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HHS expands hospital visitation rights for gay couples

Patients may designate visitors during hospital stay

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

The Department of Health & Human Services on Wednesday unveiled a new policy to enhance hospital visitation rights for same-sex couples.

The Centers for Medicare & Medicaid sent a letter on Wednesday to states building off the memorandum President Obama issued last year mandating that hospitals receiving Medicare and Medicaid funds allow patients to designate their own visitors during a hospital stay, including a same-sex partner.

In November, HHS issued the final rule implementing Obama’s proposed change. The letter sent to states on Wednesday provides the enforcement mechanism by which state survey and certification groups can ensure hospitals are abiding by the policy.

MORE IN THE BLADE: HHS SITE HELPS COMPANIES INSURE GAY EMPLOYEES

Jesse Moore, an HHS spokesperson, said his department generally works with hospitals to bring them into compliance with rules and, at this point, HHS hasn’t heard of any problems with the guidance related to same-sex couples.

However, Moore said if a hospital doesn’t comply with the new rule and fails to fix the problem, HHS has “the power to terminate a Medicare provider agreement.”

The guidance that will be given to state survey agencies marks the last step in implementing the change that Obama proposed on hospital visitation last year.

Additionally, the letter also issues guidance mandating that hospitals recognize advance directives designating a same-sex partner as someone who can make emergency medical decisions for a patient who’s incapacitated. The department clarifies hospitals should defer to patients’ wishes concerning their representatives — whether expressed in writing, verbally or through other evidence — unless prohibited by state law.

HHS Secretary Kathleen Sebelius emphasized the importance of the policy change to LGBT couples in a statement.

“Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need,” Sebelius said. “We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”

The new guidance updates the conditions of participation for hospitals participating in Medicare and Medicaid, which are the health and safety standards that these hospitals must meet. The change applies to all patients of these hospitals — even if the patient isn’t on Medicare or Medicaid.

Don Berwick, the CMS administrator, said the updated guidance to states is beneficial for same-sex couples and enhances the quality of health care throughout the country.

“This announcement is another step toward equal rights for all Americans, and it is another step toward putting the patient at the center of our health care system,” Berwick said. “All patients should be afforded the same rights and privileges when they enter our health care system, and that includes the same opportunity to see their significant other.”

LGBT rights groups were quick to praise the updated policy as a means to ensure LGBT Americans are treated fairly during hospital stays.

Rea Carey, executive director of the National Gay & Lesbian Task Force, commended HHS for issuing the updated policy in a statement as she said more work is necessary.

“Ensuring that the medical wishes of [LGBT] people are respected is an example of the federal government recognizing the life of LGBT families,” Carey said. “An emergency situation in a hospital is the last place where anyone should feel unsafe. While a positive step forward, it is critical we continue to work at all levels of government to make sure our families are fully recognized and treated fairly.”

Michael Cole-Schwartz, spokesperson for the Human Rights Campaign, also said the guidance is beneficial to LGBT people seeking hospital treatment.

“This is a great step to help ensure enforcement of a common sense policy,” Cole-Schwartz said. “No one should be denied the ability to visit their loved ones in the hospital and this next step ensures that principle will be carried out.”

In addition to sending out this letter, the Health Resources & Services Administration, an agency within HHS, is set to announce a $248,000 grant to help create a national training and technical assistance center aimed at helping community health centers improve the health of LGBT populations. The grant was awarded to Fenway Health, a Boston-based center that works to provide the LGBT community access to health care, education, research and advocacy.

NOTE: This article has been updated.

CORRECTION: An earlier version of this article, quoting HHS spokesperson Jesse Moore, incorrectly stated HHS could revoke accreditation for hospitals that fail to comply with the change.

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Pennsylvania

Pa. House passes bill to codify marriage equality in state law

Governor supports gay state Rep. Malcolm Kenyatta’s measure

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Pennsylvania Capitol Building (Washington Blade file photo by Michael Key)

The Pennsylvania House of Representatives on Wednesday passed a bill that would codify marriage equality in state law.

House Bill 1800 passed by a 127-72 vote margin. Twenty-six Republicans voted for the measure.

The Republican-controlled Pennsylvania Senate will now consider the bill that state Rep. Malcolm Kenyatta (D-Philadelphia), who is the first openly gay person of color elected to the state’s General Assembly, introduced. Democratic Gov. Josh Shapiro supports the measure.

“Here in Pennsylvania, we believe in your freedom to marry who you love,” said Shapiro on Wednesday. “Today, the House has stepped up to protect that right.”

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Florida

DeSantis signs emergency bill that restores Fla. ADAP funding

Temporary funds to last through June 30

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Republican Florida Gov. Ron DeSantis (Screen capture/NBC News)

After the Florida Department of Health made huge cuts to the AIDS Drug Assistance Program in January, Republican Gov. Ron DeSantis has signed emergency legislation restoring HIV access to more than 12,000 Floridians.

Two months ago, as the Washington Blade reported, the Sunshine State cut the vast majority of those in ADAP by shifting the income levels required for eligibility — without following standard procedure when changing government policy outside of legislative or executive action.

The bill, signed by DeSantis on Tuesday, passed both chambers of the Florida Legislature unanimously and appropriates $30.9 million in emergency bridge funding through June 30, 2026. It restores Florida’s ADAP income eligibility to 400 percent of the Federal Poverty Level — the level it was prior to the January cuts. The legislation also requires the FDOH to submit detailed monthly financial reports to legislative leadership beginning April 1.

Under the old policy, eligibility would have been limited to those making no more than 130 percent of the federal poverty level, or $20,345 per year.

“For 10 weeks, 12,000 Floridians living with HIV did not know if they could fill their next prescription. Today, they can,” Esteban Wood, director of advocacy and legislative affairs at AIDS Healthcare Foundation, said in a statement.

The detailed reports now required to be sent to legislative leadership must include all federal revenues and expenditures, including manufacturer rebates; enrollment figures by county and insurance status; prescription utilization by drug class; and any projected funding shortfalls. This is the first time the Legislature has required this level of financial transparency from the program.

DeSantis signed the legislation one day after a Leon County Circuit Court judge denied AIDS Healthcare Foundation’s request for an injunction to block the significant changes the DeSantis administration is making to the program, which it claims faces a $120 million shortfall for calendar year 2026.

AIDS Healthcare Foundation, a national organization focused on protecting and expanding HIV healthcare access and prevention methods, filed a lawsuit over the change in eligibility, arguing the Florida Department of Health did not follow the laid out path for formally changing policy and was acting outside established procedures.

Typically, altering eligibility for a statewide program requires either legislative action or adherence to a multistep rule-making process, including: publishing a Notice of Proposed Rule; providing a statement of estimated regulatory costs; allowing public comment; holding hearings if requested; responding to challenges; and formally adopting the rule. According to AIDS Healthcare Foundation, none of these steps occurred.

The long-term structure of ADAP will be determined by the 2026–2027 fiscal year state budget, something that lawmakers have until June 30 to finish.

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Federal Government

Markwayne Mullin confirmed as next DHS secretary

Okla. senator to succeed Kristi Noem

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The U.S. Senate confirmed Markwayne Mullin as the next secretary of Homeland Security on Monday, as the agency continues to grapple with what lawmakers have described as a “never-ending” funding standoff, with Democrats attempting to withhold funding from one of the nation’s largest and most costly agencies.

Mullin — a Republican senator from Oklahoma, former mixed martial arts fighter, and plumbing business owner — was confirmed in a 54–45 vote. Two Democrats — U.S. Sens. John Fetterman (D-Pa.) and Martin Heinrich (D-N.M.) — sided with Republicans in supporting his confirmation.

The new agency head is expected to follow the policy direction set by President Donald Trump, emphasizing stricter immigration enforcement. This includes proposals to support immigration agents at polling sites and to cut funding to so-called “sanctuary cities.”

Mullin replaces Kristi Noem, who was fired earlier this month following a widely scrutinized 2-day congressional hearing on Capitol Hill.

During the hearing, Noem faced intense questioning over her response to several crises, including the fatal shooting of two American citizens in Minneapolis by U.S. Immigration and Customs Enforcement agents, a $220 million border security advertising campaign that featured her on horseback near Mount Rushmore amid one of the largest federal workforce reductions in U.S. history, and the federal response to major natural disasters such as the July 2025 Texas floods and Hurricane Helene in 2024.

Noem had previously drawn criticism for a series of policy decisions in South Dakota that broadly focused on restricting the rights of LGBTQ individuals. In 2023, she signed House Bill 1080, banning gender-affirming medical care for transgender minors. She also signed legislation and executive orders restricting trans athletes’ participation in women’s sports, as well as the state’s “Religious Freedom Restoration Act,” which critics argued enabled discrimination against LGBTQ individuals. Additionally, the state canceled contracts related to LGBTQ support services — including suicide prevention and health care navigation programs‚ and later agreed to a $300,000 settlement with trans advocacy group, The Transformation Project.

Despite her removal from DHS, Noem will remain in the Trump-Vance administration as a special envoy for the “Shield of the Americas,” an initiative aimed at promoting U.S. influence in the Western Hemisphere, including efforts to counter cartel networks, reduce Chinese influence, and manage migration.

The new head of DHS has served in Congress since 2013, in both houses of the federal legislature. While in the Senate and a member of the Health, Education, Labor, and Pensions (HELP) Committee, Mullin has been a vocal critic of policies aimed at expanding LGBTQ inclusion. He led a group of lawmakers in urging the Administration for Community Living to reverse a rule requiring states to prioritize Older Americans Act services based on sexual orientation and gender identity, arguing the policy could have unintended consequences.

Mullin also makes history as the first Native American — and a citizen of the Cherokee Nation — to lead the Department of Homeland Security. He was also among the 147 Republicans who voted to overturn the 2020 presidential election results despite no evidence of widespread fraud, and was present in the U.S. House of Representatives chamber on Jan. 6.

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