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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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17 Comments

17 Comments

  1. Katie Murphy - ex catholic family

    June 10, 2011 at 2:05 am

    Thats great. Another well deserved stake through the heartless catholic church and the “anything but” christians who now vent their hatred on gays, And the repubs whose medical plans for all of us include the rape of the middle classes pocketbooks by the insurance companies where eg UHC the CEO takes home about 30 mil per year.

  2. Sean

    June 10, 2011 at 11:40 am

    Sorry, but this is not enough. Giving states the option, while so many states right now are under the control of Christian fundamentalists or Teabagger extremists, is just a cop-out on Obama’s part. On the other hand, if there was a MANDATE for the states to accept these terms, it would definitely be a credit to Obama.

    • Emily

      June 11, 2011 at 8:19 am

      I can’t vouch for the tea party, but please don’t think that all Christians are the ‘God hates fags’ kind. I am a believer, and guess what? Part of that belief is equality. Equality for everyone. God loves you. Its people that are hateful.

      • Sean

        June 11, 2011 at 11:02 am

        I didn’t say “all Christians”, I said Christian Fundamentalists. Sorry, but it’s a fact that most Evangelical and Baptist churches in this country take an extremist homophobe stance (maybe not as extreme as Fred Phelps, but then again no one is that extreme). And let’s not leave out the Mormons, who have poured money into every anti-gay initiative that’s happened on a statewide level.

  3. whiteguy

    June 10, 2011 at 2:02 pm

    someone is playing safe ..

  4. whiteguy

    June 10, 2011 at 2:07 pm

    repeal doma so that these medicaid thing will be useful

  5. Ronbo

    June 10, 2011 at 2:30 pm

    Wow! Great change can be made by nipping at the heels of history. Separate but Equal lives in the hearts of bigots everywhere!!! Don’t they also allow states the options of inter-racial marrige? These progressives may soon legalize (or rather allow states to allow) voting while hispanic. Such progress! We should be happy the moderate Republicans (Obama et al) are keeping the Extreme Republicans at bay. Never mind that 62% of the public is left of Obama on the issues (not the label “liberal” where Obama is the Liberal Devil himself). Which is why issues are important, not labels.

    • Pro-Obama

      June 10, 2011 at 7:22 pm

      Maybe you should work on building allies with people in power so that the change you want to see can be built upon. Stop biting the hand that’s trying to help you. If others wouldn’t suffer too, I’d almost wish a republican presidency on ungrateful douchebags like you. If you think it’s fun seeing what the repugs are doing to women’s rights, I can’t wait to see what they do when they turn their sights on to the gays. Build relationships and allies, that’s how change happens. If you aren’t part of the solution, then shut the hell up.

  6. @metaward

    June 10, 2011 at 4:05 pm

    Kind of sucks, Ronbo. I am with you on the sentiment of your post, but you lost a lot of credibility with “62% of the public is left of Obama on the issues.” What are “the issues,” and why do you think there only one set of them? Additionally, what is this 62% number and where did it come from?

    Make less up and your arguments will make themselves stronger.

  7. CJS

    June 10, 2011 at 11:09 pm

    I voted for a pragmatic centrist who I thought could do the job.

    I got THE HISTORIC LGBT RIGHTS PRESIDENT.

    Wow. Thank you, Mr. President.

    Greatest President since Lincoln. Greatest ever? Get back to me around 2016.

    P. S. I see some of the other commenters are what is wrong with the Left. Left baggers, useful idiots, whisperers in darkness. There are real things going on while you savour your fine whine. Thank you for the support.

    • L La

      August 10, 2011 at 11:45 am

      DOMA will never be upturned. It is the will of the majority of us and we will fight to the death to defend it from the likes of you people. I can see now all the loopholes in this proposed rule. Any single person, regardless of gender, can ask a same-sex friend to move in and pretend to be their partner and voila!!! The rules don’t apply to you anymore. Way to go Sebelius. Way to go America.

  8. Sean

    June 11, 2011 at 11:09 am

    The headline is misleading, as anyone who actually reads the article will discover. It should be “EXCLUSIVE: Obama allows states to extend protections to gay couples under Medicaid (but only if they really want to…)”

  9. Chris

    June 11, 2011 at 12:17 pm

    Always good to see any progress (however small) towards treating GLBT with equal rights, respect and compassion. This might be more symbolic than anything else, but I see a lot of good potentially coming from this. Mainly for couples that have been (for all intents and purposes) married for years but cannot care for each other in the same way that legally married people can.

  10. Bill Perdue

    June 12, 2011 at 8:15 am

    It’s good but it’s just another tiny step to nowhere. What we really need is an inclusive civil rights amendment, socialized medicine and repeal of Bill Clintons DOMA.

    It about all we can expect from Democrats in any election season and a tiny bit more than we can expect of Republicans at any time at any time.

  11. The Dream

    October 23, 2012 at 8:33 pm

    Obama is a good guy! Always looking out for us! hahaha I saw this great post on http://guyspy.com! It was a poll on who would you rather sleep with: Obama or Romney! Hahaha You might want to go to GuySpy and cast your vote! hahahah

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Texas

Texas GOP Governor Greg Abbott signs anti-Trans youth sports bill

“Despite the powerful testimony of trans kids & adults- the emails to the Governor to veto this harmful piece of legislation it is now law”

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Texas Republican Governor Greg Abbott (Blade file screenshot)

AUSTIN – Texas Republican Gov. Greg Abbott signed into law Monday H.B. 25, an anti-Transgender youth sports bill banning Trans K-12 student-athletes from playing on sports teams consistent with their gender identity. 

H.B. 25 is the 9th statewide bill signed into law this year banning transgender youth from participating in school sports and the 10th in the country. This bill also comes during a year when Texas lawmakers have proposed nearly 70 anti-LGBTQ bills, including more than 40 bills that specifically target transgender and nonbinary youth — far more than any other state.

“We are devastated at the passage of this bill. Despite the powerful testimony of trans kids and adults, families and advocates, and the many emails and calls our community placed to the Governor’s office to veto this harmful piece of legislation it is now law,” Ricardo Martinez, CEO of Equality Texas, said.

“Most immediately, our focus is our community and integrating concepts of healing justice to provide advocates who have already been harmed by this bill with spaces to refill their cup and unpack the acute trauma caused by these legislative sessions. Our organizations will also begin to shift focus to electing pro-equality lawmakers who understand our issues and prioritize representing the vast majority of Texans who firmly believe that discrimination against trans and LGB+ people is wrong,” he added.

Earlier this month, the Texas state government was criticized for removing web pages with resources for LGBTQ youth, including information about The Trevor Project’s crisis services. The Trevor Project the world’s largest suicide prevention and crisis intervention organization for LGBTQ+ young people.

“Transgender and nonbinary youth are already at higher risk for poor mental health and suicide because of bullying, discrimination, and rejection. This misguided legislation will only make matters worse,” Amit Paley, CEO and Executive Director of The Trevor Project said in a statement released Monday afternoon.

To every trans Texan who may be feeling hurt and attacked by this legislation and months of ugly political debate — please know that you are valid, and you are deserving of equal opportunity, dignity and respect. The Trevor Project is here for you 24/7 if you ever need support, and we will continue fighting alongside a broad coalition of advocates to challenge this law,” Paley said.

********************

Additional resources:

Research consistently demonstrates that transgender and nonbinary youth face unique mental health challenges and an elevated risk for bullying and suicide risk compared to their peers.  

  • The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health found that more than half (52%) of transgender and nonbinary youth seriously considered suicide in the past year, and 1 in 5 attempted suicide. 94% of LGBTQ youth reported that recent politics negatively impacted their mental health. 
  • A newly published research brief on “Bullying and Suicide Risk among LGBTQ Youth,” found that 61% of transgender and nonbinary (TGNB) students reported being bullied either in-person or electronically in the past year, compared to 45% of cisgender LGBQ students. TGNB students who were bullied in the past year reported more than twice the rate of attempting suicide in the past year compared to those who were not. And TGNB students who said their school was LGBTQ-affirming reported significantly lower rates of being bullied (55%) compared to those in schools that weren’t LGBTQ-affirming (65%).
  • A 2020 peer-reviewed study found that transgender and nonbinary youth who report experiencing discrimination based on their gender identity had more than double the odds of attempting suicide in the past year compared to those who did not experience discrimination based on their gender identity.
  • Trevor’s research has also found that a majority of LGBTQ young people (68%) had never participated in sports for a school or community league or club — with many citing fear of bullying and discrimination as a key factor for not participating.

If you or someone you know needs help or support, The Trevor Project’s trained crisis counselors are available 24/7 at 1-866-488-7386, via chat at TheTrevorProject.org/Help, or by texting START to 678678.

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National

Ohio high school cancels play with Gay character after Pastor complains

The School’s fall production of “She Kills Monsters” was scheduled to open in less than one month until the play was canceled

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Hillsboro High School (Screenshot via Cincinnati ABC affiliate WCPO-TV)

HILLSBORO, Oh. — A Southwest Ohio high school’s play was abruptly canceled after Jeff Lyle, a local pastor from Good News Gathering, complained of a gay character. 

Hillsboro High School’s fall production of “She Kills Monsters” was scheduled to open in less than one month, until students learned the play would be canceled last week, reports Cincinnati’s ABC affiliate WCPO

The story follows a high school senior as she learns about her late sister’s life. It is implied throughout the play that her sister is gay, according to the news station.

The play’s cancellation comes a week after Lyle, a long-time voice of the anti-LGBTQ+ religious-right in Ohio, and a group of parents confronted the production’s directors at a meeting, according to Cincinnati CBS affiliate Local 12. Lyle denies pressuring school officials, but tells WCPO he supports the decision.

“From a Biblical worldview this play is inappropriate for a number of reasons, e.g. sexual innuendo, implied sexual activity between unmarried persons, repeated use of foul language including taking the Lord’s name in vain,” Lyle said. 

Some families say they believe Lyle did influence the school’s decision. 

“I think that’s wrong,” Jon Polstra, a father of one of the actors, told WCPO. “All they would have had to do if they objected to something in the play was not go to the play.”

In a statement to Local 12, Hillsboro City Schools Superintendent Tim Davis said the play was canceled because it “was not appropriate for our K-12 audience.”

The Lexington Herald Leader reports that the school planned to perform a version intended for audiences as young as 11 years old. 

Students were “devastated” and “blindsided” by the news, according to WCPO. 

“It felt like we had just been told, ‘Screw off and your lives don’t matter,'” Christopher Cronan, a Hillsboro High student, said. “I am openly bisexual in that school and I have faced a lot of homophobia there, but I never expected them to cancel a play for a fictional character.”

Cronan’s father, Ryan, also voiced his frustration. 

“They want to say the town is just not ready, but how are you not ready? It’s 2021,” Ryan Cronan said.

Students have started a GoFundMe in hopes of putting on the production at a community theater in 2022.

“If we do raise enough money, I am going to be genuinely happy for a very long time, because that means people do care,” Cronan told WCPO.

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Utah

VIDEO: Utah deal promoted as national model for LGBTQ rights, religious liberty

Data finds state has 2nd highest support for LGBTQ rights

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(Screen capture via YouTube)

A new video from the premier LGBTQ group in Utah, challenging the idea LGBTQ rights must be at odds with religious liberty, promotes an agreement reached in the state as a potential model to achieve a long sought-after update to civil rights law at the federal level.

The video, published Friday by Equality Utah, focuses on a 2015 agreement in Utah between the supporters of LGBTQ rights and the Mormon Church to enact a compromise acceptable to both sides. The agreement by those two sides led to an LGBTQ civil rights law in the state, which has Republican control of the state legislature and the governor’s mansion.

Troy Williams, executive director of Equality Utah, says in the video dialogue is key to achieving meaningful success, whether its among the people of Utah, a state legislature or lawmakers in Congress.

“When you are working with LGBT rights in a state like Utah, and you want to advance legal equality, you can’t do it without working with Republicans, with conservative, with people of faith,” Williams says.

Williams, speaking with the Washington Blade over a Zoom call, said the main audience for the video is people on “the center right and the center left” willing to listen to other side when it comes to LGBTQ rights and religious liberty.

“People that have the courage to reach out to each other, and sit down across from each other and say, ‘Hey look, let’s hammer this out,” Williams said. “That’s who my audience is.”

Not only did Utah enact non-discrimination protections for LGBTQ people, but the state under a Republican governor administratively banned widely discredited conversion therapy for youth. When lawmakers proposed legislation that would ban transgender youth from competing in school sports, the proposal was scuttled when Gov. Spencer Cox (whom Williams called a “super Mormon”) said he’d veto it after it came to his desk.

Marina Gomberg, a former board for Equality Utah, is another voice in the video seeking dispel the narrative religious liberty and LGBTQ rights are in conflict.

“in order to protect LGBTQ people, we don have to deny religious liberty, and in order to provide protections for religious liberties, we don’t have to deny LGBTQ people,” Gomberg says. “The idea that we do is a fallacy that Utah has dismantled.”

In July, new polling demonstrated the surprisingly the Utah, despite being a conservative state, has the second highest percentage of state population in support for non-discrimination protections for LGBTQ people. The data Public Religion Research Institute from 77 percent of Utah residents support LGBTQ people, which is just behind New Hampshire at 81 percent.

Tyler Deaton, senior adviser for the pro-LGBTQ American Unity Fund, said the Utah agreement demonstrates the possibility of reaching an agreement at the federal level once “second order” issues are put into perspective.

“The first order question has to be how are we winning the culture,” Deaton said. “Do people even want to pass the bill? And if they do, you then figure out the details.”

The American Unity Fund has helped promote as a path forward for LGBTQ non-discrimination at the federal level the Fairness for For All Act, legislation seeking to reach a middle ground on LGBTQ rights and religious freedom. Polling earlier this year found 57 percent of the American public back a bipartisan solution in Congress to advance LGBTQ civil rights.

Supporters of the Equality Act, the more established vehicle for LGBTQ rights before Congress, say the Fairness for For All Act would give too many carve-out for LGBTQ rights in the name of religious freedom. The Equality Act, however, is all but dead in Congress and has shown no movement in the U.S. Senate.

Skeptics of the Utah law would point out the law doesn’t address public accommodations, one of the more challenging aspects in the fight for LGBTQ rights and one or remaining gaps in civil rights protections for LGBTQ people in the aftermath of the U.S. Supreme Court’s decision last year in Bostock v. Clayton County. As a result, it’s perfectly legal in Utah for a business owner to discriminate against LGBTQ coming as patrons.

Williams, however, shrugged off the idea the lack of public accommodations protections in Utah make the agreement in the state makes it any less of a model, making the case the spirit behind the deal is what matters.

“I think copying and pasting Utah’s law doesn’t work for lots of reasons,” Wililams said. “What’s most important is a model of collaboration because when you are sitting around the table with each other — Democrats and Republicans, LGBTQ people and people of faith — that’s when the transformation happens. That is when the mutual respect is really forged.”

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