Americans may have been surprised to learn on Wednesday that requiring insurers to cover HIV-prevention medication is not a “compelling government interest.” Federal judge Reed O’Connor, a George W. Bush appointee in Texas’s Northern District, ruled that the Affordable Care Act’s mandated coverage of pre-exposure prophylaxis, or PrEP, violated the religious liberty of a Christian-owned business, Braidwood Management. Braidwood’s owner, Steven Hotze, had argued that the pills “facilitate and encourage homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman”—and that requiring him to cover PrEP for his employees makes him “complicit” in such behavior.
O’Connor ruled that the PrEP mandate ran afoul of the Religious Freedom Restoration Act, but the decision effectively restricts the privacy rights of LGBTQ people. If employers object that the prophylactics Truvada and Descovy encourage gay men to have sex by lowering their chances of HIV infection—by more than 99 percent if taken daily—then those employers can punish them for their behavior by taking away one of their most effective means of protection from the virus. The ruling empowers such business owners to offer their LGBTQ employees a sinister choice: Be celibate, or engage in riskier sex.
This is yet further proof that many on the right don’t view public health policy as a matter of reducing disease or improving quality of life. Rather, it’s about punishment—a weapon to wield against political enemies.
We’ve seen this time and again over the past two-plus years. Republican politicians and right-wing media figures did not believe the various measures intended to slow the spread of Covid-19 were earnest attempts to protect American lives. Instead, they accused liberals of manipulating the administrative state to crack down on dissent from the mask and vaccine orthodoxy. When the sharp uptick in delta variant cases prompted the Democratic-led House of Representatives to reinstate a mask mandate last July, Minority Leader (and possible future speaker) Kevin McCarthy called the Centers for Disease Control and Prevention a “political arm of the administration” that “wants to control every element of our lives.” In this case, at least, the right claimed to be deeply concerned about privacy rights.
It quickly abandoned that specious line of reasoning when monkeypox began spreading globally earlier this year, mostly among gay and bisexual men. Now that the outbreak was localized in a minority (and largely Democratic) community whose sexual choices many on the right oppose, and it didn’t require the drastic interventions that Covid did, prominent conservative media figures saw an opposite problem: The liberal elite, with the tentacles of government bureaucracy still at its disposal, wasn’t hard enough on the people between whom the virus was spreading.
Conservative commentators have characterized gay men as sex-crazed perverts who lack the self-control to stay away from orgies like the “gay San Francisco fuckfest” (podcaster Steven Crowder’s words) that coddling Democrats refused to clamp down on. The Federalist’s Chad Felix Greene, a self-described gay conservative, wrote that it “really isn’t too much to ask for gay men to stop engaging in orgies and public sex events for their ‘mental health,’ their ‘self esteem,’ and to continue ‘having fun.’” Dr. Bryan Tyson went even further on an episode of Sean Hannity’s radio show, bemoaning that the CDC and the National Institues of Health are “afraid to come out and tell the gay community to stop having intercourse” altogether “until this pandemic goes away.”
Public health relies on society-wide cooperation. Sometimes it even requires making painful sacrifices for the sake of fellow citizens. It’s hardly surprising, then, that a political movement that generally denies the existence of the common good would fail to grasp these facts. Whether on guns, public education, or public health, conservatives see no broader social responsibility, believing that personal beliefs take precedence. With the help of judges like Reed O’Connor and the Supreme Court’s conservatives, they’re waging a war for individual rights over the rights of all—unless, of course, those individuals are likely Democratic voters. In which case, let ’em rot.