
Right-wing Christian business owners in Texas argue that the task force’s recommendations are unconstitutional because its members were not Senate-confirmed. Kilpatrick highlights the critical role of these preventative treatments. “Not only is it the humane thing to do, it also saves health insurers a lot of money,” she wrote.
She likened it to catching cervical cancer early with pap smears rather than providing expensive end-of-life care. Similarly, PrEP significantly reduces the burden of HIV on patients, healthcare providers, and insurers. A ruling in favor of the business owners could allow Trump to reappoint the task force, likely reshaping its recommendations.
Kilpatrick warns that care requirements for HIV prevention and other essential health services might be eliminated. “A woo-woo ‘wellness’-obsessed Department of Health and Human Services secretary could decide that mental illnesses, such as anxiety and depression, are best treated with meditation and the like, and cut mental and behavioral health services from the preventative care requirement,” she wrote.
The impact, however, could be most devastating for those living with HIV. This potential shift harks back to the bitter HIV/AIDS debates of the 1980s when AIDS was heavily stigmatized and often fatal. Politicians like Sen. Jesse Helms (R-NC) notoriously blocked federal funding for HIV prevention programs, exacerbating the crisis.
“It is impossible to count just how many people of all backgrounds died from HIV as a result of Helms and the moral cowardice of 95 of his fellow senators,” Kilpatrick wrote. She concluded with a chilling reminder: “With a new administration openly beating their chests about transforming the federal government into an engine of retribution against disfavored groups.
it’s simultaneously frightening to think how little has changed since the late 1980s, and how much could—very quickly—change again.” This case could mark a turning point for public health, reigniting old battles over HIV care and potentially leaving vulnerable populations at risk.
