>> The latest legal battle over
the affordable health care act
centers on its requirement
private health insurance fully
cover preventive services like
cancer screenings, vaccinations,
and birth control.
Also on the list, drugs that
prevent HIV infections called
preexposure prophylaxis.
The retail price can be as much
as $6,000 for a 90 day supply.
It puts it out of reach for many
of those who benefit from it but
don't have insurance.
Cheval the Luther's health
reporter at 19 news.
She focuses on gender and
health.
Tell me about prep.
How effective is it?
>> Prep is incredibly effective.
More than 90% in preventing HIV.
Some would call it a wonder drug
raid it is not wrong.
It has transformed what it means
to live in our society.
Especially in a group that is
high risk for contacting HIV,
taking it in a daily pill,
although there is a new
injectable form, can allow you
to live a life that is much
safer, free of risk, and without
fear of contracting in the days
that have been incredibly
dangerous in the past.
>> Given what you said, pills
have been around for about a
decade.
The CDC estimated only about a
quarter of the people who would
benefit are actually on prep.
Why that gap?
>> A historic number of reasons
as to why it was not as high and
is not as high as public health
experts would like.
The price tag, the pills taken
have been very expensive.
There are generics on the market
bringing down the price without
the insurance that covers the
medication.
It can be prohibitive for many
with lower incomes.
The other challenge we don't
talk about what really is
important is outreach.
There's a lot of effective
outreach making sure certain
demographics know about prep.
This is largely seen as a drug
that has been good at making its
way to men who are white and
gay.
It often doesn't reach out in
the same way to many people who
are high risk but not considered
in the archetype.
In particular, to expand
outreach to trans-american and
black Americans at higher risk
of HIV and may not be told about
prep by their doctor or for
other reasons may not consider
it as the right drug for them.
People talk about the fact you
have to take a pill every day.
Does the fact this injectable
prep, which you only get a shot
every other month after two
shots and two months, do you
think it would help spread use
of this drug?
>> That is an open question.
Even with injectable prep, you
need regular visits to a doctor
to get the injection, which can
be a barrier for folks who are
not plugged into the system or
don't have a regular medical
professional who don't have
health insurance.
The injectable prep is fairly
new.
It is not always covered at no
cost by health insurance unless
you have shown you cannot take
the daily pill.
It seems like a really viable
possibility to expand options.
But I think it is too early to
say how meaningful an impact
they can have.
>> This is the center of a new
legal battle.
A lawsuit before the fifth
circuit court of appeals.
The group wants to knock out the
preventive care mandate.
Who is bringing the suit and why
do they want out?
>> This group of employers has
challenged the preventive
services mandate.
They filed it in Texas where it
is known to be hostile to the
affordable care act.
And their argument is twofold.
They say the federal government
has overstepped its authority in
determining preventive services
that must be covered at no cost.
They also claim they have a
religious exemption.
Providing insurance, employees
covering prep violates their
religious beliefs.
What many legal authorities have
told me, the arguments are
steeped against largely gay men
and what many describe as
homophobic claims that covering
prep would facilitate or
encourage people to have sex
outside of marriage between a
man and a woman.
What was troubling is there is
interests in those arguments.
But those are not the main
claims as to why prep should not
be covered.
What is happening is the fifth
circuit court of appeals is
hearing arguments in this case,
they will issue a decision
relatively soon.
But for now, they have said
health insurers must keep
covering prep and under -- other
preventive services.
>> What is due to not only HIV
prevention, but birth control,
cancer screenings, and other
things falling into that
category?
>> The contraception question is
tricky.
The guarantee for birth control
with no out-of-pocket costs
comes from multiple facets of
the ACA.
We know that there could be new
costs for consumers for prep,
mental health screenings, cancer
screenings, reproductive health
care services we now take for
granted and can become expensive
for people if they are no longer
able to have the preventive
services mandate.
It has been in effect for a long
time.
The ACA was passed in 2010, more
than a decade ago.
>> Thank you very much.