Washington, D.C. has the second-lowest rate of people who lack health insurance in the country, but many residents are facing new barriers to health care due to provisions of the sweeping federal law passed in July, which threatens access for thousands. 

Changes to insurance eligibility and the rising cost of premiums, which kicked in for some in October and others more recently, are expected to leave many more patients uninsured or unable to afford medical care. Federally qualified health centers, including D.C.’s Whitman-Walker Health, where 10 to 12 percent of patients are uninsured, are bracing for an influx of newly uninsured patients while facing their own financial challenges. 

Even in D.C., where uninsured rates have been among the lowest in the country, changes brought on by the passage of the Republican mega bill (known as the “Big Beautiful Bill”) will have major effects. 

The changes from the bill affect Medicaid, which is free to low-income patients, and subsidies for insurance that people buy on the health insurance exchanges that were started under the Affordable Care Act, which were allowed to expire on Dec. 31. 

Erin Loubier, vice president for access and strategic initiatives at Whitman-Walker Health, says some Whitman-Walker Health patients have received notices about premium increases, including several who say the increases are up to 1,000 percent more than they were paying. 

“That is like paying rent,” she says. “We live in an expensive city, so any increases are going to be really, really hard on people.”

Whitman-Walker Health and other healthcare providers are expecting the changes to have multiple effects — some patients may not be able to afford coverage or may avoid going to the doctor and allow health conditions to worsen because they can’t afford care, and many more will be seeking care who don’t have insurance. 

“I’m worried that we’re going to not just have people who can’t get care, but that they delay care until they’re really sick, and then the care is not as effective because they might have waited too long, and then we may have a less healthy population,” Loubier says.

Loubier says delaying care, and serving more people without insurance has major implications for Whitman-Walker Health and other health centers serving the community.

“There’s going to be a lot of pressure on us to try to find and raise more money, and that’s going to be harder, because I think all organizations who provide health care are going to be facing this,” she says. 

The U.S. health care system is the most expensive in the world, and has much higher out-of-pocket costs for individuals. But in other countries like the United Kingdom, Australia, Canada, and many others, health care is much less expensive — or even free.

Even though the U.S. has a high-priced healthcare system, critics say there are still ways to bring down costs by forcing insurance and pharmaceutical companies to absorb more of the costs, rather than transferring the costs to patients.

“In the U.S., they end up trying to cut costs at the person’s level, not at the level of the different corporations or structures that are making a lot of money in healthcare,” said Loubier. “Our system is so complicated and there is probably waste in it, but I don’t think that that cost and waste is at the ‘people’ level. I think it’s higher up at the system level, but that is much, much harder to get people to try to make cuts at that end.”

Ultimately at Whitman-Walker Health, healthcare providers and insurance navigators are planning to help with everyday necessities when it comes to healthcare coverage and striving to provide healthcare in partnership with patients, said Loubier.

“The key here is we’re going to have a lot of people who may lose insurance, and they’re going to rely on places like Whitman-Walker Health and other community health centers, so we have to figure out how we keep providing that care,” she said. 

(This article was written by a student in the journalism program at Bard High School Early College DC. This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser.)

As Kenya prepares for next year’s August general election, local queer rights groups have joined Gen Zers in also mobilizing their members to register as voters. 

The groups’ drive began ahead of the electoral commission’s official launch of a one-month nationwide mass voter registration on March 30, targeting 6.5 million new voters to bring the total to more than 28 million. 

The groups — led by the Initiative for Equality and Non-Discrimination (INEND) and Galck+ — note that politics is not optional, but rather it is “our responsibility” to use the ballot to put an end to bad leadership and discriminatory laws against them. 

“Voting is one of the most powerful ways we exercise our autonomy and remind the State that our human rights are not ‘Western imports’; our struggles for housing, employment, safety, and dignity are fundamentally Kenyan issues,” INEND states. 

It reminds queer individuals that the nation entrusts them with an identity card at age 18 as a recognition of their ability to make decisions, follow laws, and take responsibility for the country’s future. 

INEND also notes that despite this honor, LGBTQ people get kicked out of their homes due to homophobia, are discriminated against at work, and face violence in public places due to the punitive laws that the same State legislates. 

“As queer Kenyans, our vote matters,” INEND states. “Our voice belongs in the democratic and governance conversations, and true democracy includes everyone.”

Some voter mobilization initiatives the queer lobby groups have been using include ‘Queering the Ballot’ Podcasts on civic participation, dubbed ‘Your Vote is Your Future’. The topics explored include how laws shape their lives, the relationship between lived experiences of common citizens, discrimination fatigue, distrust in government systems, and voter apathy. 

The groups through the mobilization drive hope to create a queer voting bloc to actively participate in restructuring and reconstructing the existing governance system they argue has been a problem for them. They maintain the queer community navigates a system that was not built for them from its questioning of their right to exist, yet the Kenyan Constitution clearly states that no citizen should be discriminated against based on sexual orientation or gender identity.   

The Court of Appeal next month will hear a case challenging the constitutionality of provisions in Kenya’s Penal Code that criminalize consensual same-sex relationships among adults. The appeals court postponed the case after adjourning on Feb. 4, its first substantive hearing since the High Court judgement in 2019. 

“Change requires more than pointing fingers. It requires reflection, action, and showing up, especially at the ballot box as LGBTQ Kenyan citizens and declaring that this is our country, our business, and we can no longer watch from the sidelines,” INEND states. 

The group notes that they want a governance system that embraces queer people as they go about their daily lives without any form of homophobic discrimination, harassment, or arrests. Queer people are therefore urged to pick the right leaders who listen to them in Kenya’s six elective positions, from the president down to the local government representatives, as their decisions while in power affect them. 

“It is very irresponsible for any human being, even around the world, to assume that they don’t have political responsibility. It is easy and sounds fancy to say ‘I don’t like politics,’ but it does not make one good as it makes one abandon their political responsibility as a citizen,” INEND states.

The groups are also concerned with the existing homophobia among Kenyans, especially whenever they join them in street protests against the government’s punitive measures or advocating for change. However, they maintain that the LGBTQ community won’t be left behind despite being marginalized in society, yet they are the most affected group when the government raids people’s pockets for taxes.      

“Now we are moving from the margins to the centre of this political conversation early enough to ensure that our community sees the sense because if we live in a country that doesn’t work, we will be the most affected,” INEND states. 

INEND, with the National Gay and Lesbian Human Rights Commission and Galck+, last November launched the second Queering the Ballot Campaign and the 2024 Situation Report on queer participation in Kenya’s democracy. 

The report surveyed 14 of the country’s 47 local governments, whose key findings affirm that queer Kenyans are not outsiders to democracy but its heartbeat.   

“The title ‘Our Vote, Our Future: LGBTQ+ Inclusion in Democratic and Governance Processes’ in Kenya is an ode to the spirit of the queer movement in Kenya; unshaken in the face of adversity, determined in its pursuit of justice, and unrelenting in demand to be seen, heard and counted in democratic and political processes,” reads the report forwarded by former Chief Justice Willy Mutunga.         

The report calls on Parliament, the Independent Electoral and Boundaries Commission, the County Assemblies, and every Kenyan to make inclusion not symbolic but systemic. 

D.C. Mayor Muriel Bowser on March 20 signed a bill approved by the D.C. Council that requires health insurance companies to cover the costs of HIV prevention or PrEP drugs for D.C. residents at risk for HIV infection.

Like all legislation approved by the Council and signed by the mayor, the bill, called the PrEP D.C. Amendment Act, was sent to Capitol Hill for a required 30-day congressional review period before it takes effect as D.C. law.

Gay D.C. Council member Zachary Parker (D-Ward 5) last year introduced the bill.

Insurance coverage for PrEP drugs has been provided through coverage standards included in the Affordable Care Act, known as Obamacare. But AIDS advocacy organizations have called on states and D.C. to pass their own legislation requiring insurance coverage of PrEP as a safeguard in case federal policies are weakened or removed by the Trump administration, which has already reduced federal funding for HIV/AIDS-related programs.

Like legislation passed by other states, the PrEP D.C. Amendment Act requires insurers to cover all PrEP drugs approved by the U.S. Food and Drug Administration.

Studies have shown that PrEP drugs, which can be taken as pills or by injection just twice a year, are highly effective in preventing HIV infection.

“I think this is a win for our community,” Parker said after the D.C. Council voted unanimously to approve the bill on its first vote on the measure in February. “And this is a win in the fight against HIV/AIDS.”