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.
Politics
Smithsonian staff concerned about future of LGBTQ programming amid GOP scrutiny
Secretary Lonnie Bunch says ‘LGBTQ+ content is welcome’
Staff at the Smithsonian Institution are concerned about the future of LGBTQ programming as several events featuring a drag performer were cancelled or postponed following scrutiny by House Republicans, according to emails reviewed by the Washington Post.
In December, Secretary Lonnie G. Bunch III appeared before a hearing led by GOP members of the Committee on House Administration, who flagged concerns about the Smithsonian’s involvement in “the Left’s indoctrination of our children.”
Under questioning from U.S. Rep. Stephanie Bice (R-Okla.), Bunch said he was “surprised” to learn the Smithsonian had hosted six drag events over the past three years, telling the lawmakers “It’s not appropriate to expose children” to these performances.
Collaborations with drag artist Pattie Gonia in December, January, and March were subsequently postponed or cancelled, the Post reported on Saturday, adding that a Smithsonian spokesperson blamed “budgetary constraints and other resource issues” and the museums are still developing programming for Pride month in June.
“I, along with all senior leaders, take seriously the concerns expressed by staff and will continue to do so,” Bunch said in a statement to the paper. “As we have reiterated, LGBTQ+ content is welcome at the Smithsonian.”
The secretary sent an email on Friday expressing plans to meet with leaders of the Smithsonian Pride Alliance, one of the two groups that detailed their concerns to him following December’s hearing.
Bunch told the Pride Alliance in January that with his response to Bice’s question, his intention was to “immediately stress that the Smithsonian does not expose children to inappropriate content.”
“A hearing setting does not give you ample time to expand,” he said, adding that with more time he would have spoken “more broadly about the merits and goals of our programming and content development and how we equip parents to make choices about what content their children experience.”
Politics
Survey finds support for Biden among LGBTQ adults persists despite misgivings
Data for Progress previewed the results exclusively with the Blade
A new survey by Data for Progress found LGBTQ adults overwhelmingly favor President Joe Biden and Democrats over his 2024 rival former President Donald Trump and Republicans, but responses to other questions may signal potential headwinds for Biden’s reelection campaign.
The organization shared the findings of its poll, which included 873 respondents from across the country including an oversample of transgender adults, exclusively with the Washington Blade on Thursday.
Despite the clear margin of support for the president, with only 22 percent of respondents reporting that they have a very favorable or somewhat favorable opinion of Trump, answers were more mixed when it came to assessments of Biden’s performance over the past four years and his party’s record of protecting queer and trans Americans.
Forty-five percent of respondents said the Biden-Harris administration has performed better than they expected, while 47 percent said the administration’s record has been worse than they anticipated. A greater margin of trans adults in the survey — 52 vs. 37 percent — said their expectations were not met.
Seventy precent of all LGBTQ respondents and 81 percent of those who identify as trans said the Democratic Party should be doing more for queer and trans folks, while just 24 percent of all survey participants and 17 percent of trans participants agreed the party is already doing enough.
With respect to the issues respondents care about the most when deciding between the candidates on their ballots, LGBTQ issues were second only to the economy, eclipsing other considerations like abortion and threats to democracy.
These answers may reflect heightened fear and anxiety among LGBTQ adults as a consequence of the dramatic uptick over the past few years in rhetorical, legislative, and violent bias-motivated attacks against the community, especially targeting queer and trans folks.
The survey found that while LGBTQ adults are highly motivated to vote in November, there are signs of ennui. For example, enthusiasm was substantially lower among those aged 18 to 24 and 25 to 39 compared with adults 40 and older. And a plurality of younger LGBTQ respondents said they believe that neither of the country’s two major political parties care about them.
Politics
Court records raise concerns about right-wing TikTok investor’s influence
Jeff Yass is a Pa. billionaire who has funded anti-LGBTQ causes
The role played by Pennsylvania billionaire Jeff Yass in the creation of TikTok might be far greater than was previously understood, according to new reporting that raises questions about the extent of the right-wing megadonor’s influence over matters at the intersection of social media, federal regulations, and electoral politics.
In 2012, Yass’s firm, Susquehanna International Group, spent $5 million for 15 percent of the short-form video hosting platform’s Chinese-owned parent, ByteDance. In the years since, as TikTok grew from a nascent startup to a tech giant with 1.5 billion active monthly users and an estimated $225 billion valuation, Yass and his firm pocketed tens of billions of dollars.
Beyond the size of Susquehanna’s ownership stake, little was known about its relationship with ByteDance until documents from a lawsuit filed against the firm by its former contractors were accidentally unsealed last month, leading to new reporting by the New York Times on Thursday that shows Susquehanna was hardly a passive investor.
In 2009 the firm used a proprietary, sophisticated search algorithm to build a home-buying site called 99Fang, tapping software engineer and entrepreneur Zhang Yiming to serve as its CEO. The company folded. And then, per the Times’s review of the court records, in 2012 Susquehanna picked Yiming to be the founder of its new startup ByteDance and repurposed the technology from 99Fang for use in the new venture.
Importantly, the documents do not provide insight into Yass’s personal involvement in the formation of ByteDance. And Susquehanna denies that the company’s search algorithm technologies were carried over from the real estate venture — which, if true, would presumably undermine the basis for the lawsuit brought by the firm’s former contractors who are seeking compensation for the tech used by ByteDance.
Questions about Yass’s influence come at a pivotal political moment
In recent weeks, federal lawmakers have moved forward with a proposal that would force ByteDance to divest TikTok or ban the platform’s use in the U.S. altogether, citing the potential threats to U.S. national security interests stemming from the company’s Chinese ownership.
The bill was passed on March 13 with wide bipartisan margins in the House but faced an uncertain future in the Senate. However, on Wednesday, House Speaker Mike Johnson (R-La.) announced plans to fold the proposal into a measure that includes foreign aid to Ukraine, Israel, and Taiwan, likely bolstering its chances of passage by both chambers.
Last month, shortly after meeting with Yass at his home in Mar-a-Lago, former President Donald Trump changed his longtime stance and came out against Congress’s effort to break up or ban TikTok. The timing led to speculation about whether the billionaire businessman was behind Trump’s change of heart, perhaps by contributing to the cash-strapped Republican presidential nominee’s electoral campaign or through other means.
Meanwhile, Yass has emerged as the largest donor of the 2024 election cycle. A coalition of public interest and government watchdog groups have called attention to the vast network of right-wing political causes and candidates supported by the billionaire, often via contributions funneled through dark money PACs that are designed to conceal or obscure the identities of their donors.
The Action Center on Race and the Economy, Make the Road, POWER Metro: Faith in Action, Free the Ballot, and Little Sis launched a website called All Eyes on Yass that features research into the various causes he supports, along with insight into the networks connecting the entities funded by his contributions.
Broadly, in Pennsylvania they fall into five categories: Advocacy against reproductive freedom and LGBTQ rights via the Pennsylvania Family Institute, lobbying on behalf of oil and gas industry interests by the Pennsylvania Manufacturers’ Association, anti-union groups supported by Commonwealth Partners, a privately owned registered investment advisory firm/independent broker-dealer, the Commonwealth Foundation for Public Policy Alternatives, which seeks to privatize public schools and defeat proposed increases to the minimum wage, and the Citizens Alliance of Pennsylvania, which advocates for lowering taxes on corporations and the rich.
Additionally, All Eyes on Yass reports that the billionaire has given massive contributions to Club for Growth and direct spending to support the electoral campaigns of right-wing Republicans including Florida Gov. Ron DeSantis; U.S. Sens. Ted Cruz (Texas), Rand Paul (Ky.), and Josh Hawley (MO); U.S. Rep. Lauren Boebert (Colo.), and former U.S. Rep. Madison Cawthorn (N.C.).
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