Politics
New guidance affords gay couples equal access to Medicaid
Non-marriage equality states can refuse new policy for gay couples
The Centers for Medicare & Medicaid has issued new post-DOMA guidance (Image public domain).
Gay married couples will now have the same eligibility opportunities for Medicaid coverage as straight couples in certain states following the Supreme Court decision against the Defense of Marriage Act, according to new guidance from the Obama administration obtained Friday by the Washington Blade.
In two separate pieces of guidance dated Sept. 27, the Centers for Medicare & Medicaid outlines new policy bringing the agency in line with the ruling against DOMA. They’re published in time for enrollment into insurance exchanges and Medicaid expansion under the health care reform law starting on Tuesday.
One piece of guidance from Gary Cohen, CMS director of the Center for Consumer Information & Insurance Oversight, clarifies gay married couples will be for a spousal tax credit and cost-sharing reductions by signing up for a health insurance exchange — provided they submit a joint tax return for that year.
“In light of the Ruling, the eligibility rules with respect to premium tax credits under Code section 36B treat same-sex spouses in the same manner as opposite-sex spouses,” Cohen writes.
That policy decision has nationwide implications thanks to an Aug. 29 ruling from the Internal Revenue Service that married same-sex couples should be treated the same as opposite-sex couples for tax purposes — regardless of whether or not they reside in a state recognizing the union.
The other piece of guidance from Sept. 27, signed by CMS Director of the Center for Medicaid & CHIP Services Cindy Mann, is more complex and says DOMA is no longer a factor in determining the income-based eligibility of same-sex couples for Medicaid and the Children’s Health Insurance Program.
“[B]ecause Section 3 of DOMA no longer controls the definition of marriage or spouse under the framework for state Medicaid and CHIP programs, DOMA is no longer a bar to states recognizing same-sex marriages in Medicaid or CHIP,” Mann writes.
Medicaid is a health insurance program jointly run by the states and government in which a person is eligible for coverage if have income up to 133 percent of the poverty line. Most individuals apply for Medicaid not on an individual basis, but on a family basis.
With DOMA out of the picture, the new policy would make a gay person more eligible for Medicaid if their spouse’s income is lower and places them lower on the poverty scale. Also, it can make a gay person less eligible if a spouse’s income is higher and the couple seems less in need.
The guidance says that state may begin factoring an applicant’s same-sex marriage into eligibility for Medicaid and CHIP “immediately,” but acknowledges some operational challenges and says it should be implemented “as soon as reasonably practicable.”
States where same-sex marriage is legal will have to adopt the new eligibility requirements, but since the Medicaid is jointly run by the states, CMS isn’t requiring non marriage-equality states to recognize same-sex marriages for the purposes of the purposes of the program. States can elect to opt out of the new policy.
“[A] state is permitted and encouraged, but not required, to recognize same-sex couples who are legally married under the law of the jurisdiction in which the marriage was celebrated as spouses for purposes of Medicaid and CHIP,” Mann writes. “States that do not recognize same-sex marriages are thus free to adopt a different marriage recognition policy for Medicaid and CHIP purposes.”
That’s similar to policy under health care reform. Because of the Supreme Court ruling on Obamacare, states can opt out of participating in the Medicaid expansion under the law.
The guidance also allows states to adopt this eligibility standard for Medicaid and CHIP if the state offers civil unions or domestic partnerships that are the legal equivalent to marriage. Among these states are Colorado and Illinois.
“Consistent with this guidance, a marriage is recognized for Medicaid and CHIP purposes if (it is legally valid under applicable law,” Mann writes. “Thus, if a state or territory recognizes a civil union or domestic partnership as a marriage, that marital status is recognized under the Medicaid and CHIP programs, consistent with this guidance.”
CMS says this guidance isn’t the last word. The agency is awaiting additional guidance on non-income related eligibility for Medicaid and CHIP that hinges on yet-to-be-released guidance from the Social Security Administration in determining eligibility for Supplemental Security Income. Some Social Security spousal benefits are beginning to flow to married gay couples, but the Obama administration hasn’t finalized this post-DOMA policy yet.
“The Centers for Medicare & Medicaid Services (CMS) will issue additional guidance once the SSA announces its post-Windsor SSI marriage recognition policy,” Mann writes.
Despite the effort to bring the Medicaid into alignment with the court ruling against DOMA, the nation’s largest LGBT group is expressing discontent with the guidance and says the eligibility should extend to married gay couples nationwide.
Michael Cole-Schwartz, a spokesperson for the Human Rights Campaign, said the policy decisions “fall short” by allowing states to determine whether they can provide Medicaid coverage to same-sex couples.
“While it might be advantageous for some families to remain unrecognized in order to maintain eligibility for certain programs, as a general rule we oppose different standards for gay versus straight married couples,” Cole-Schwartz said. “Given that there are no impediments to the federal government adopting an across the board standard that recognizes all legally married couples in this instance, we believe that the new rules fall short of the ideal where the sexual orientation of those in a marriage is irrelevant.”
Federal officials insist the new policy is extended in the maximum possibly way because, unlike in other cases where the Department of Health & Human Services has extended standards and benefits to same-sex married couples in non-marriage equality states, there is a special federal-state relationship in Medicaid with the states administering this program.
Congress
Padilla forcibly removed from federal building for questioning DHS secretary
Prominent Democrats rushed to defend senator
Democratic U.S. Sen. Alex Padilla of California was forcibly removed from a federal building in Los Angeles after attempting to ask questions of U.S. Homeland Security Secretary Kristi Noem during a press conference on immigration Thursday
The city has been rattled in recent days as protestors objecting to the Trump-Vance administration’s immigration crackdowns clashed with law enforcement and then the president deployed National Guard troops and U.S. Marines, which was seen as a dramatic escalation.
According to a video shared by his office, the senator, who serves as ranking member of the Senate Judiciary Immigration Subcommittee, introduced himself and said, I have questions for the secretary.” After he was pushed out of the room, officers with FBI-identifying vests told Padilla to put his hands behind his back and handcuffed him.
“Senator Padilla is currently in Los Angeles exercising his duty to perform Congressional oversight of the federal government’s operations in Los Angeles and across California,” reads a statement from his office.
“He was in the federal building to receive a briefing with General Guillot and was listening to Secretary Noem’s press conference,” the statement continued. “He tried to ask the secretary a question, and was forcibly removed by federal agents, forced to the ground and handcuffed. He is not currently detained, and we are working to get additional information.”
Democrats were furious, with many releasing strong statements online condemning the actions of law enforcement officers, including California Gov. Gavin Newsom (D), Los Angeles Mayor Karen Bass (D), and the state’s other U.S. senator, Adam Schiff (D).
Human Rights Campaign Chief of Staff Jay Brown also issued a statement: “A sitting U.S. senator should be allowed to ask a Cabinet secretary a question at a press conference — in his own state, on an issue affecting his constituents — without being violently thrown to the floor and handcuffed. Everyone who cares about our country must condemn this undemocratic act. Full stop.”
Congress
51 lawmakers sign letter to Rubio about Andry Hernández Romero
U.S. Rep. Robert Garcia (D-Calif.) spoke about gay Venezuelan asylum seeker
Forty nine members of Congress and two U.S. senators, all Democrats, signed a letter Monday to Secretary of State Marco Rubio demanding information about Andry Hernández Romero, a gay Venezuelan national who was deported to El Salvador and imprisoned in the country’s notorious Terrorism Confinement Center, a maximum-security prison known by the Spanish acronym CECOT
“We are deeply concerned about the health and wellbeing of Mr. Hernández Romero, who left
Venezuela after experiencing discriminatory treatment because of his sexual orientation and
opposition to Venezuela’s authoritarian government,” the lawmakers wrote. They urged the State Department to facilitate his access to legal counsel and take steps to return him.
After passing a credible fear interview and while awaiting a court hearing in March, agents with U.S. Immigration and Customs Enforcement reportedly transported Hernández out of the U.S. without due process or providing evidence that he had committed any crime.
In the months since, pressure has been mounting. This past WorldPride weekend in Washington was kicked off with a rally in front of the U.S. Supreme Court and a fundraiser, both supporting Hernández and attended by high profile figures including members of Congress, like U.S. Rep. Mark Takano (D-Calif.)
U.S. Rep. Robert Garcia (D-Calif.) was among the four members who wrote to Rubio about Hernández in April. On Friday, he spoke with the Washington Blade before he and his colleagues, many more of them this time, sent the second letter to Rubio.
“There’s a lot of obviously horrible things that are happening with the asylum process and visas and international students and just the whole of our value system as it relates to immigration,” he said, which “obviously, is under attack.”
“Andry’s case, I think, is very unique and different,” the congressman continued. “There is, right now, public support that is building. I think he has captured people’s attention. And it’s growing — this is a movement that is not slowing down. He’s going to be a focal point for Pride this year. I mean, I think people around the world are interested in the story.”
Garcia said he hopes the momentum will translate to progress on requests for proof of life, adding that he was optimistic after meeting with Hernández’s legal team earlier on Friday.
“I mean, the president, Kristi Noem, Marco Rubio — any of these folks could could ask to see if just he’s alive,” the congressman said, referring to the secretary of Homeland Security, whom he grilled during a hearing last month. ICE is housed under the DHS.
“People need to remember, the most important part of this that people need to remember, this isn’t just an immigration issue,” Garcia noted. “This is a due process issue. This is an asylum case. We gave him this appointment. The United States government told him to come to his appointment, and then we sent him to another country, not his own, and locked him up with no due process. That’s the issue.”
Garcia said that so far neither he nor his colleagues nor Hernández’s legal team were able to get “any answers from the administration, which is why we’re continuing to advocate, which is why we’re continuing to reach out to Secretary Rubio.”
“A lot more Democrats are now engaged on this issue,” he said. U.S. Sens. Adam Schiff and Alex Padilla, both from California, joined Monday’s letter. “The more that we can get folks to understand how critical this is, the better. The momentum matters here. And I think Pride does provide an opportunity to share his story.”
Asked what the next steps might be, Garcia said “we’re letting his legal team really take the lead on strategy,” noting that Hernández’s attorneys have “already engaged with the ACLU” and adding, “It’s very possible that the Supreme Court could take this on.”
In the meantime, the congressman said “part of our job is to make sure that that people don’t forget Andry and that there is awareness about him, and I think there’s a responsibility, particularly during WorldPride, and during Pride, all throughout the month — like, this is a story that people should know. People should know his name and and people should be aware of what’s going on.”
Congress
Wasserman Schultz: Allies must do more to support LGBTQ Jews
A Wider Bridge honored Fla. congresswoman at Capital Jewish Museum on Thursday
Florida Congresswoman Debbie Wasserman Schultz on Thursday said allies need to do more to support LGBTQ Jewish people in the wake of Oct. 7.
“Since Oct. 7, what has been appalling to me is that LGBTQ+ Jewish organizations and efforts to march in parades, to be allies, to give voice to other causes have faced rejection,” said the Florida Democrat at the Capital Jewish Museum in D.C. after A Wider Bridge honored her at its Pride event.
Wasserman Schultz, a Jewish Democrat who represents Florida’s 25th Congressional District in the U.S. House of Representatives, added the “silence of our allies … has been disappointing.”
“It makes your heart feel hollow and it makes me feel alone and isolated, which is why making sure that we have spaces that we can organize in every possible way in every sector of our society as Jews is so incredibly important,” she said.
The Israeli government says Hamas militants on Oct. 7, 2023, killed roughly 1,200 people, including upwards of 360 partygoers at the Nova Music Festival, when it launched a surprise attack on the country. The militants also kidnapped more than 200 people on that day.
The Hamas-controlled Gaza Health Ministry says Israeli forces have killed nearly 55,000 people in the enclave since Oct. 7. Karim Khan, the International Criminal Court’s chief prosecutor, has said Israeli Prime Minister Benjamin Netanyahu and former Hamas leader Yahya Sinwar, who the Israel Defense Forces killed last October, are among those who have committed war crimes and crimes against humanity in Gaza and Israel.
A Wider Bridge is a group that “advocates for justice, counters LGBTQphobia, and fights antisemitism and other forms of hatred.”
Thursday’s 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 Capital Jewish Museum.
Police say a man who injured more than a dozen people on June 1 in Boulder, Colo., when he threw Molotov cocktails into a group of demonstrators who were calling for the release of the remaining Israeli hostages was yelling “Free Palestine.” The Associated Press notes that authorities said the man who has been charged in connection with the attack spent more than a year planning it.
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