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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

Politicians, activists pay tribute to Barney Frank

Former congressman died on Tuesday

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Then-U.S. Rep.Barney Frank (D-Mass.) (Washington Blade photo by Doug Hinckle)

Former U.S. Rep. Barney Frank (D-Mass.), who served in the U.S. House of Representatives from 1981 until his retirement in 2013 and who became the first member of Congress to voluntarily come out as gay in 1987, died on May 19, at the age of 86, at his home in Ogunquit, Maine.

His passing came less than a month after he announced he had entered home hospice care due to terminal congestive heart failure under the care of his husband, Jim Ready, and shortly after finishing writing a new book entitled, “The Hard Path to Unity: Why We Must Reform the Left to Rescue Democracy.”

Despite his frail health, during the last few weeks of his life, Frank agreed to do interviews with multiple news media outlets, including the Washington Blade, where he reflected on his sometimes-controversial positions on issues such as transgender rights.

He told the Blade he had been living with his husband in their shared home in Maine since the time of his retirement in 2013 and called his husband a “saint” for caring for him during his illness. In 2012, at the age of 72, Frank married Ready, becoming the first sitting member of Congress to marry someone of the same sex.   

Barney Frank (left) and Jim Ready at their wedding ceremony. (File photo courtesy of Frank’s office)

News of his passing prompted an outpouring of praise and reflection on his life as a groundbreaking out gay lawmaker by current and former members of Congress and LGBTQ rights leaders.

Massachusetts Gov. Maura Healey announced on May 20 that she had ordered the U.S. flag and the state flag to be lowered to half-staff at all state buildings in honor of Frank’s life and legacy and the recognition of his passing.

“Barney Frank was nothing short of a trailblazer,” said Kelley Robinson, president of the Human Rights Campaign, the nation’s largest LGBTQ advocacy organization, in a statement. “At a time when being openly gay in public service could cost you everything, he chose visibility,” Robinson said.

Robinson and other LGBTQ advocates also pointed to Frank’s role in speaking out in Congress for stronger efforts to address the AIDS epidemic during the early years of HIV/AIDS, his push for the repeal of the “Don’t Ask, Don’t Tell” policy to initially allow gays to serve openly in the military, the enactment of marriage equality for same-sex couples, and broader anti-discrimination protections.

Frank has also been credited with helping to pass the federal Matthew Shepard and James Byrd Jr. Hate Crimes Protection Act of 2009.

In addition to his longstanding support for LGBTQ rights, political observers have said one of his most important achievements in Congress was his role, as chair of the House Financial Services Committee, in becoming co-author of what became known as the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010.

Coming at the time of a nationwide banking crisis, the New York Times has called the Frank bill that he and then-U.S. Sen. Christopher Dodd (D-Conn.) wrote “the most significant overhaul of the nation’s financial regulations since the Great Depression.”

Frank was born and raised in Bayonne, N.J., and graduated from Bayonne High School.

He graduated from Harvard College in Massachusetts in 1962 and worked in various places, including as an assistant to then-Boston Mayor Kevin White, before winning election to the Massachusetts House of Representatives in 1972, where he served for eight years representing a Boston area district. During that time he attended and graduated from Harvard Law School and became a member of the Massachusetts bar in 1979 after passing the bar exam.   

In 1980, Frank became a candidate for the U.S. House in the Massachusetts 4th Congressional District, which he won with 52 percent of the vote in a four-candidate race, taking office in January 1981. He won re-election decisively over the next 30 years until announcing in 2012 his plans to retire and he would not run for re-election that year.  

The New York Times is among the publications that have reported this week since Frank’s passing that his record as an esteemed and admired lawmaker helped him survive a sex scandal that surfaced in 1990 linking him to male prostitute Stephen Gobie.

Media reports at the time said Frank had patronized Gobie as one of his customers and for a time had Gobie as a roommate in Frank’s D.C. residence in the Capitol Hill neighborhood. In its article this week, the New York Times says Gobie “claimed that in the mid-1980s he had run a prostitution ring out of Mr. Frank’s home.”

Like other media accounts, the Times report adds that following an investigation, “The House Ethics Committee did not substantiate that claim, but it did find that Mr. Frank had fixed 33 parking tickets for Mr. Gobie and sought to shorten his probation on drug and sex-offense convictions by writing a misleading memorandum on congressional stationery to an official involved in supervising Mr. Gobie’s probation.”

The full House voted 408-18 to reprimand Frank for misuse of his office, but it rejected calls by some to censure or expel him.

“I should have known better,” Frank said in a speech on the House floor at that time, according to the New York Times. “There was in my life a central element of dishonesty,” the Times quoted him as saying. “Three years ago, I decided concealment wouldn’t work. I wish I decided that long ago,” he said referring to his 1987 decision to come out publicly as gay.

Despite all of this, Frank was re-elected that year with 66 percent of the vote, a development that his friends and supporters attribute to his reputation as a beloved and highly regarded public figure.

PFLAG, the national advocacy group for parents and friends of LGBTQ people, is among the groups that issued statements this week reflecting on Frank’s positive impact on the LGBTQ community.

“Frank was not only the first openly gay member of Congress, but he was also co-author of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 as chair of the House Financial Services Committee, which helped enshrine housing access for LGBTQ+ people,” PFLAG says in a statement.

“He was also a leading advocate on laws to combat HIV/AIDS,” the statement says, adding that PFLAG’s national office honored Frank with its Champion of Justice Award in 2018.

“Barney was candid, outspoken, quick-witted and downright funny, and he always had his eye on making progress,” said U.S. Sen. Tammy Baldwin (D-Wis.), the first openly lesbian woman elected to the U.S. Senate, in a statement. “He was willing to take on anyone who was in his way, regardless of who they were — I should know, I was one of the many who on occasion got an earful from him,” Baldwin said.

‘But I, and anyone else who spent time with him, were lucky to watch him in action and learn from him,” her statement continues. “Barney was a masterful legislator, savvy and strategic, and always thinking of the long game,” she said. “Our country is a better, more just, more equal place because of him, and he will be sorely missed.”

U.S. Sen. Tammy Baldwin (D-Wis.) with former Congressman Barney Frank (D-Mass.) in 2022. (Washington Blade photo by Michael Key)

U.S. Rep. Mark Takano (D-Calif.), who serves as chair of the Congressional Equality Caucus, which represents LGBTQ members of Congress and their congressional allies, issued his own statement on behalf of the caucus pointing out that Frank was one of the two founding members of the caucus.

“I was honored that he came to campaign for me during my run for Congress just a few years after he co-founded the Congressional Equality Caucus, which I now have the distinct honor of leading,” Takano said.

He was referring to Frank and then-Congresswoman Tammy Baldwin’s action in 2008 to found the House LGBT Equality Caucus as the only two openly gay members of Congress, which evolved into the Congressional Equality Caucus.

“Barney proved that what mattered most was the work you did for others,” Takano says in his statement. “I truly believe that we are closer to a more equal world because of Barney Frank,” he said, adding, “Congressman Frank’s legacy touches every part of our fight for LGBTQI+ equality: from his work advocating for HIV and AIDS research to helping pass major pro-equality legislation like the Don’t Ask, Don’t Tell Repeal Act and the Hate Crimes Prevention Act into law.” 

In his May 5 interview with the Blade, Frank responded to criticism he received during his tenure in Congress from some LGBTQ rights advocates, especially trans activists, who claimed he had not provided sufficient support for trans rights legislation.

He said he fully supported ongoing efforts to advance trans rights but said those efforts could be jeopardized by pushing issues for which many voters have yet to accept, such as “male to female transgender people playing in women’s sports.”

Among those praising Frank’s life and legacy at the time of his passing is longtime trans activist Diego Sanchez, who became the first openly trans congressional staffer when Frank hired Sanchez as his office’s Senior Policy Advisor. Sanchez remained on Frank’s staff until Frank’s retirement in 2013.

“Barney was a revered statesman for our country at the local, state, and federal levels and a treasured friend to me,” Sanchez told the Blade in a statement. “His belief that prejudice comes from ignorance and is only stricken by visibility explains how he came out openly and how he brought me to his staff, with intent and without apology,” Sanchez said.

He added, “I miss him terribly and am glad I got to spend a week with his husband Jim and him this month. Barney made sure that members of Congress could not say they had never met a trans person. I was honored to be a groomsman in their wedding and will miss Barney’s brilliance, counsel, friendship, and wit.”

Sanchez said celebration of life events are expected to take place in Boston and D.C. and details of those events will be announced soon. 

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Wyoming

U.S. attorney nominee confirmed despite anti-LGBTQ history, no trial experience

Nine felony grand jury indictments tied to Darin Smith dismissed last week

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Darin Smith (Photo public domain)

Republicans confirmed Darin Smith as U.S. Attorney for the District of Wyoming on Monday, regardless of his history as interim U.S. Attorney for Wyoming and a state senator.

While serving as interim U.S. Attorney for Wyoming — after being appointed by President Donald Trump last July despite never trying a case outside of his time as a law student intern — former state Sen. Darin Smith likely prejudiced jurors during grand jury proceedings.

Nine felony grand jury indictments tied to Smith’s tenure were dismissed last week.

Judges dismissed felony indictments against Cheyenne Swett, Richard Allen, Michael Scott Hopper, Brian Joseph Johnson, Dennison Jay Antelope, Matthew Christopher Jacoby, Matthew Miller Jr., Wolf Elkins Duran, and Jose Benito Ocon. The now-dismissed charges included felony firearm possession, drug distribution, and possession of child pornography, among other allegations.

Smith allegedly told the grand jury that the defendants were “bad guys,” described them as “murderers,” and said deliberations “won’t take long.”

Even the U.S. Attorney’s Office for the District of Wyoming acknowledged that Smith’s comments were “ill-advised.”

Smith has a history of aligning with Trump over the Constitution and supporting anti-LGBTQ legislation.

In 2025, Smith co-sponsored House Bill 0194, titled “Obscenity amendments,” which, among other provisions, would have criminalized drag shows. The bill also would have repealed exemptions for public and school librarians from the crime of “promoting obscenity” to minors. The wording of the bill was so vague that Republican state Rep. Lee Filer said, “We will end up having to arrest somebody for allowing a child to read the Holy Bible.”

Smith also co-sponsored SF0062, a bill requiring public school students to use restrooms, sex-designated changing facilities, and sleeping quarters that align with their sex assigned at birth. In March 2025, the Wyoming governor signed the bill into law, along with its House companion.

He also attended the Jan. 6 Capitol riot alongside thousands of other Trump supporters.

“Smith was on the Capitol grounds on Jan. 6 … and made the reprehensible claim … that the hundreds of Capitol Police officers who risked their lives that day were guilty of ‘massive incompetence.’ Smith blames the police for what happened on Jan. 6. Without evidence, he claimed that rioters who breached the Capitol were victims of entrapment,” U.S. Sen. Dick Durbin (D-Ill.) said. “Moreover, Smith is not remotely qualified to be a U.S. Attorney. He’s going to be in the package — take it or leave it. Prior to becoming the interim U.S. Attorney, he had no courtroom or litigation experience whatsoever. None. And Smith’s lack of experience has had real-world consequences.”

Prior to his work in the Wyoming state legislature, Smith worked as Director of Planned Giving for the Family Research Council, an organization that describes homosexuality as “harmful” to society with “negative physical and psychological health effects.”

The organization also believes that sexual orientation “should [not] be included as a protected category in nondiscrimination laws or policies, as it is not comparable to inborn, immutable characteristics such as race or sex.”

During questioning before the U.S. Senate, he denied that his work with the organization shows he has loss of impartiality when it comes to matters of LGBTQ rights.

Also questioning, Smith was asked about a now-deleted Facebook post in which he appeared to express support for Kim Davis, the Kentucky county clerk who was found to be unconstitutional in her refusal to issue same-sex marriage licenses, despite Obergefell v. Hodges.

“Perhaps Hillary and Obama can share the cell with Kim Davis for refusing to uphold the Defense of Marriage Act,” the post said.

When asked why he posted it, Smith told Durbin: “I do not recall.”

Josh Sorbe, spokesperson for the Senate Judiciary Committee Democrats and Durbin, said:

“Anti-LGBTQ+ extremist Darin Smith has no business serving as a top law enforcement officer in any state — let alone a state with as much history of queer importance as Wyoming. He’s an unqualified insurrectionist with no experience litigating criminal or federal matters, and his bigotry puts into serious question his commitment to upholding the law for all Americans.”

Human Rights Campaign Vice President of Government Affairs David Stacy also condemned Smith’s confirmation to the U.S. Attorney’s office.

“The justice system in America is supposed to be about ensuring the law is applied fairly and equally. But Darin Smith has spent his career obsessed with making life worse for LGBTQ+ people, opposing marriage equality, cosponsoring state legislation targeting transgender youth, and smearing LGBTQ+ people in public statements,” Stacy said. “Just over two decades after Matthew Shepard was brutally murdered in that same state, Wyoming deserves better than tired anti-LGBTQ+ hate at the helm of federal law enforcement. The Senate should reject Darin Smith and demand a nominee who will put the people — and justice — first.”

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Vermont

Vt. lawmaker equates transgender identity with bestiality

Vermont Democrats condemned comments, demanded apology

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Vermont state Sen. Steven Heffernan (R-Addison) (Photo public domain; courtesy Vermont General Assembly)

State Sen. Steven Heffernan (R-Addison) equated transgender people to bestiality on the Vermont Senate floor on May 15 while debating an animal cruelty bill.

Heffernan, who was elected in 2024 to the state Senate, constructed a scenario in which a trans person is indistinguishable from someone committing bestiality.

“In these crazy times, what happens if the individual identifies as an animal having intercourse with an animal? How is the courts going to handle that?” the former member of the Vermont Air National Guard said while debating House Bill 578. “Being that we voted through Prop Four, and if it does make it through this state, and I have a gender identity that I identify as a dog and had sex with my dog, is this law going to affect me?”

State Sen. Tanya Vyhovsky (D-Chittenden Central), who presented H. 578 responded professionally.

“The bill that we are putting forward in the current law is quite clear that any act between a person and an animal that involves contact with the mouth, sex organ, or anus of the person, and the mouth, sex organ, or anus of the animal, without a bona fide veterinary purpose, will be a crime.”

In the video, Heffernan continued to ask inappropriate questions — questions that Vyhovsky answered.

“If I identify as that animal, will this be able to … It says a person. I’m not a person. I’m identifying as this animal I’m having intercourse with,” he said. “We are identifying genders, of whatever gender we decide we want to be, and I think I like this bill. I’m going to vote for this bill, but I want to make this chamber aware of what’s coming.”

Vyhovsky made a statement saying this was a planned move in an attempt to “other” trans Vermonters instead of protecting them.

“Senator Heffernan knew exactly what he was doing,” said Vyhovsky. “Sen. Heffernan is using the same dehumanizing playbook that has been used against LGBTQ+ people for generations — the false, ugly suggestion that queer and trans identity is synonymous with deviance and harm. It was wrong then and it is wrong now.”

This derogatory action at the expense of trans people appears to be part of a pattern of behavior from Heffernan in his official capacity.

In March, Heffernan left the floor right before lawmakers voted on Proposal 4, conveniently missing the bill vote. PR 4, if passed by the state’s voters in the fall, would amend the state constitution to enshrine protections against unjust treatment, including discrimination based on a “person’s race, ethnicity, sex, religion, disability, sexual orientation, gender identity, gender expression, or national origin.”

Heffernan told VTDigger at the time that he left because his stomach was feeling “agitated” and he needed to use the restroom. He said he had not made up his mind on how to vote on the amendment, largely because he’d heard from constituents urging him both to vote for and against it.

“My pizza hit at the right time, I guess,” he said, calling the timing “convenient.”

Despite his leaving — and being the only lawmaker to do so — the state Senate voted to pass it 29-0, with Heffernan marked “absent.” This came after the state House of Representatives voted to pass it 128-14 last week.

Vermont Senate Democrats condemned the statement and used the opportunity to emphasize the need for the state to pass PR 4 on Nov. 4.

“In the wake of Sen. Heffernan’s comments, the stakes of this election couldn’t be more clear,” the statement provided to the Washington Blade read. “Transgender and nonbinary Vermonters are our neighbors, our friends, and our family members. On Friday, Sen. Heffernan used his platform as an elected official representing the people of Vermont to dehumanize them. Senate Democrats will never stop fighting for dignity for all Vermonters. We demand Senator Heffernan apologize to those he has harmed with his words and actions.”

State Sen. Kesha Ram Hinsdale (D-Chittenden Southeast), speaking in her capacity as chair of the Senate Ethics Panel, responded to similar transphobic comments made by President Donald Trump in a White House counterterrorism strategy document last week, in which he said those with “extreme transgender ideologies” should know “we will find you and we will kill you,” stating:

“A lot of people are living in fear in this country because of what somebody with the power of the pen and the power of the military is saying every day,” Hinsdale said. “Just because [speech] is protected does not mean it is worthy of this institution, and does not mean it is worthy of the office we hold and the power that we wield in the lives of Vermonters.”

The Blade reached out to Heffernan for comment but has not heard back.

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