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EXCLUSIVE: Obama extends protections to gay couples under Medicaid

Protects against liens, period of ineligibility and estate recovery

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Secretary of Health & Human Services Kathleen Sebelius (Blade file photo by Michael Key)

The Obama administration is set on Friday to issue policy guidance to states expanding their ability to offer same-sex couples the same protections afforded to straight couples when they receive long-term care under Medicaid, the Washington Blade has learned exclusively.

Under the new guidance, dated June 10, states have the option to allow healthy partners in a same-sex relationship to keep their homes while their partners are receiving support for long-term care under Medicaid, such as care in a nursing home.

Medicaid kicks in for a beneficiary to receive care after an individual depletes virtually all of their money. To pay for the beneficiary’s expenses under Medicaid, a state could impose a lein, or take possession, of a beneficiary’s home to pay for Medicaid expenses.

However, federal law prohibits imposing this lein if beneficiaries are married to someone of the opposite-sex who’s still living in their home. The new guidance, signed by Deputy Administrator of the Centers for Medicare & Medicaid Services Cindy Mann, clarifies that states can offer this protection to the healthy partner of a Medicaid recipient in a same-sex relationship.

“A State can have a policy or rule not to pursue liens when the same-sex spouse or domestic partner of the Medicaid beneficiary continues to lawfully reside in the home,” the guidance states.

The Obama administration previously hadn’t articulated whether gay couples could receive these protections under the Defense of Marriage Act, which prohibits federal recognition of same-sex marriage. The guidance doesn’t mandate that same-sex couples receive this protection, but allows states to “incorporate their criteria for determining when to impose a lien in the Medicaid State plan.”

The Department of Health & Human Services had been examining ways to offer more protections to same-sex couples under Medicaid as part of the work it has undertaken for LGBT people, but until now hadn’t issued the policy guidance to states.

Secretary of Health & Human Services Kathleen Sebelius said in a statement the new guidance represents a path for low-income same-sex couples to receive care under Medicaid.

“Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need,” she said. “That is now changing. Today’s guidance represents another important step toward ensuring the rights and dignity of every American are respected by their government.”

Michael Cole-Schwartz, a Human Rights Campaign spokesperson, praised the Obama administration for issuing the guidance, but maintained same-sex couples won’t have equal protection under the law until DOMA is repealed.

“No one should have to choose between keeping their home and getting the medical care they need and deserve,” Cole-Schwartz said. “This is an important step to give some couples the security and dignity they deserve when they need it most. However all same-sex couples will remain vulnerable until we end discrimination in marriage and repeal the Defense of Marriage Act.”

In addition to allowing states not to impose liens on the homes of same-sex couples, the guidance also allows individuals in same-sex relationships to sell their home below market value to their partner and still receive Medicaid support.

An individual seeking Medicaid coverage may want to make this transfer to deplete his or her assets more quickly to be eligible for care. Under other circumstances, the state could impose a period of ineligibility on the beneficiary because of this sale, but the guidance says states can ignore this transfer if they believe such ineligibility would institute “undue hardship.”

“Because of the flexibility afforded to States in determining undue hardship, we believe that States may adopt criteria, or even presumptions, that recognize that imposing transfer of assets penalties on the basis of the transfer of ownership interests in a shared home to a same-sex spouse or domestic partner would constitute undue hardship,” the guidance states.

Furthermore, the guidance says states can opt not to seize the home of Medicaid beneficiaries upon their death if their same-sex partner is still living in the home.

States may seize the property of Medicaid beneficiaries upon their death — if a lien has been imposed on the home or the recipient is age 55 or over and has received nursing services — but not if the recipient’s child or spouse is living in the home. The guidance clarifies that states may also decide not to do so if a same-sex partner is living in the home.

“States have flexibility to design reasonable criteria for determining what constitutes an undue hardship and who may be afforded protection from estate recovery in such instances,” the guidance states. “At the State’s discretion, this may include establishing reasonable protections applicable to the same-sex spouse or domestic partner of a deceased Medicaid recipient.”

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National

Man charged in Mall of America shooting plot inspired by Pulse massacre: report

Suspect exchanged hundreds of messages, pledged loyalty to ISIS

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The U.S. Department of Justice charged Sheikhdoon Abdullahi Mohamud with planning a crime of terrorism.

The U.S. Department of Justice charged Sheikhdoon Abdullahi Mohamud, 18, of Richfield, Minn., on Oct. 7 with one count of knowingly receiving a firearm and ammunition in order to commit a federal crime of terrorism. Mohamud allegedly planned to carry out a mass-casualty attack in support of ISIS, inspired in part by the Pulse nightclub massacre that took place on June 12, 2016 when then-29-year-old Omar Mateen murdered 49 people and wounded 58 – one of the deadliest mass shootings in U.S. history, and the deadliest targeting the LGBTQ+ community. 

According to a DOJ statement release, Mohamud was arrested on Oct. 6 by the FBI, which had arranged to sell him an AK-47 assault rifle, magazines, and ammunition through an undercover FBI employee. Mohamud was arrested shortly after paying $600 in cash and taking possession of those items; he reaffirmed his intention to shoot people at the Mall of America during the transaction.

“Mohamud allegedly sought to carry out a mass-casualty shooting at the Mall of America, expressing a desire to emulate some of the most horrific ISIS-inspired attacks in the United States, including the atrocities at Pulse Nightclub and 2025 New Year’s Day attack in New Orleans,” said Assistant Attorney General for National Security John A. Eisenberg in the statement by the DOJ. “The National Security Division will continue to work closely with the FBI and Joint Terrorism Task Force to track down and prosecute ISIS-inspired terrorists in the United States.”

According to the complaint, beginning on or about December 2024, Mohamud had exchanged hundreds of messages through multiple social media and messaging apps with a confidential source, and expressed a desire to travel to Somalia to join a designated foreign terrorist organization to fight on their behalf.

The defendant stated many times that if he was unable to travel overseas because of a lack of funds, he planned to carry out a mass-casualty event in Minnesota in support of ISIS. 

According to the DOJ, “In July 2026, Mohamud sent messages discussing his intent to carry out a mass-casualty shooting attack at the Mall of America because he claimed it was owned by Jews. He wrote that [he] wanted to kill 30 to 60 people so no one would go there.”

“During the course of his communications, Mohamud stated that he wanted to commit an attack similar to those of the Pulse Nightclub mass-shooting in Orlando, the Bondi Beach mass-shooting in Australia, and the New Year’s Day vehicle-ramming attack in New Orleans.”

This case is being prosecuted by Trial Attorney Ryan White of the National Security Division’s Counterterrorism Section and Assistant U.S. Attorney Benjamin Bejar for the District of Minnesota.

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California

Calif. GOP gubernatorial candidate ad ‘disgusting attempt to exploit lesbian intimacy’

Activists, anti-LGBTQ religious leaders criticized Steve Hilton spot

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(Screenshot of Steven Hilton ad)

Two women sit on a bed, a Pride flag hanging behind them. One is nervous; the other tells her to be calm and that she’ll do “all the work.” The music swells. The two hold hands and —  fill out a ballot voting for Steve Hilton? 

This is the new advertisement from the Hilton gubernatorial campaign that is drawing rebuke from both sides of the aisle, but for very different reasons. 

Jorge Reyes Salinas, the communications director at Equality California, said the ad was an insult to the queer community. 

“This ad is a disgusting attempt to exploit lesbian intimacy for political attention,” he said. The advertisement plays on media tropes that Salinas says “reduce lesbian and bisexual women … to sexual entertainment,” rather than showing them as well-rounded characters. “Any group of the LGBTQ+ community deserves the same dignity and respect as everyone else,” he said. 

The ad is truly hyper-sexualized. It ends with one woman telling the other, “Now lick it.” The two pause and stare before she reveals an envelope to send the ballot, and large text pops up saying, “Just try it!”  

Salinas characterized the ad as a desperate attempt to get attention from a candidate who is trailing far behind in the polls in heavily Democratic California. The Democratic candidate Xavier Becerra, who is endorsed by Equality California, holds a 25-point lead over Hilton according to recent polling by the UC Berkeley Institute of Governmental Studies. 

Conservatives have also criticized the ad.

Influential evangelical Pastor Jack Hibbs thought the ad was distasteful and said, “lesbianism among college girls and some high school girls that right now is an actual pandemic of social ill.” Republican attorney general candidate Michael Gates said it undermines “the sanctity of the relationship between parents and their children.” This criticism is rather confusing because although the ad features two relatively young women, they both appear to be adults, not minors. 

“The comments from Pastor Jack Hibbs should be criticized because there is nothing wrong with two women being attracted to each other,” Salinas said. “We’re calling out the ad’s stereotypes, while also rejecting the homophobia in the response to it … by other Republicans.” 

The backlash from Hilton’s own party and supporters shows that an advertisement full of queer innuendo was ill-considered, considering the national GOP’s attacks on LGBTQ people in recent years. Hilton himself has been campaigning against transgender girls and women competing in school sports and using locker rooms that correspond with their gender identity. This context might be why Hilton’s political base responded to the ad just as poorly as the liberal voters he was attempting to court. 

Hilton says the ad is part of a new series rolling out before Election Day, showing stereotypical California liberal archetypes voting for Hilton. He claims these ads are authentically filmed with real actors, as opposed to being A.I. generated, like many of his previous ads. One other advertisement has been released so far by the campaign showing a man at a spiritual retreat also being swayed to vote for Hilton, although it is notably absent of sexual innuendo.

Caleb Kaufman is a California Local News Fellow placed with the Los Angeles Blade. The California Local News Fellowship is a state-funded initiative to support and strengthen local news reporting. Learn more about it at fellowships.journalism.berkeley.edu/cafellows.

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2026 Midterm Elections

Trump uses anti-trans slur against Democratic Senate candidate

President mocked Annie Andrews

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President Donald Trump (Washington Blade photo by Michael Key)

President Donald Trump used an anti-trans slur against Democratic South Carolina Senate candidate Annie Andrews on Monday as he sought to rally support for Republicans in the state’s Senate race.

In a post on Truth Social, Trump attacked Andrews three times, referring to her as “trannie” while promoting U.S. Sen. Darline Graham (R-S.C.)’s campaign.

Andrews is running against Graham for a Senate seat in the solidly Republican state.

Earlier this year, Graham was specially appointed to the seat following the death of her brother, Lindsey Graham, who represented South Carolina in the Senate from 2003 to 2026.

Andrews, the Democratic nominee from the state, is a pediatrician that lives in Charleston with her three children. She told NBC News that she will “work with anyone to put South Carolina first.”

“As a mom and a pediatrician, I’m in this race to fight for my patients, my three kids, and South Carolina,” Andrews said, adding that “lowering costs and making life better for families across our state is going to take all of us working together.”

Andrews used the attention from the president’s attack to emphasize what she described as a focus on policy issues rather than the culture wars that have dominated much of the political debate.

“If you care more about your bills than the politics in Washington, this campaign is for you,” she added.

Trump’s remarks have drawn criticism from leaders on both sides of the aisle.

Senate Minority Leader Chuck Schumer (D-N.Y.) condemned Trump’s words Monday night on social media, calling his attacks on Andrews “despicable.”

“Annie Andrews is a mom and pediatrician who’s always put her community first — and she’s exactly who South Carolina needs representing them in the Senate,” Schumer said on X.

Former South Carolina Gov. David Beasley, a Republican, also criticized the president’s attack on Andrews, urging voters to “reject politics based on division and hate.”

“This is abhorrent. Elections don’t have to be about cruelty and lies. South Carolina deserves better,” Beasley wrote Monday night on X.

South Carolina has not elected a Democratic senator in nearly three decades.

Andrews’s campaign website does not mention her positions on LGBTQ issues.

The Washington Blade reached out to Andrews’s campaign for comment on Trump’s attack and her positions on transgender rights but did not hear back by time of publication.

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