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Obama admin says insurers can’t discriminate against gay unions

Prohibits discrimination even in non-marriage equality states

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Centers for Medicare & Medicaid Services, gay news, Washington Blade
Centers for Medicare & Medicaid Services, gay news, Washington Blade

The Centers for Medicare & Medicaid has issued guidance clarifying insurers can’t discriminate against same-sex couples. (Image public domain)

The Obama administration clarified on Friday that insurers are prohibited from discriminating against same-sex marriages for the purposes of non-grandfathered family coverage — even if applicants are applying in non-marriage equality states.

In guidance dated March 14, the Centers for Medicare & Medicaid says existing provisions in the health care reform law prohibiting discrimination by insurers on the basis of gender — which the Obama administration has interpreted to extend non-discrimination protections based on sexual orientation and gender identity — also requires insurers not to refuse family coverage for married same-sex couples.

The guidance is set up as Q&A. The question is “If a health insurance issuer in the group or individual market offers coverage of an opposite-sex spouse, may the issuer refuse to offer coverage of a same-sex spouse?” The response starts off simply, “No.”

“This section prohibits an issuer from choosing to decline to offer to a plan sponsor (or individual in the individual market) the option to cover same-sex spouses under the coverage on the same terms and conditions as opposite sex-spouses,” the guidance states.

Alicia Hartinger, a CMS spokesperson, said the guidance spells out that non-discrimination is the rule for insurers — both on and off the health insurance exchanges — when selling policies.

“CMS recognizes the importance of all Americans and their families having access to quality, affordable coverage,” Hartinger said. “Today’s guidance clarifies that issuers may not choose to treat same-sex spouses differently from opposite-sex spouses. If an issuer offers opposite-sex spouse coverage, it may not choose to deny the same coverage to a same-sex spouse. We will continue to work with states and issuers to help ensure all Americans have an equal opportunity to purchase the new coverage options available to them.”

The guidance says insurers cannot refuse family coverage to married same-sex couples even if they live in — or the insurance is sold in — a non-marriage equality state that doesn’t recognize those unions.

Additionally, the guidance acknowledges insurers may not have realized this prohibition when designing their policies for the 2014 coverage year. Accordingly, while encouraging immediate compliance, CMS says insurers need not begin adhering to this policy until Jan. 1, 2015. The guidance also directs states to begin enforcing the regulations no later than Jan. 1, 2015.

The guidance doesn’t address whether it requires CMS to provide coverage to same-sex couples in domestic partnerships or civil unions. A CMS official said the guidance applies only to marriages, not these other unions.

LGBT advocates praised the new guidance as a step toward ensuring that married same-sex couples have the same access to health insurance as their opposite-sex counterparts.

Rea Carey, executive director of the National Gay & Lesbian Task Force, earlier said her group wanted the Obama administration to make the clarification and upon news of the guidance said it would help same-sex couples “hurting right now” because they were denied health insurance.

“Today’s important HHS announcement will help remove this type of discrimination by requiring the health insurance industry to treat us the same as straight married couples — even if the states where we live do not recognize marriage equality,” Carey said. “While insurers are not required to be in compliance with the new rules until January 2015, we urge the industry to act now — as affordable health care delayed is affordable health care denied.”

There have been reported incidents of married gay couples being unable to receive family coverage in the aftermath of the implementation of the Affordable Care Act. In February, a gay couple — Alfred Cowger and Anthony Wesley of Gates Mills, Ohio — filed a federal lawsuit charging that they were unable to obtain family coverage because their state doesn’t recognize their marriage.

In January, Blue Cross and Blue Shield canceled family insurance policies it sold to same-sex couples under the Affordable Care Act in North Carolina. Following news reports about the cancellations, the insurer changed course and agreed to offer family coverage on the health insurance exchange to same-sex couples.

Kellan Baker, director of the LGBT State Exchanges Project for the Center for American Progress, said the new guidance is important because research shows LGBT families have trouble accessing health insurance.

“Research has shown that same-sex couples, as well as transgender people and other members of the lesbian, gay, bisexual, and transgender, or LGBT, communities, frequently face obstacles to affordable, comprehensive insurance coverage,” Baker said. “My colleagues and I look forward to working with HHS to ensure that this guidance is fully implemented in a timely manner and that similar action is taken to remove other barriers to coverage, such as discriminatory insurance exclusions that target transgender people.”

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Cuba

Cuba marks IDAHOBiT amid heightened tensions with U.S.

Energy crisis, fears of military intervention overshadow events

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A transgender Pride flag flies over Mi Cayito, a beach east of Havana. International Day Against Homophobia, Transphobia, and Biphobia events took place in Cuba against the backdrop of increased tensions between the country and the U.S. and a severe energy crisis. (Washington Blade photo by Michael K. Lavers)

International Day Against Homophobia, Transphobia, and Biphobia commemorations took place in Cuba against the backdrop of increased tensions between the country and the U.S.

Mariela Castro, the daughter of former Cuban President Raúl Castro who is the director of the country’s National Center for Sexual Education, spoke at a Havana press conference on May 13. Mariela Castro, who is a member of Cuba’s National Assembly, also participated in an IDAHOBiT gala that took place in the Cuban capital on May 14.

CENESEX organized an IDAHOBiT event in Havana on Sunday. The group this month also put together panels and other gatherings.

‘Love is law’

IDAHOBiT commemorates the World Health Organization’s declassification of homosexuality as a mental disorder on May 17, 1990.

This year’s IDAHOBiT theme was “At the Heart of Democracy.” CENESEX-organized IDAHOBiT events took place under the “Love is Law” banner.

“On this day we remember diversity is wealth and equality is a right that does not allow exceptions,” said Cuba’s National Office of Statistics and Information on Sunday. “To say ‘no’ to homophobia, transphobia, and biphobia is to affirm Cuba is being built around the inclusion, the dignity, and the recognition of all people.”

Mariela Castro’s uncle, Fidel Castro, in the years after the 1959 Cuban revolution sent thousands of gay men and others deemed unfit for military service to labor camps known as Military Units to Aid Production.

His government forcibly quarantined people living with HIV/AIDS in state-run sanitaria until 1993. Fidel Castro in 2010 formally apologized for the labor camps, which are known by the Spanish acronym UMAP.

His brother, Raúl Castro, succeeded him as Cuba’s president in 2008. Fidel Castro died in 2016.

The Cuban constitution bans discrimination based on sexual orientation and gender identity, among other factors. Authorities, however, routinely harass and detain activists who publicly criticize the government. (The Cuban government in 2019 detained this reporter for several hours at Havana’s José Martí International Airport after he tried to enter the country to cover IDAHOBIT events. Officials then allowed him to board a flight back to the U.S.)

Same-sex couples have been able to marry on the island since 2022.

Cuba’s national health care system has offered free sex-reassignment surgeries since 2008. Activists who are critical of Mariela Castro and/or CENESEX have previously told the Washington Blade that access to these procedures is limited.

Lawmakers in 2025 amended Cuba’s Civil Registry Law to allow transgender people to legally change the gender marker on their ID documents without surgery.

Federal prosecutors to reportedly indict former Cuban president

American forces on Jan. 3 seized now former Venezuelan President Nicolás Maduro and his wife, Cilia Flores, at their home in Caracas, the Venezuelan capital, during an overnight operation.

Venezuela after Maduro’s ouster stopped oil shipments to Cuba. That, combined with a U.S. energy blockade, has caused widespread blackouts and a severe fuel shortage that has paralyzed the country.

Federal prosecutors are reportedly planning to indict Raúl Castro over his alleged role in the 1996 shooting down of four planes that Brothers to the Rescue, a Miami-based Cuban exile group, operated over the Florida Straits that separate Cuba and the Florida Keys. The Associated Press notes Raúl Castro, who is 94, was Cuba’s defense minister when the incident took place.

CIA Director John Ratcliffe on May 14 met with Raúl Castro’s grandson, Raúl Guillermo Rodríguez Castro, and other Cuban officials in Havana.

Axios on Sunday reported Cuba “has acquired” more than 300 drones and is preparing to use them to attack Guantánamo Bay, a U.S. naval base on the island’s southern coast, and other targets that include Key West, Fla., which is less than 100 miles north of the Communist country. Cuban President Miguel Díaz-Canel said Cuba is “not a threat, nor does it have aggressive plans or intentions against any country.”

“Cuba, which is already suffering from a multidimensional aggression by the U.S., does indeed have the absolute and legitimate right to defend itself against a military onslaught. This cannot, however, be logically or honestly be wielded as an excuse to wage war against the noble Cuban people.”

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Comings & Goings

Chef Jamie Leeds opens new dining concepts

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Jamie Leeds

The Comings & Goings column is about sharing the professional successes of our community. We want to recognize those landing new jobs, new clients for their business, joining boards of organizations and other achievements. Please share your successes with us at [email protected]

The Comings & Goings column also invites LGBTQ college students to share their successes with us. If you have been elected to a student government position, gotten an exciting internship, or are graduating and beginning your career with a great job, let us know so we can share your success.

Congratulations to Jamie Leeds, chef extraordinaire, and owner of Hank’s Oyster Bars, as she ventures into some new areas. Leeds is an award-winning Washington, D.C.–area chef, restaurateur, and entrepreneur with more than three decades of experience shaping the region’s dining scene.

Her first new venture is a restaurant opening in Alexandria this week. It will be called Hank’s Pasta Bar, bringing a personalized twist to classic Italian dining with a hiddenrestaurant-inside-a-restaurant in Old Town, Alexandria. The new trattoria is above Hank’s Oyster Bar, and will feature a build-your-own menu, marking a new direction for Leeds in partnership with chef Darren Norris. Norris brings more than three decades of experience to Hank’s Pasta Bar, with a foundation grounded in Italian cooking. The grand opening was scheduled for May 14. The elevated casual eatery blends an inventive chef-driven menu with an easy-going, sit-down dining experience that puts guests in charge. Hank’s Pasta Bar bridges the gap between elevated fast casual, like Norris’s Shibuya, and full-service dining, like Leeds’s Hank’s Oyster Bar. Diners order electronically at the table, but unlike fast casuals, food and beverages are delivered on plate ware, and a server is on site at all times.  

The restaurant-inside-a-restaurant, welcomes guests to dine in with a full bar, including Italian wines and craft cocktails, maintaining its focus on traditional Italian fare with contemporary touches, including a build-your-own pasta bowl experience starting at $16. Create your own pasta bowl from seven artisanal pastas (including gluten-free), nine made-in-house sauces, proteins, vegetables, and toppings. Leeds said, “It’s the kind of place you’d find down a side street in a Tuscan hill town, after being tipped off by a friend who says, ‘trust me.’ If you know, you know.” 

The restaurant will continue Hank’s community partnerships, including with Real Food for Kids, supporting programs that improve school food and nutrition equity. 

In addition to this you should try Jaimie’s other new venture. Back Door Taco at Hank’s in Dupont Circle. You walk down the alley from 17th Street to the back door of Hank’s, and enter a small patio to partake of great tacos and interesting cocktails.

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District of Columbia

HIV Vaccine Awareness Day set for May 18

Whitman-Walker joins nationwide recognition of efforts to develop vaccine

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(Image courtesy of the NIH)

Whitman-Walker Health, the D.C.-based community healthcare center that specializes in HIV/AIDS and LGBTQ-related health services, will join health care advocates from across the country to support efforts to develop an HIV vaccine on HIV Vaccine Awareness Day on May 18.

“HIV Awareness Day, observed annually on May 18, was established to recognize and thank the volunteers, scientists, health professionals, and community members working toward a safe and effective prevention HIV vaccine,” Whitman-Walker said in a statement.

“Led by the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID), the day is also an opportunity to educate communities about the critical importance of preventive HIV vaccine research,” the statement says.

It adds, “The reality is that any new vaccine discovery must be built community by community, institution by institution, and then it must reach everyone – especially the communities who have carried the heaviest burden of this epidemic.”

On its own website, the National Institutes of Health says HIV Vaccine Awareness Day also highlights its longstanding efforts, coordinated by its Office of AIDS Research, to support researchers’ efforts to develop an HIV vaccine.  

“Researchers are making promising headway in efforts to develop a safe, effective HIV vaccine,” it says in a statement on its website.

A Whitman-Walker spokesperson said Whitman-Walker was not holding a specific event to observe HIV Vaccine Awareness Day, but it will recognize the day as a way of encouragement for its ongoing work to address the AIDS epidemic and support for vaccine research.

“Today, no one has to die from HIV,” said Whitman-Walker’s Health System division’s CEO, Dr. Heather Aaron in the Whitman-Walker statement. “We have the treatments, the technology, and the research to change outcomes, and yet people in our community are still dying from HIV//AIDS,” she said in the statement.

“That is unacceptable, and it is exactly why our work continues,” she added. “Here in D.C. with more focus on Southeast D.C., the Whitman-Walker Health System remains committed to making a difference through cutting-edge research, policy advocacy, and philanthropy, because fair access to life-saving treatment is not a privilege. It is a right.”  

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