One of the more prominent supermarket brands in the southeast has taken a hard line against including the HIV-prevention medication known as pre-exposureprophylaxis ( PrEP ) in its employee insurance coverage, reports Ryan Lee in The Body. The lack of justification offered by Publix is fueling speculation that the company is refusing to cover the drug on moral grounds, given the political leanings of the company and a long history of accusations of anti-LGBT discrimination.
"PrEP is the most important prevention tool to happen in HIV prevention, and its rollout has lagged in the South where it is needed the most, said Kenyon Farrow, senior editor with TheBody.com . "Now, we're seeing a political climate that embraces religious excuses for discrimination, The Body will continue to connect the experiences of people living with HIV and those seeking HIV prevention to show the realities of biased policies."
Publix, a privately-traded company, scored a zero on the Human Rights Campaign's analysis of workplace fairness and has been accused of multiple instances of anti-LGBT discrimination. The company, which remains largely under the control of descendants of founder George Jenkins, has a political action committee thatdonated to Republicans more than two to one in 2012, 2014 and 1016, according to the Center for Responsive Politics.
"It's not like every single employee is going to go out and get PrEP, so it can't be cost," Devin Barrington Ward, a social justice advocate and strategist who works with Georgia legislators on behalf of the National Black Leadership Commission on AIDS, told The Body. "And I guarantee you, if you did a cost analysis, it would cost them less on their insurance premiums if they covered PrEP for someone who is HIV negative versus that person becoming HIV positive. We know that the cost for providing that person care increases exponentially."
Publix's refusal to fund the HIV prevention pill comes at a time when American employers and service providers are asserting their "religious freedom" to set workplace policies on moral grounds. Anne Tucker, associate professor at the Georgia State University College of Law, told Lee that if Publix's decision is motivated by morality, it continues "the narrative of Hobby Lobby," the U.S. Supreme Court's 2014 decision in Burwell v. Hobby Lobby Stores, Inc., that ruled that privately held companies can be exempted from the Affordable Care Act ( ACA )'s mandate to provide contraception based on their owners' religious views. The ruling immediately spurred concerns that it could be used to limit PrEP access. "The message of that particular case was [that] if employers disagree on personal moral bases and want to make health insurance coverage decisions based on that individual morality, [then] that, when it is sufficiently tied to a religion, can be a justification," she explained. "While U.S. Supreme Court Justice Samuel Alito wrote that the majority opinion in Hobby Lobby "should not be understood to hold that insurance-coverage mandates … must necessarily fall if they conflict with an employer's religious beliefs[,]" businesses like Publix stand on solid legal ground due to longstanding attitudes toward health care in the United States.
Earlier this month, the Trump administration's implemented new rules at the civil rights division of the U.S. Department of Health and Human Services ( HHS ) epermitting medical providers to deny service based on their religious beliefs. White House lawyers also argued on behalf of "religious liberty" when the U.S. Supreme Court heard oral arguments in Masterpiece Cakeshop, Ltd. v. Colorado Civil Rights Commission last November.
On Feb. 6 Publix announced via Twitter that they are in the process of reversing course on PrEP: "Publix appreciates the concerns shared by our associates and customers. We offer generous health coverage to our eligible full-time and part-time associates at an affordable premium and are committed to the health and well-being of our associates and their families. We regularly evaluate what is covered by our health plan and have made the decision to expand our health plan's coverage of Truvada to include Pre-exposure Prophylaxis (PrEP). We are working with our pharmacy benefits manager to implement this change as quickly as possible."