US judge cites religious freedoms in voiding insurance coverage for HIV drugs |  JD Supra

US judge cites religious freedoms in voiding insurance coverage for HIV drugs | JD Supra

As a growing number of Americans tell pollsters they are renouncing religion and watching its practice decline in their lives, those with religious fervor find a federal justice system willing to delve into the complexities faith and medicine in deeply polarizing ways.

The looming midterm elections, pollsters say, have already been turned upside down by the U.S. Supreme Court’s reversal of a half-century-long law that was established by returning critical rulings about women’s reproductive health back to states. and the authorization of abortions, including in cases of rape and incest.

A Texas federal judge with blatantly extreme views has further fanned the growing fires around religion and health care by declaring unconstitutional the process by which Obamacare decides what kinds of preventative health care should be covered by private health insurance, such as the New York Times and other media reported.

U.S. District Judge Reed O’Connor – who has already been overturned by top courts in his effort to strike down the entire landmark Affordable Care Act that provided health coverage to tens of millions of poor, working poor and middle-class Americans – specifically sought to prevent a Christian company from having to pay for HIV medications for its employees, saying it violated the religious freedoms of the owners.

Critics attacked the decision, pointing out to begin with that the company, Braidwood Management, and its owner, Dr. Steven F. Hotze, described to The New York Times as a well-known Republican donor and Houston doctor, did not been obliged to make any payment for the drugs in question. He simply claimed that the potential demand to do so would force him to tolerate homosexuality, which he says his Christian faith rejects.

Another problem critics see with this case and its underpinnings: It’s a lie that HIV prevention and treatment only affects gay men, because the federal Centers for Disease Control and Prevention has reported that 1 in 5 new infections in 2020 involved heterosexual women, and 1 in 10 of those cases involved intravenous drug users (who may or may not have also had same-sex relationships).

O’Connor’s decision has another important collateral consequence, as he also rejected the federal government’s reliance on expert health advice provided by independent, nonpartisan experts who voluntarily serve on the US Preventive. Services Task Force.

The task force, which solicits public input and examines available data on a range of medical services, publishing its rigorous findings in detail in leading medical journals, has won praise for providing clear and helpful advice on controversial health issues, including mammograms, prostate tests, vitamin intake to prevent cancer, and daily low-dose aspirin use to stave off heart disease.

O’Connor, however, said the panel is unconstitutional in its action because its recommendations are binding while its members are not appointed by the president and confirmed by the Senate.

The American Medical Association and other medical groups have denounced O’Connor’s decision, on which the judge asked the parties involved to provide further briefs and which will likely be appealed when he will be final.

Ruth Marcus, Washington Post columnist and associate editor of the newspaper’s editorial pages, wrote about the challenges posed by a growing battery of cases involving religion and health care. It traces the current upheavals, in part, not only to the recent High Court abortion decision, but also to an earlier decision in Burwell v. Hobby Lobby, in which “the court declared that the religious freedom of a private company had been violated by the contraceptive mandate of the ACA”. She argues this:

“My aim here is not to despise freedom of religion. As a member of a minority religion, I am sensitive to such arguments. Some of them — as in the case of the religious baker called upon to create a bespoke cake for a same-sex wedding — present difficult stakes. But, as this dispute [on HIV drugs] demonstrates, things have gone absolutely haywire and, in this age of conservative-dominated courts, are now leaning too far in the direction of religious rights. Medicine has made enormous progress since the emergence of the AIDS epidemic. Antiviral drugs PrEP – short for pre-exposure prophylaxis – reduce the risk of contracting HIV through sex by 99%. As a result, a government advisory committee in 2019 recommended that the drugs be part of the mandatory fully subsidized preventive care package. This is a development that everyone should applaud, including people who call themselves Christians: it avoids unnecessary deaths.

In my practice, I see not only the harms that patients experience when seeking medical services, but also their difficulties in accessing and paying for safe, effective, and excellent health care. It has become an ordeal with the skyrocketing costs, complexity and uncertainty of treatments and prescription drugs, too many of which turn out to be dangerous drugs.

In a world of rapid and shocking change, the practice of medicine has become legendary for its conservatism. It may take years for the widely reported results of rigorous clinical trials to turn into accepted bedside treatments. Of course, it’s great when medical-scientific advances are so powerful that they transform certain aspects of medical treatment.

But when patients’ lives are at stake, it makes sense for medicine to embrace cautious, evidence-based care, rejecting fads and seeming improvements that, alas, can prove harmful. These are not uncommon, alas, and chronicles report surgical “breakthroughs” that end up weakening or killing patients (think of the cancer-spreading “morcellator” used on women) or prescription drugs touted as miracle drugs who are not. t (think thalidomide).

Uncertainty is not a happy feature of financial markets or medical treatments. Clear and carefully established standards for doctors, nurses and hospitals have helped to significantly improve modern health care.

Courts must take great care to become an external and disruptive force, particularly if the public reputation of the judiciary is endangered by the slightest appearance of political partisanship. Most health workers and institutions across the country are struggling to give the best available medical treatment to patients, even as the nation’s highest court has seemingly erased standards of care developed over decades for better medicine. such as when life begins, let alone when a woman’s life is in sufficient danger, legally speaking, for medical intervention.

We are a nation that has flourished in accommodating and accepting many viewpoints. We have a lot of work to do to ensure that this democratic ideal endures and that caution, nuance, compassion and common sense are not overwhelmed by extremists.

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