First-of-Its-Kind Lawsuit from Gay Man Denied Insurance Because He’s on PrEP

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First-of-Its-Kind Lawsuit from Gay Man Denied Insurance Because He’s on PrEP

lawsuit form

Earlier this week, the Gay & Lesbian Advocates & Defenders (GLAD, not to be confused with GLAAD) filed a claim with the Massachusetts Commission Against Discrimination charging that Mutual of Omaha Insurance Company discriminated against a gay man when they denied him long-term care insurance because he’s taking Truvada as PrEP.

This is the first lawsuit in the country challenging discrimination against a person for being on Pre-exposure Prophylaxis, or PrEP. Long-term care insurance can pay for some or all of the costs of nursing homes, assisted living facilities, or home health care for people who become unable to take care of themselves. Long-term care insurance is important because Medicare and other health insurance packages frequently limit the length of time a person can receive care in theses facilities or use them for in-home services.

“I was being responsible and doing the right thing,” the plaintiff, identified as John Doe, said in the complaint. “Insurance companies should be begging everyone to take Truvada—not discouraging them. As someone who lived through the worst of the epidemic and saw dozens of my friends die, I want to do everything I can to stop it.”

Some wonder if the insurance agency assumed that the man’s use of Truvada suggested he was at a heightened risk of contracting HIV, and could therefore be at high risk for needing long-term care. Of course, that kind of assumption would be false, not the least because, as a recent study has further demonstrated, those on PrEP are some of the least likely people to become HIV-positive.

In that study, 600 people at risk of HIV infection took Truvada for 32 months. In that time not a single one of the study participants became HIV-positive.

The legal complaint reports that the 61-year-old Boston resident applied for long-term care insurance with Mutual of Omaha in November 2014. The following February, he received a denial letter, which stated that the reason for the denial was his use of PrEP. He appealed the denial, but his appeal was rejected in April 2015.

“Mutual of Omaha’s denial is nonsensical,” Bennett Klein, Senior Attorney and AIDS Law Project Director at GLAD, said in a written statement. “If our client were not taking Truvada, not protecting his health and the health of others, he would have received the insurance. We should be well beyond the days when insurers make decisions based on fear and stereotypes about HIV. The assumption is that gay male sexuality is inherently risky and unhealthy, and that’s just wrong.”

GLAD, which uses strategic litigation, public policy advocacy, and education to fight for a society free of discrimination based on gender identity and expression, HIV status, or sexual orientation, claims in their lawsuit that Mutual of Omaha broke the law when it denied John Doe insurance. That claim is based on the legal argument that refusing Doe insurance is equivalent to denying him access to a place of public accommodation based on sexual orientation and disability. Antidiscrimination laws protect both those who are disabled themselves as well as people who are discriminated against based on false beliefs about a health condition.

“We can’t stop the HIV epidemic if people face discrimination for doing the very thing that’s proving to prevent transmission,” Klein added.

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