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April 2, 2023 - LOS ANGELES — Last Thursday, Hours after a federal trial court struck down national protections for critical preventive care benefits under the Affordable Care Act, Insurance Commissioner Ricardo Lara said that California law still requires insurance coverage for HIV prevention medication, screening for sexually transmitted infections, and breast and colorectal cancer screening. Today’s federal trial court ruling in Braidwood Management Inc. v. Becerra strikes down the Affordable Care Act’s preventive health services mandate requiring health insurance policies and health plans to cover recommendations of the United States Preventive Services Task Force (Task Force) without out-of-pocket cost to consumers. The ruling also found that the requirement to cover HIV PrEP violated the rights of federally defined religious employers and could not be enforced against them. 

“Today’s ruling is another egregious example of conservative judges legislating discrimination against women, people of color, LGBTQ+, and lower income working Americans who have a hard enough time accessing health care and, in many cases, can’t afford the expense of lifesaving preventive care,” said Commissioner Lara. “I will continue to fight to protect our most vulnerable and the hard-working people in California and beyond to access their right to coverage of zero-dollar preventive health care.”

He continued: “There is still good news in California. Under state law, health insurance policies and health plans must continue to cover preventive care without cost sharing.”

Current California law requiring state-regulated health insurance policies and health plans to cover preventive health care under the ACA without any cost sharing is unaffected by the ruling. Today’s district court ruling may affect employer-sponsored plans that are not regulated by the state of California and grandfathered health policies and plans.

Commissioner Lara, along with Equality California, the Los Angeles LGBT Center, APLA Health, and the San Francisco AIDS Foundation, are co-sponsoring Assembly Bill (AB) 1645 this year, a bill that would strengthen state preventive care law in the face of these incessant judicial attacks on the Affordable Care Act.

AB 1645, authored by Assembly Member Rick Chavez Zbur, would build on state preventive care law by establishing that health insurance policies and health plans must cover all preventive care without charge, including office visits and necessary health care for delivering a preventive benefit like HIV PrEP. AB 1645 would also require health insurance policies and health plans to cover STI screening that is recommended by the U.S. Centers for Disease Control and Prevention (CDC) without cost sharing, correcting an inequity in the law. Under AB 1645, there will be no question that HIV PrEP and all the necessary care for delivering this life-saving medication, including lab tests and STI screening, will remain covered without cost sharing.

“Today’s ruling makes it even more important to pass AB 1645 to strengthen health care access for all Californians by offering fully covered preventive care, including for HIV PrEP and STI screenings, among other critical things,” said Assemblymember Rick Chavez Zbur (D-West Hollywood, Santa Monica). “AB 1645 represents California values, and we need to act to protect Californians from the harmful decisions of these activist conservative judges.”

Similarly, under another bill sponsored by Commissioner Lara this year, SB 427, authored by Senator Anthony Portantino, health insurance policies and health plans would be required to cover both HIV PrEP and post-exposure prophylaxis (PEP) without any cost sharing, including by grandfathered health insurance policies and health plans that are not otherwise required to cover preventive care under the ACA and state law. The bill would expand zero-dollar coverage of PrEP to one million Californians who must currently pay out-of-pocket for PrEP.

“Pre-Exposure Prophylaxis (PrEP) and post-exposure prophylaxis are important for the overall health of our communities,” said Senator Anthony J. Portantino (D-Burbank). “Today’s court ruling creates barriers to preventive care services and contributes to disparities in health. It's outrageous that a judge would rule against conventional wisdom on the need for preventative medicines and strategies. It once again illustrates just how much public interest is determined by the courts and not by policy and medical experts. California will continue to be at the forefront of preventive care and public health."

"More than 150 million Americans currently have private insurance with coverage for preventive care under the ACA. Yet, a partisan judge in Texas is attempting to roll back access to these basic healthcare services single-handedly. While right-wing judges and politicians are attempting to roll back our rights and inflict harm on LGBTQ+ people, California will continue doubling down to protect the health and safety of our communities." said Equality California Executive Director Tony Hoang. "Equality California is proud to be sponsoring legislation with Assemblymember Rick Chavez Zbur and Insurance Commissioner Ricardo Lara, AB 1645, which will strengthen existing law and go even further to ensure that Californians have access to essential preventive services, including STD screening and PrEP for HIV prevention. Equality California is committed to ensuring that these critical preventive services remain in place for the health of all Americans."

“These bills, combined with existing state law, ensure that Californians are protected against this utterly reprehensible, unreasoned, and partisan decision from the same judge who has tried, and repeatedly failed, to strike down the ACA,” said Commissioner Lara. “No single person should be able to subvert acts of the U.S. Congress and President that block access to basic life-saving health care services."
Source: CA. Dept. of Ins.