The Affordable Care Act’s health insurance coverage mandate for HIV prevention medications substantially burdened a Christian for-profit corporation’s religious exercise, a Texas federal judge ruled last week (Braidwood Management Inc. v. Becerra, No. 4:20-cv-00283 (N.D. Texas Sept. 7, 2022)).
U.S. District Court Judge Reed O’Connor granted summary judgment in favor of Braidwood Management, a Texas-based health and wellness business, holding that defendants — the U.S. federal government — failed to demonstrate that the mandate furthered a compelling governmental interest and was the least restrictive means of furthering that interest.
Under the ACA, Braidwood Management could have faced monetary penalties for refusing to cover PrEP, or pre-exposure prophylaxis, medications that reduce a person’s risk of contracting HIV. The company claimed that the mandate violated the protections of the Religious Freedom Restoration Act, which prohibits government from interfering with a person’s exercise of religion, even if the burden results from a rule of general applicability.
Braidwood objected to the PrEP mandate because, the company’s owner alleged, such coverage “facilitates and encourages homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman” and coverage would make the owner complicit in those behaviors.
O’Connor, the same federal judge whose decision in the 2018 case California v. Texas struck down the ACA as unconstitutional — leading to an appeal to the U.S. Supreme Court — applied the high court’s 2013 decision in Burwell v. Hobby Lobby Stores, Inc. In Hobby Lobby, the Supreme Court held that the ACA’s mandate for contraception coverage violated the RFRA freedoms of closely held, for-profit corporations.
Separately, O’Connor set a Sept. 9 deadline for the parties in Braidwood to file supplemental briefing on the scope of relief for the plaintiffs.
The judge’s decision comes just over two years after the Supreme Court’s decision in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, in which the court upheld two Trump administration regulations that expanded employers’ ability to claim an exemption from the ACA’s contraceptive mandate on the basis of either moral convictions or religious beliefs.