Texas judge says Affordable Care Act's requirement of free HIV drugs violates religious freedom

FORT WORTH — A federal judge has sided with a Fort Worth orthodontist who argued that requiring health insurance to pay for HIV prevention drugs was a violation of his religious freedom.

U.S. District Judge Reed O'Connor, of the Northern District of Texas, issued a ruling in the case Wednesday.

Technically, O'Connor's ruling focused on just one plaintiff: Braidwood Management Inc., a company based in Texas. But in principle, his decision supports the reasoning of multiple North Texas Christians, who challenged a key part of the Affordable Care Act when they sued the federal government in 2020. The plaintiffs include Fort Worth oral surgeon Gregory Scheideman, Fort Worth orthodontist John Kelley, and his company, Kelley Orthodontics.

Braidwood Management Inc., Kelley and the other plaintiffs opposed a core feature of the Affordable Care Act, often known as Obamacare. The law requires that private health insurance plans pay for preventive health care in full, with no charge to the insured patients. Kelley and his co-plaintiffs disagreed with the groups that determine what kind of health care is preventive, and also opposed insurance coverage of services like birth control, testing for sexually transmitted infections, and the HIV prevention drug PrEP on religious grounds.

Kelley is "a Christian, and he is therefore unwilling to purchase health insurance that subsidizes abortifacient contraception or PrEP drugs that encourage homosexual behavior and intravenous drug use," according to the lawsuit.

In his ruling Wednesday, O'Connor focused on Braidwood Management Inc., a for-profit company owned by QAnon conspiracy theorist Dr. Steven Hotze. Because Braidwood employs more than 50 people, it is required by law to offer health insurance to all of its full-time employees. For his part, Hotze argued that offering his employees insurance plans that would pay for drugs like PrEP would violate "his religious beliefs by making him complicit in encouraging those behaviors," O'Connor wrote in his ruling.

O'Connor agreed with Hotze and ruled that the requirement that insurance companies pay for PrEP violates Braidwood Management Inc.'s religious freedoms.

Attorneys for the plaintiffs did not respond to an email asking for comment.

The ruling does not have any immediate effect on people with private health insurance, or people who take drugs like Truvada to reduce their chances of contracting HIV.

O'Connor has scheduled a hearing in the case on Friday.