National
LGBT, AIDS cuts held off two months under ‘fiscal cliff’ deal
Advocates to press need for programs in coming weeks
Vice President Joe Biden and President Barack Obama appeared at the White House last night to discuss the fiscal cliff deal (Washington Blade file photo by Michael Key)
The legislative package that Congress passed this week to avert the “fiscal cliff” puts off for only two months devastating across-the-board budget cuts to federal programs — including programs directly relevant to LGBT people and people with HIV/AIDS — putting advocates in the position to continuing fighting for them in the weeks to come.
The deal, known as the Biden-McConnell plan because it was negotiated by Vice President Joseph Biden and Senate Minority Leader Mitch McConnell, raises an estimated $620 billion in revenue for the U.S. government. It continues the Bush-era tax cuts for lower and middle-class income households while eliminating them for individuals making more than $400,000 a year and married couples making more than $450,000.
Immediately following House passage of the bill, Obama delivered a statement at the White House saying passage of the plan fulfills his campaign promise to adjust a tax code that favored the wealthy at the expense of fiscal health for the country — although he had campaigned on letting tax cuts expire households with a lower income of $250,000 a year.
“Thanks to the votes of Democrats and Republicans in Congress, I will sign a law that raises taxes on the wealthiest 2 percent of Americans while preventing a middle-class tax hike that could have sent the economy back into recession and obviously had a severe impact on families all across America,” Obama said.
Some spending cuts are also in the plan. The agreement saves $12 billion, half in revenue and half from spending cuts which are divided equally between defense and non-defense programs. But the plan also places a two-month hold on the much larger sequester instituted under the Budget Control Act of 2011 in automatic cuts that were supposed to take effect on Wednesday.
Under the proposed cuts, $1.2 trillion would be cut for the U.S. government across-the-board for starting this year over the course of 10 years. An estimated 8.2 percent in the first year would be cut from discretionary federal programs, including HIV/AIDS and LGBT-related programs.
The cuts could be particularly devastating to individuals with HIV/AIDS who receive medication through AIDS Drug Assistance Programs. Some estimates predict that proposed cuts could lead to up to 12,000 people being placed on waiting list for drugs. Also on the cutting board may be housing provided to low-income people with AIDS.
Carl Schmid, deputy executive director for the AIDS Institute, said HIV/AIDS advocates will have to continue fighting to ensure an alternative plan is proposed that would stave off these massive cuts.
“We will still have to work to protect our programs over the next couple of months,” Schmid said. “I don’t see an appetite to address taxes again so they will have to address the spending side and entitlements along with the debt limit in the new Congress.”
Exemptions to theses cuts include to Medicaid — a program under which an estimated 50 percent of people with HIV/AIDS reductions rely on for support — as well as Social Security. Medicare cuts would be limited to a 2 percent reduction to providers.
The proposed cuts could also interfere with the investigation and prosecution of hate crimes against LGBT people and reduce or possibly eliminate funds for programs like the National LGBT Aging Resource Center and the LGBT Refugee Resource Center could be reduced.
LGBT groups — including Human Rights Campaign and the Center for American Progress — acknowledged that their fight to preserve funding for these programs continues despite the deal reached this week.
Michael Cole-Schwartz, an HRC spokesperson, said his organization has no position on the deal overall, but supports putting off the sequester to make more a balanced approach to spending cuts at a later time.
“HRC does not have a position on the overall package,” Cole-Schwartz said. “However we support the delay in the sequestration cuts which would be devastating to our community and will be working with the new Congress to mitigate the impact of budget cuts as they take up the issue over the coming months.”
Jeff Krehely, the Center for American Progress’ vice president of LGBT research at the Center for American Progress, also had no comment on the overall deal, but expressed concern the way sequestration is being discussed in current debate.
“I can say that I remain concerned that the current conversation seems detached from the real-world impacts that sequestration could have on vulnerable populations,” Krehely said. “It also seems increasingly likely that advocates will have to continue to engage on these issues for the near-term, at least. It’s not going to be wrapped up neatly anytime soon.”
In November, a coalition of 25 organization led by Center for American Progress and the National Gay & Lesbian Task Force issued a report detailing how the proposed would impact hurt LGBT employment discrimination claims, limit the ability of the federal government to address the high rate of homelessness among LGBT youth and reduce funds for programming directed at LGBT health.
Obama in his White House statement seemed intent on pursuing additional cuts to federal programs — saying he agrees Medicare is “the biggest contributor to our deficit” — while he added the country “can’t simply cut our way to prosperity.”
“Cutting spending has to go hand-in-hand with further reforms to our tax code so that the wealthiest corporations and individuals can’t take advantage of loopholes and deductions that aren’t available to most Americans,” Obama said. “And we can’t keep cutting things like basic research and new technology and still expect to succeed in a 21st century economy.
One anti-gay group is expressing outright opposition the deal. Before the House voted on the measure Tuesday night, Tony Perkins, president of the Family Research Council, issued a statement decrying the measure for not addressing entitlement reform or introducing significant spending cuts.
“This deal fails the American people by allowing for more runaway spending from the federal government,” Perkins said. “President Obama has made it clear he has no real intention to address Washington’s out of control spending problem. By voting for this package, Congress gives the green light to finance his liberal agenda and further burden taxpayers.”
Perkins also took issue with what he said was a tax penalization for married couples that will result in the deal.
“Research out of Family Research Council’s Marriage and Religion Research Institute routinely shows that married couples with children create the most capital and generate the most income on average,” Perkins said. “This economic activity leads to higher revenue for government and more capital for economic expansion. Why then would we penalize marriage? We should be encouraging family formation, not penalizing it.”
This complaint of tax penalization against marriage comes from one of the chief organizations working to prevent legalization of marriage for same-sex couples.
Another provision in the bill also would have an impact on wealthy married same-sex couples in comparison to their straight counterparts. The agreement raises the tax rate on the wealthiest estates – those worth upwards of $5 million per person – from 35 percent to 40 percent.
Because of the Defense of Marriage Act, gay Americans in same-sex marriage who are wealthy enough will have to have pay this estate tax to receive the inheritance of their spouse, unlike straight Americans in the same situation. New York widow Edith Windsor is challenging DOMA before the Supreme Court on the basis that she had to pay $363,000 in estate taxes upon the death of her spouse, Thea Spyer.
According to a November 2009 report from the Williams Institute, this differential treatment of gay and married couples in the estate tax code was set to affect an estimated 73 same-sex couples that year, costing them each, on average, more than $3.3 million.
Jimmy LaSalvia, executive director of the conservative group GOProud, has been an opponent of the estate tax and said the hike continues a discriminatory policy that was already made permanent in Democrats in years past.
“We said two years ago when Nancy Pelosi and Harry Reid passed legislation to make the estate tax permanent, that it is ‘discrimination by taxation,'” LaSalvia said. “These changes certainly twist that knife.”
CORRECTION: An initial version of this article misstated the terms for tax increases under the “fiscal cliff” plan. The Blade regrets the error.
Federal Government
Holiday week brings setbacks for Trump-Vance trans agenda
Federal courts begin to deliver end-of-year responses to lawsuits involving federal transgender healthcare policy.
While many Americans took the week of Christmas to rest and relax, LGBTQ politics in the U.S. continued to shift. This week’s short recap of federal updates highlights two major blows to the Trump-Vance administration’s efforts to restrict gender-affirming care for minors.
19 states sue RFK Jr. to end gender-affirming care ban
New York Attorney General Letitia James announced on Tuesday that the NYAG’s office, along with 18 other states (and the District of Columbia), filed a lawsuit to stop U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. from restricting gender-affirming care for minors.
In the press release, Attorney General James stressed that the push by the Trump-Vance administration’s crusade against the transgender community — specifically transgender youth — is a “clear overreach by the federal government” and relies on conservative and medically unvalidated practices to “punish providers who adhere to well-established, evidence-based care” that support gender-affirming care.
“At the core of this so-called declaration are real people: young people who need care, parents trying to support their children, and doctors who are simply following the best medical evidence available,” said Attorney General James. “Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices. My office will always stand up for New Yorkers’ health, dignity, and right to make medical decisions free from intimidation.”
The lawsuit is a direct response to HHS’ Dec. 18 announcement that it will pursue regulatory changes that would make gender-affirming health care for transgender children more difficult, if not impossible, to access. It would also restrict federal funding for any hospital that does not comply with the directive. KFF, an independent source for health policy research, polling, and journalism, found that in 2023 federal funding covered nearly 45% of total spending on hospital care in the U.S.
The HHS directive stems directly from President Donald Trump’s Jan. 28 Executive Order, Protecting Children From Chemical and Surgical Mutilation, which formally establishes U.S. opposition to gender-affirming care and pledges to end federal funding for such treatments.
The American Medical Association, the nation’s largest and most influential physician organization, has repeatedly opposed measures like the one pushed by President Trump’s administration that restrict access to trans health care.
“The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity,” a statement on the AMA’s website reads. “Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population.”
The lawsuit also names Oregon, Washington, California, Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, and Wisconsin as having joined New York in the push against restricting gender-affirming care.
At the HHS news conference last Thursday, Jim O’Neill, deputy secretary of the department, asserted, “Men are men. Men can never become women. Women are women. Women can never become men.”
DOJ stopped from gaining health care records of trans youth
U.S. District Judge Cathy Bissoon blocked an attempt by the Department of Justice (DOJ) to gain “personally identifiable information about those minor transgender patients” from the University of Pittsburgh Medical Center (UPMC), saying the DOJ’s efforts “fly in the face of the Supreme Court.”
Journalist Chris Geidner originally reported the news on Dec. 25, highlighting that the Western District of Pennsylvania judge’s decision is a major blow to the Trump-Vance administration’s agenda to curtail transgender rights.
“[T]his Court joins the others in finding that the government’s demand for deeply private and personal patient information carries more than a whiff of ill intent,” Bissoon wrote in her ruling. “This is apparent from its rhetoric.”
Bissoon cited the DOJ’s “incendiary characterization” of trans youth care on the DOJ website as proof, which calls the practice politically motivated rather than medically sound and seeks to “…mutilate children in the service of a warped ideology.” This is despite the fact that a majority of gender-affirming care has nothing to do with surgery.
In United States v. Skrmetti, the Supreme Court ruled along party lines that states — namely Tennessee — have the right to pass legislation that can prohibit certain medical treatments for transgender minors, saying the law is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment because it does not involve suspect categories like race, national origin, alienage, and religion, which would require the government to show the law serves a compelling interest and is narrowly tailored, sending decision-making power back to the states.
“The government cannot pick and choose the aspects of Skrmetti to honor, and which to ignore,” Judge Bissoon added.
The government argued unsuccessfully that the parents of the children whose records would have been made available to the DOJ “lacked standing” because the subpoena was directed at UPMC and that they did not respond in a timely manner. Bissoon rejected the timeliness argument in particular as “disingenuous.”
Bissoon, who was nominated to the bench by then-President Obama, is at least the fourth judge to reject the DOJ’s attempted intrusion into the health care of trans youth according to Geidner.
A Wider Bridge on Friday announced it will shut down at the end of the month.
The group that “mobilizes the LGBTQ community to fight antisemitism and support Israel and its LGBTQ community” in a letter to supporters said financial challenges prompted the decision.
“After 15 years of building bridges between LGBTQ communities in North America and Israel, A Wider Bridge has made the difficult decision to wind down operations as of Dec. 31, 2025,” it reads.
“This decision comes after challenging financial realities despite our best efforts to secure sustainable funding. We deeply appreciate our supporters and partners who made this work possible.”
Arthur Slepian founded A Wider Bridge in 2010.
The organization in 2016 organized a reception at the National LGBTQ Task Force’s Creating Change Conference in Chicago that was to have featured to Israeli activists. More than 200 people who protested against A Wider Bridge forced the event’s cancellation.
A Wider Bridge in 2024 urged the Capital Pride Alliance and other Pride organizers to ensure Jewish people can safely participate in their events in response to an increase in antisemitic attacks after Hamas militants attacked Israel on Oct. 7, 2023.
The Jewish Telegraphic Agency reported authorities in Vermont late last year charged Ethan Felson, who was A Wider Bridge’s then-executive director, with lewd and lascivious conduct after alleged sexual misconduct against a museum employee. Rabbi Denise Eger succeeded Felson as A Wider Bridge’s interim executive director.
A Wider Bridge in June honored U.S. Rep. Debbie Wasserman Schultz (D-Fla.) at its Pride event that took place at the Capital Jewish Museum in D.C. The event took place 15 days after a gunman killed two Israeli Embassy employees — Yaron Lischinsky and Sarah Milgrim — as they were leaving an event at the museum.
“Though we are winding down, this is not a time to back down. We recognize the deep importance of our mission and work amid attacks on Jewish people and LGBTQ people – and LGBTQ Jews at the intersection,” said A Wider Bridge in its letter. “Our board members remain committed to showing up in their individual capacities to represent queer Jews across diverse spaces — and we know our partners and supporters will continue to do the same.”
Editor’s note: Washington Blade International News Editor Michael K. Lavers traveled to Israel and Palestine with A Wider Bridge in 2016.
The White House
‘Trump Rx’ plan includes sharp cuts to HIV drug prices
President made announcement on Friday
President Donald Trump met with leaders from some of the world’s largest pharmaceutical companies at the White House on Friday to announce his new “Trump Rx” plan and outline efforts to reduce medication costs for Americans.
During the roughly 47-minute meeting in the Roosevelt Room, Trump detailed his administration’s efforts to cut prescription drug prices and make medications more affordable for U.S. patients.
“Starting next year, American drug prices will come down fast, furious, and will soon be among the lowest in the developed world,” Trump said during the meeting. “For decades, Americans have been forced to pay the highest prices in the world for prescription drugs by far … We will get the lowest price of anyone in the world.”
Trump signed an executive order in May directing his administration “to do everything in its power to slash prescription drug prices for Americans while getting other countries to pay more.”
“This represents the greatest victory for patient affordability in the history of American health care, by far, and every single American will benefit,” he added.
Several pharmaceutical executives stood behind the president during the announcement, including Sanofi CEO Paul Hudson, Novartis CEO Vas Narasimhan, Genentech CEO Ashley Magargee, Boehringer Ingelheim (USA) CEO Jean-Michel Boers, Gilead Sciences CEO Dan O’Day, Bristol Myers Squibb General Counsel Cari Gallman, GSK CEO Emma Walmsley, Merck CEO Robert Davis, and Amgen Executive Vice President Peter Griffith.
Also in attendance were Health and Human Services Secretary Robert F. Kennedy Jr., Commerce Secretary Howard Lutnick, Centers for Medicare and Medicaid Services Administrator Mehmet Oz, and Food and Drug Administration Commissioner Marty Makary.
Under the Trump Rx plan, the administration outlined a series of proposed drug price changes across multiple companies and therapeutic areas. Among them were reductions for Amgen’s cholesterol-lowering drug repatha from $573 to $239; Bristol Myers Squibb’s HIV medication reyataz from $1,449 to $217; Boehringer Ingelheim’s type 2 diabetes medication jentadueto from $525 to $55; Genentech’s flu medication xofluza from $168 to $50; and Gilead Sciences’ hepatitis C medication epclusa from $24,920 to $2,425.
Additional reductions included several GSK inhalers — such as the asthma inhaler advair diskus 500/50, from $265 to $89 — Merck’s diabetes medication januvia from $330 to $100, Novartis’ multiple sclerosis medication mayzent from $9,987 to $1,137, and Sanofi’s blood thinner plavix from $756 to $16. Sanofi insulin products would also be capped at $35 per month’s supply.
These prices, however, would only be available to patients who purchase medications directly through TrumpRx. According to the program’s website, TrumpRx “connects patients directly with the best prices, increasing transparency, and cutting out costly third-party markups.”
Kennedy spoke after Trump, thanking the president for efforts to lower pharmaceutical costs in the U.S., where evidence has shown that drug prices — including both brand-name and generic medications — are nearly 2.78 times higher than prices in comparable countries. According to the Pharmaceutical Research and Manufacturers of America, roughly half of every dollar spent on brand-name drugs goes to entities that play no role in their research, development, or manufacturing.
“This is affordability in action,” Kennedy said. “We are reversing that trend and making sure that Americans can afford to get the life-saving solutions.”
Gilead CEO Dan O’Day also spoke about how the restructuring of drug costs under TrumpRx, combined with emerging technologies, could help reduce HIV transmission — a virus that, if untreated, can progress to AIDS. The LGBTQ community remains disproportionately affected by HIV.
“Thank you, Mr. President — you and the administration,” O’Day said. “I think this objective of achieving the commitment to affordability and future innovation is extraordinary … We just recently launched a new medicine that’s only given twice a year to prevent HIV, and we’re working with Secretary Kennedy and his entire team, as well as the State Department, as a part of your strategy to support ending the epidemic during your term.
“I’ve never been more optimistic about the innovation that exists across these companies and the impact this could have on America’s health and economy,” he added.
Trump interjected, asking, “And that’s working well with HIV?”
“Yes,” O’Day replied.
“It’s a big event,” Trump said.
“It literally prevents HIV almost 100 percent given twice a year,” O’Day responded.
A similar anti-HIV medication is currently prescribed more than injectable form mentioned by O’Day. PrEP, is a medication regimen proven to significantly reduce HIV infection rates for people at high risk. Without insurance, brand-name Truvada can cost roughly $2,000 per month, while a generic version costs about $60 per month.
Even when medication prices are reduced, PrEP access carries additional costs, including clinic and laboratory fees, office visits, required HIV and sexually transmitted infection testing, adherence services and counseling, and outreach to potentially eligible patients and providers.
According to a 2022 study, the annual total cost per person for PrEP — including medication and required clinical and laboratory monitoring — is approximately $12,000 to $13,000 per year.
The TrumpRx federal platform website is now live at TrumpRx.gov, but the program is not slated to begin offering reduced drug prices until January.
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