News
Obama admin says insurers can’t discriminate against gay unions
Prohibits discrimination even in non-marriage equality states

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.”
District of Columbia
‘No Kings’ protests set for D.C.
Anti-Trump demonstrations to take place across country on Saturday
As President Donald Trump and his administration escalate rhetoric targeting transgender youth and student athletes, push efforts to restrict voting access for millions of Americans, and pursue foreign policy decisions that critics say bypass congressional authority, organizers across the country are once again mobilizing in protest.
For many LGBTQ advocates, the moment feels especially urgent.
In recent months, activists have pointed to a surge in anti-trans legislation, attacks on gender-affirming care, and efforts to roll back nondiscrimination protections as direct threats to the safety and visibility of queer and trans communities. Organizers say the demonstrations are not just about policy, but about defending the right of LGBTQ people — particularly trans youth and people of color — to live openly and safely.
Thousands of “No Kings” protests are planned nationwide, with multiple demonstrations set to take place in D.C.
One of the primary events, “No Kings Washington,” will be held in Anacostia, an overwhelmingly Black area of D.C. that is often at the center of conversations around racial justice, policing, and access to resources in the nation’s capital.
The protest in Anacostia is focused on what organizers describe as the “power behind the throne,” specifically Stephen Miller, the White House Deputy Chief of Staff for Policy and Homeland Security Advisor. Miller has been closely associated with the administration’s “zero tolerance” immigration policy, including the family separation practice that resulted in thousands of children being separated from their parents at the Southern border.
Activists have also linked immigration enforcement policies to broader concerns about LGBTQ migrants, including queer asylum seekers who often face heightened risks of violence and discrimination both in their home countries and within detention systems.
Anacostia protest details:
Participants are asked to gather starting at 1:30 p.m. on the southeast side of the Frederick Douglass Bridge. The closest Metro station is Anacostia on the Green Line, about an 8-minute walk from the starting point. Organizers strongly encourage attendees to use public transportation, as street parking is limited.
The march will proceed past Fort McNair and conclude near the Waterfront Metro station.
D.C. icon and LGBTQ activist Rayceen Pendarvis is set to speak at the protest around 2 p.m.
Kalorama protest details:
A separate protest will take place earlier in the day in Kalorama, a neighborhood long associated with political power and home to presidents, cabinet officials, and foreign ambassadors. Demonstrators are expected to gather at 10 a.m., with a march running until approximately noon near the intersection of Connecticut Avenue and Kalorama Road.
Arlington/National Mall protest details:
Another group is expected to assemble at Memorial Circle near Arlington National Cemetery at 10 a.m. before crossing the Memorial Bridge into D.C., passing the Lincoln Memorial and continuing on to the Washington Monument. Organizers say the march is intended to defend “American democracy, the rule of law, and a healthy planet.”
Unlike last June — when organizers discouraged large-scale demonstrations in D.C. due Trump’s military/birthday parade — activists are now explicitly calling on people to show up in the nation’s capital and surrounding areas.
The protests also coincide with Transgender Day of Visibility weekend, which includes additional gatherings and celebrations on the National Mall. At the same time, peak bloom for the National Cherry Blossom Festival is expected to draw large crowds to the city. With multiple major events happening simultaneously, officials and organizers anticipate significant congestion, increased traffic, and crowded public transit throughout the weekend.
Organizers are urging participants to plan ahead and come prepared.
“Bring your signs, noisemakers, music, and creative ideas, and gather in joyful, nonviolent protest,” they said. “Children are very welcome.”
For more information, visit nokings.org.
Pennsylvania
Pa. House passes bill to codify marriage equality in state law
Governor supports gay state Rep. Malcolm Kenyatta’s measure
The Pennsylvania House of Representatives on Wednesday passed a bill that would codify marriage equality in state law.
House Bill 1800 passed by a 127-72 vote margin. Twenty-six Republicans voted for the measure.
The Republican-controlled Pennsylvania Senate will now consider the bill that state Rep. Malcolm Kenyatta (D-Philadelphia), who is the first openly gay person of color elected to the state’s General Assembly, introduced. Democratic Gov. Josh Shapiro supports the measure.
“Here in Pennsylvania, we believe in your freedom to marry who you love,” said Shapiro on Wednesday. “Today, the House has stepped up to protect that right.”
BREAKING: The Pennsylvania House just passed @RepKenyatta's bill to codify marriage equality into law in PA — and they did it with broad bipartisan support.
— Governor Josh Shapiro (@GovernorShapiro) March 25, 2026
Here in Pennsylvania, we believe in your freedom to marry who you love. Today, the House has stepped up to protect that…
Florida
DeSantis signs emergency bill that restores Fla. ADAP funding
Temporary funds to last through June 30
After the Florida Department of Health made huge cuts to the AIDS Drug Assistance Program in January, Republican Gov. Ron DeSantis has signed emergency legislation restoring HIV access to more than 12,000 Floridians.
Two months ago, as the Washington Blade reported, the Sunshine State cut the vast majority of those in ADAP by shifting the income levels required for eligibility — without following standard procedure when changing government policy outside of legislative or executive action.
The bill, signed by DeSantis on Tuesday, passed both chambers of the Florida Legislature unanimously and appropriates $30.9 million in emergency bridge funding through June 30, 2026. It restores Florida’s ADAP income eligibility to 400 percent of the Federal Poverty Level — the level it was prior to the January cuts. The legislation also requires the FDOH to submit detailed monthly financial reports to legislative leadership beginning April 1.
Under the old policy, eligibility would have been limited to those making no more than 130 percent of the federal poverty level, or $20,345 per year.
“For 10 weeks, 12,000 Floridians living with HIV did not know if they could fill their next prescription. Today, they can,” Esteban Wood, director of advocacy and legislative affairs at AIDS Healthcare Foundation, said in a statement.
The detailed reports now required to be sent to legislative leadership must include all federal revenues and expenditures, including manufacturer rebates; enrollment figures by county and insurance status; prescription utilization by drug class; and any projected funding shortfalls. This is the first time the Legislature has required this level of financial transparency from the program.
DeSantis signed the legislation one day after a Leon County Circuit Court judge denied AIDS Healthcare Foundation’s request for an injunction to block the significant changes the DeSantis administration is making to the program, which it claims faces a $120 million shortfall for calendar year 2026.
AIDS Healthcare Foundation, a national organization focused on protecting and expanding HIV healthcare access and prevention methods, filed a lawsuit over the change in eligibility, arguing the Florida Department of Health did not follow the laid out path for formally changing policy and was acting outside established procedures.
Typically, altering eligibility for a statewide program requires either legislative action or adherence to a multistep rule-making process, including: publishing a Notice of Proposed Rule; providing a statement of estimated regulatory costs; allowing public comment; holding hearings if requested; responding to challenges; and formally adopting the rule. According to AIDS Healthcare Foundation, none of these steps occurred.
The long-term structure of ADAP will be determined by the 2026–2027 fiscal year state budget, something that lawmakers have until June 30 to finish.
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