The Supreme Court of the United States (SCOTUS) is gearing up to hear a case that could gut a key provision of the Affordable Care Act (ACA): the requirement that insurers cover preventive services like PrEP without cost to patients. For queer communities, particularly those most vulnerable to HIV, this isn’t just another legal battle—it’s a fight for survival.
The Case That Could Cost Lives
At the centre of this challenge is PrEP (pre-exposure prophylaxis), a game-changing medication that reduces the risk of HIV transmission by up to 99%. The plaintiffs argue that requiring insurance coverage for PrEP violates their religious beliefs because it allegedly “encourages homosexual behaviour.” (Yes, even a quarter of the way through the 21st century, this is still an argument being made in courts of law.)
If SCOTUS sides with the plaintiffs, the consequences will be devastating:
- PrEP Becomes Prohibitively Expensive: Without the ACA mandate, the average annual cost of PrEP can exceed $20,000. This would make the medication inaccessible for many in the queer community, particularly those without comprehensive insurance coverage.
- Health Inequities Widen: Black and Latinx queer communities already experience disproportionately high rates of HIV diagnoses and lower access to PrEP. Removing free access would only exacerbate these disparities.
- A Setback in Ending HIV: The United States has made significant strides in reducing new HIV infections. Stripping away access to a proven prevention tool risks undoing decades of progress.
Faith, Fear, and Control
This case is about more than healthcare. It’s part of a broader campaign to undermine queer rights under the guise of “religious freedom.” Using faith to justify denying life-saving healthcare is a chilling reminder of how precarious queer rights remain.
It’s not just about PrEP, either: A ruling in favour of the plaintiffs could embolden efforts to block access to other LGBTQ+ health services, like gender-affirming care, further eroding protections for vulnerable communities.
How to Fight Back
While the case winds its way through the courts, queer advocacy groups are mobilizing. Organisations like the National Center for Lesbian Rights and the Human Rights Campaign are working to amplify voices and protect healthcare access.
For individuals relying on PrEP, now is the time to connect with your healthcare provider and explore alternative options like patient assistance programs. Staying informed is key as the legal landscape shifts.
A Dangerous Precedent
Healthcare is a human right, not a privilege to be dictated by the personal beliefs of a select few. This case is a stark reminder that queer health and rights are still seen by some as expendable.
We’ve fought too hard and come too far to back down now. Let’s stay loud, stay united, and keep fighting—for PrEP, for equity, and for every member of our community. – TML