SCOTUS Ruling Maintains Status Quo, but Concerns About PrEP Access Linger
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Jul 10, 2025
The Supreme Court’s ruling on June 27 upholding the constitutionality of the Affordable Care Act’s preventive care coverage mandate helped ensure millions of patients will continue to have access without cost-sharing to pre-exposure prophylaxis (PrEP) treatments for HIV. Jesse Dresser, a partner with law firm Frier Levitt, says the ruling means it’s “status quo” for payers and plan sponsors, but he adds that it “creates continued financial exposure” to PrEP, which is becoming a crowded market with the FDA approving another medication last month and several pharmaceutical companies developing treatments. He also notes that former President Joe Biden’s administration last October released guidance prohibiting the use of prior authorization for PrEP.
“I don’t think that the focus on PrEP is over,” says Dresser, citing the high costs associated with the medication and potential legal challenges on religious grounds. “It’s not like covering a $5 medication or something inexpensive. I foresee there being continued focus on the prescribing, dispensing and coverage of PrEP medications.”
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