SCOTUS Ruling Maintains Status Quo, but Concerns About PrEP Access Linger

Jul 10
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.”
Read more
© 2025 MMIT

Tim Casey

Tim has been a reporter and editor for newspapers, websites and magazines for more than 20 years, including 10 years covering health care business topics. He has a deep knowledge of the managed care industry and pharmacy benefit management. He also has experience covering medical conferences and clinical and legislative health care issues. In 2014, the Society for Advancing Business Editing and Writing selected Tim as one of 15 journalists to participate in a national symposium on the Affordable Care Act. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.