In his 42-page ruling, U.S. District Judge Reed O’Connor said the requirement that the company comply with the order or pay a fine “imposes a significant burden on religious freedom.” He also declared unconstitutional the government’s scheme to decide which health care services should be covered under the health care law — a decision that could jeopardize a wide range of free services, including screenings for cancer and heart disease, for millions of Americans. The decision is the latest in a series of challenges to the health care law. O’Connor himself ruled the entire law unconstitutional in late 2018 — a ruling that didn’t stand after the Supreme Court upheld the law 7-2 last year, the third time the chamber has heard such a challenge. The challenge this time focused on several issues, including whether requiring certain preventive services violated the Religious Freedom Restoration Act, passed by Congress in 1993, and the authority of the administration’s Preventive Services Task Force to determine what preventive services employers must cover. Steve Hotze, one of the plaintiffs and owner of the Christian nonprofit Braidwood Management Inc., opposed providing coverage for HIV prevention drugs, called PrEP, saying they “facilitate and encourage homosexual behavior and sexual activity outside of marriage between a a man and a woman.” The decision was followed up in 2014 Hobby Lobby case, in which the Supreme Court ruled 5-4 that a company could not be forced to provide its employees with contraception coverage, a mandate the company argued would make it complicit in what it considered sinful behavior. PrEP, which stands for pre-exposure prophylaxis, was first approved by the US Food and Drug Administration in 2012 and recommended in 2019 by the US Preventive Services Task Force. O’Connor’s decision was met with swift opposition from consumer advocacy groups and many Democrats, who said they expected an appeal. A Biden administration official said the decision was under review. Since the judge has not issued an order specifying the scope of his ruling, “it’s too early to really know what that means,” said the official, who spoke on condition of anonymity because they were not authorized to discuss the case. Consumer group Protect Our Care said the decision “threatens the Affordable Care Act’s preventive services requirement that guarantees free access to more than 100 preventive health services, including preventive health exams, routine immunizations, well-baby and child visits, prenatal care, contraception and more”. services used by 150 million Americans, according to the group. “In a legally sane world, this would be overturned quickly, but that’s not the world we live in,” said Ira Lupu, a professor emeritus at the George Washington University School of Law who has specialized in the study of religious freedom. Lupu said the new ruling stretched the high court’s reach Hobby Lobby decision. “It’s not the medicine that’s sinful,” he said. “They say that many of the people who will want to use this medicine will have committed a sin.” Lupu said the ruling is based on the Religious Freedom Restoration Act, enacted in response to a previous Supreme Court ruling that was deemed hostile to religion. The 1990 case convicted a group of Native Americans who wanted to use peyote in their services. The court ruled that the law against the use of peyote applies to all, religious and non-religious groups.
