National
Higher AIDS drug costs under Obamacare?
Sebelius urged to allow drug company subsidies in exchanges
AIDS groups sent a letter to HHS Secretary Kathleen Sebelius urging her to allow drug company discount programs to operate under Obamacare. (Washington Blade file photo by Michael Key).
AIDS advocacy organizations say people with HIV could be forced to pay hundreds of dollars more each month for life-saving prescription drugs through health insurance plans required under the soon-to-be implemented Affordable Care Act known as Obamacare.
Leaders of more than 160 national and local organizations advocating for people with AIDS and other diseases sent a joint letter on Monday to Kathleen Sebelius, the U.S. Secretary of Health and Human Services, urging her to allow drug company discount programs to operate under Obamacare.
“We, the undersigned organizations and individuals, are writing to urge that the HHS issue clear guidance on the allowance of drug industry-provided co-payments, co-insurance, or other out-of-pocket discount cards and coupons in the Affordable Care Act’s Health Insurance Marketplaces,” the letter to Sebelius says.
“As people living with, and organizations serving people with HIV, HCV [Hepatitis C Virus], and other life-threatening and chronic health conditions, we are alarmed by the possibility of the prohibition of these critical financial lifelines,” the letter says.
The signers of the letter were referring to a controversy that erupted last month when Sebelius released a letter she sent to U.S. Rep. Jim McDermott (D-Wash.) saying HHS determined that the Obamacare health insurance exchanges were not “federal health care programs” as defined by a separate federal law aimed at curtailing health care fraud.
By declaring that the exchanges are not federal health care programs HHS, among other things, made the exchanges and the insurance plans sold under them exempt from a provision of the Social Security Act that bans pharmaceutical companies from providing insurance co-payment discounts or subsidies to patients for the purchase of prescription drugs.
Although this initial action by HHS drew strong support from AIDS organizations it surprised and angered many private health insurance companies and federal and state consumer protection regulators, who argued that the exemption would take away an important tool for preventing and prosecuting health care fraud.
Critics, including U.S. Charles Grassley (R-Iowa), noted that the Social Security Act prohibits pharmaceutical companies from providing co-payment assistance to patients under Medicare and Medicaid and that the Affordable Care Act should be considered as a similar federal health program.
Possibly due to the criticism of Sebelius’s initial determination on the issue, a short time later the HHS Center for Consumer Information and Insurance Oversight, which oversees insurance-related matters, issued a memo that appeared to contradict Sebelius’s interpretation of the Social Security Act.
The latter development prompted the AIDS organizations and allied groups to send their Dec. 2 letter to Sebelius urging her to hold firm on her initial determination that the insurance exchanges are exempt from the Social Security Act’s ban on drug company subsidies for prescription drug coverage.
The D.C.-based national group Health HIV participated in efforts to recruit groups to sign the letter.
According to the Wall Street Journal, drug companies spent about $4 billion on co-payment assistance programs for patients with HIV and other illnesses in 2011. The paper cited experts in the pharmaceutical industry that said the assistance programs often lowered a patient’s co-payment from $250 or more per month to just $5 per month for a prescription drug.
Critics of the program say the subsidies often are given for brand-name drugs and encourage patients not to request cheaper generic drugs. This forces insurance companies to pay more for the name-brand drugs, resulting in higher premiums for everyone in the long run, critics have said.
But in their letter to Sebelius, the AIDS organization officials said most AIDS-related drugs needed by people with HIV are not available in generic forms.
“[W]e urge you to consider the unintended consequences of suddenly removing industry-provided out-of-pocket assistance for brand-name drugs without generic equivalents from the patchwork of programs that so many people with serious and chronic conditions rely on,” the joint letter says.
“It could potentially threaten access to lifesaving medications for thousands of people living with HIV; bar millions of people with hepatitis C from benefiting from the new short-course curative treatment combinations; and keep countless people with cancer and other debilitating and life-threatening illnesses from the treatment they need to stay alive,” the letter says.
“We fear this will be a major setback to the goals of the Affordable Care Act,” it says.
HHS spokesperson Mike Robinson said he would make inquiries in response to a request by the Blade for Sebelius’s response to the joint letter by the AIDS organizations, but he did not immediately respond.
“We’re still waiting for a clear determination from HHS,” said Carl Schmid, deputy director of the AIDS Institute, one of the groups that signed on to the letter to Sebelius. “There have been some mixed signals from the department.”
Schmid said the drug company assistance programs seek to help people with HIV who are not eligible for the federal-state AIDS Drug Assistance Program known as ADAP, which provides AIDS drugs to low-income people who don’t have insurance.
Although people being helped by the pharmaceutical company assistance programs often are employed and have moderate incomes, the high cost of prescription drug co-payments could be devastating to them, Schmid and others familiar with the programs said. Some people with HIV need more than one drug for their treatment regimen, and co-payments under their insurance plans often result in co-payments of more than $200 per drug per month.
Dan Mendelson, president of the heath care consulting firm Avalere Health LLC told the Wall Street Journal that the average “silver” health insurance plan under the Obamacare exchanges has a required annual deductible of $2,500. He told the WSJ that the average deductible for the “bronze” plans under the exchanges, which are said to be the cheapest plans, is $5,000.
Schmid said these costs are often prohibitive for patients with modest incomes. The elimination of the drug company assistance programs under the Affordable Care Act’s exchanges would create a serious burden on HIV patients and others who now rely on the assistance programs.
National
LGBTQ Catholic groups slam Trump over pope criticism
‘Moral truth and compassion always overcome ignorant hate’
LGBTQ Catholic groups have sharply criticized President Donald Trump over his criticisms of Pope Leo XIV.
Leo on April 13 told reporters while traveling to Algeria that he had “no fear of the Trump administration” after the president described him as “weak on crime” and “terrible for foreign policy” in response to his opposition to the Iran war. (Trump on the same day posted to Truth Social an image that appeared to show him as Jesus Christ. He removed it on April 13 amid backlash from religious leaders.)
Vice President JD Vance, who is Catholic, during a Fox News Channel interview on the same day said “in some cases, it would be best for the Vatican to stick to matters of morality, to stick to matters of what’s going on with the Catholic church, and let the president of the United States stick to dictating American public policy.” Vance on April 14 once again discussed Leo during an appearance at a Turning Point USA event in Athens, Ga., saying he should “be careful when he talks about matters of theology.”
Italian Prime Minister Giorgia Meloni; former U.S. Ambassador to the Vatican Miguel Díaz; and Oklahoma City Archbishop Paul Coakley, president of the U.S. Conference of Catholic Bishops, are among those who have criticized Trump over his comments. The president, for his part, has said he will not apologize to Leo.
“The world is being ravaged by a handful of tyrants,” said Leo on Thursday at a cathedral in Bamenda, Cameroon.
Francis DeBernardo is the executive director of New Ways Ministry, a Maryland-based LGBTQ Catholic organization. He told the Washington Blade on Thursday that Trump’s comments about Leo “are one more example of the ridiculous hubris of this leader (Trump) whose entire record shows that he is nothing more than a middle-school bully.”
“LGBTQ+ adults were often bullied as children, and they have learned the lesson that bullies act when they feel frightened or threatened,” said DeBernardo. “But secular power does not threaten the Vicar of Christ, and Pope Leo’s response illustrates this truth perfectly.”
DeBernardo added Trump “is obviously frightened that Pope Leo, an American, has more power and influence than the president on the world stage.”
“Like most Trumpian bullying, this strategy will backfire,” DeBernardo told the Blade. “Moral truth and compassion always overcome ignorant hate. Trump’s actions are not an example of his power, but of his impotence.”
Marianne Duddy-Burke, executive director of DignityUSA, an LGBTQ Catholic organization, echoed DeBernardo.
“He [Trump] has demonstrated throughout both presidencies that he doesn’t understand the basic concepts of any faith system that is founded on the dignity of human beings, the importance of common good,” Duddy-Burke told the Blade on Thursday during a telephone interview. “It’s just appalling.”
Duddy-Burke praised Leo and the American cardinals who have publicly criticized Trump.
“The pope’s popularity — given how much more respect Pope Leo has than the man sitting in the White House — is a blow to his ego,” Duddy-Burke told the Blade. “That seems to be a sore sport for him.”
“It’s such an imperialistic world view,” she added.
Leo ‘is the real peacemaker’
The College of Cardinals last May elected Leo to succeed Pope Francis after his death.
Leo, who was born in Chicago, is the first American pope. He was the bishop of the Diocese of Chiclayo in Peru from 2015-2023.
Francis made him a cardinal in 2023.
Juan Carlos Cruz — a gay Chilean man and clergy sex abuse survivor who Francis appointed to the Pontifical Commission for the Protection of Minors — has traveled to Ukraine several times with Dominican Sister Lucía Caram since Russia launched its war against the country in 2022. Cruz on Thursday responded to Trump’s criticism of Leo in a text message he sent to the Blade from Kyiv, the Ukrainian capital.
“I am in Ukraine under many attacks,” said Cruz. “Trump is an asshole and has zero right to criticize the Pope who is the real peacemaker.”
Tennessee
Charlie Kirk Act advances in Tenn.
Bill would limit protests, protects speakers opposing ‘transgender’ identities
The Tennessee legislature has passed Senate Bill 1741 / House Bill 1476, dubbed the “Charlie Kirk Act,” which, if signed by Republican Gov. Bill Lee, would reshape how public colleges and universities regulate speech on campus.
The measure targets all public higher education institutions and requires them to adopt a “free expression” policy modeled on the University of Chicago’s framework. That framework emphasizes that universities should not shield students from controversial or offensive ideas and requires state schools to formally embrace institutional neutrality — meaning they do not publicly take a stance on political or social issues.
Under the legislation, publicly funded schools cannot disinvite or cancel invited speakers based on their viewpoints or in response to protests from students or faculty. Student organizations, however — like Turning Point USA, an American nonprofit that advocates for conservative politics on high school, college, and university campuses, founded by Charlie Kirk, and often lack widely represented liberal counterparts — would retain broad authority to bring speakers to campus regardless of controversy.
The law includes broad protections for individuals and organizations expressing religious or ideological beliefs, including opposition to abortion, homosexuality, or transgender identity, regardless of whether those views are rooted in religious or secular beliefs. It further prohibits public institutions from retaliating against faculty for protected speech or scholarly work.
The bill, which has been hailed by supporters as an effort to “preserve campus free speech,” ironically also limits protest activity. Shouting down speakers, blocking sightlines, staging disruptive walkouts, or physically preventing entry to events are now considered “substantial interference” under the legislation, making those who engage in such actions subject to discipline.
Some of those disciplinary consequences include probation, suspension, and even expulsion for students, while faculty who protest in ways deemed to violate the policy could face unpaid suspensions and termination after repeated violations.
Supporters of the bill argue it strengthens free expression on campus. State Rep. Gino Bulso (R-Brentwood), the bill’s sponsor, said it reinforces a commitment to “civil and robust” debate at public universities.
“The Charlie Kirk Act creates critical safeguards for students and faculty and renews the idea that our higher education institutions should be centers of intellectual debate,” Bulso told Fox 17. “This legislation honors the legacy of Charlie Kirk by promoting thoughtful engagement and defending religious freedom.”
Critics, including Democratic lawmakers, have raised concerns that the legislation effectively elevates certain ideological viewpoints — particularly those tied to religious objections to LGBTQ identities — while exposing students and faculty to punishment for protest or dissent.
“It’s ironic that this body is talking about free speech when we had professors in Tennessee schools expelled and suspended when they did not mourn the death of Charlie Kirk — when they said that his statements were problematic and that the way he died did not redeem the way he lived,” state Rep. Justin Jones (D-Nashville) told WKRN.
Kirk, the right-wing activist and founder of Turning Point USA, for whom the bill is named, was assassinated in September 2025 at a public event at Utah Valley University. His legacy and rhetoric remain deeply polarizing, particularly among LGBTQ advocates, who have cited his history of anti-LGBTQ statements in opposing his campus appearances.
The bill now heads to Lee’s desk for his signature.
National
Demonstrators disrupt OMB director hearing over PEPFAR
Capitol Police arrested five protesters
A group of protesters interrupted Office of Management and Budget Director Russell Vought during his testimony before Congress on Wednesday.
Vought was at the Cannon House Office Building to give testimony to the House Budget Committee.
Committee Chair Jodey Arrington (R-Texas) began the hearing by touting what he described as economic accomplishments of the Trump-Vance administration’s economic accomplishments. Ranking Member Brendan Boyle (D-Pa.) disputed those claims in his opening statement.
Boyle went on to admonish Vought for not attending a committee hearing in the previous year.
Vought, the “Project 2025” architect, was invited to speak after Arrington and Boyle made their statements.
Shortly after Vought began reading his statement, Housing Works CEO Charles King stood up in the gallery and began shouting, “PEPFAR saves lives: spend the money!”
The U.S. Capitol Police moved quickly to escort King from the room. Other activists began chanting with King as they unfolded signs bearing a picture of Vought’s face and statements such as, “Vought’s cuts kill people with AIDS,” and “Protect PEPFAR from Vought.”
The group of HIV/AIDS activists included independent activists, former U.S. Agency for International Development and PEPFAR staff, members of Health GAP, Housing Works, and the Treatment Action Group. Six activists were escorted from the hearing and the U.S. Capitol Police detained five of them.
The HIV/AIDS treatment activists protested at the hearing in response to the dismantling of global health programs, including PEPFAR, a federally-funded program credited with saving millions of lives from HIV/AIDS, particularly in sub-Saharan Africa.
“Russell Vought is directly responsible for illegally withholding Congressionally appropriated funds for PEPFAR and related global health initiative,” King said in a statement provided to the Washington Blade. “These funding disruptions have already contributed to preventable deaths and threaten to reverse decades of progress in the fight against HIV worldwide. Enough is enough. Congress must ensure Vought stops this deadly sabotage.”
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