Braidwood v. Becerra and the Erosion of the Affordable Care Act

May 3, 2023

On March 30, 2023, U.S. District Judge Reed O’Connor issued his decision in Braidwood v. Becerra, eliminating the requirement that insurers cover a wide swath of vital preventative care and jeopardizing the health of people throughout many states. (It’s worth mentioning that O’Connor, a Bush-appointed judge, found the entirety of the ACA unconstitutional in a different case.)

Lisa Needham writes that the Braidwood decision interferes with many kinds of preventative care – from “giving statins to people over 40 at high risk of heart attacks and making colorectal cancer screening free.” But these were not the focus of the Braidwood plaintiffs. They brought the case to seek exemption from providing insurance coverage for “PrEP, contraception, the HPV vaccine, and screenings and behavioral counseling for STDs and drug use.”

The plaintiffs’ argument centered on the idea that providing these preventative services would violate their religious beliefs by “making them complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.” And this argument succeeded.

Braidwood’s erosion of the ACA will end free STI screenings, including those for chlamydia, gonorrhea, hepatitis B and C, syphilis, and HIV. It will end the requirement that insurance plans cover PrEP. Without insurance coverage, PrEP – a highly effective preventative drug to stop the transmission of HIV – costs around $14,000 per year. Needham puts it bluntly: “Getting rid of this coverage only makes sense if you want people to die for having sex. If that feels like it is dragging us back decades, that’s because it is.”

Needham is correct; PrEP is life-saving. We at the Woodhull Freedom Foundation firmly disagree with O’Connor’s decision in Braidwood. We know that everyone deserves free life-saving preventative care.