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
Whitman-Walker Health to present ‘Pro Bono Excellence’ award to law firm
Health center set to celebrate 40th anniversary of legal services program
Whitman-Walker Health, the D.C.-based community healthcare center that specializes in HIV/AIDS and LGBTQ-related health services, announced it will present its annual Dale Edwin Sanders Award for Pro Bono Excellence to the international law firm McDermott Will & Schulte at a May 6 ceremony.
“This year’s award is especially significant as it coincides with the 40th anniversary of Whitman-Walker Health’s Legal Services Program, marking it as the nation’s longest running medical-legal partnership,” a statement released by Whitman-Walker says.
“As a national leader in public health, Whitman-Walker celebrates our partnership with McDermott to strengthen the health center and to enable Whitman-Walker to reach more medical and legal clients,” the statement adds.
“McDermott’s firm-wide commitment to Whitman-Walker’s medical-legal partnership demonstrates a shared vision to serve those most in need,” Amy Nelson, Whitman-Walker’s director of Legal Services, says in the statement. “Our work protects individuals and families who face discrimination and hostility as they navigate increasingly complex administrative systems,” Nelson said.
“Pro bono legal services – like that of McDermott Will & Schulte – find solutions for people who have no place else to turn in the face of financial and health threats,” she added.
“Our partnership with Whitman-Walker Health is a treasured commitment to serving our neighbors and communities,” Steven Schnelle, one of the law firm’s partners said in the statement. “We are deeply moved by Whitman-Walker’s unwavering dedication to inclusion, respect, and equitable access to health care and social services,” he said.
The statement notes that the award for Pro Bono Excellence honors the legacy of the late gay attorney Dale Edwin Sanders. It says Sanders’s pro bono legal work for Whitman-Walker clients “shaped HIV/AIDS law for more than four decades by securing key victories on behalf of individuals whose employment and patient rights were violated.”
It says the Whitman-Walker Legal Services program began during the early years of the AIDS epidemic in the 1980s at a time when people with AIDS faced widespread discrimination and often needed legal assistance. According to the statement, the program evolved over the years and expanded to advocate for transgender people and immigrants.
Whitman-Walker spokesperson Lisa Amore said the presentation of the Dale Edwin Sanders Pro Bono Excellency Award will be held at the May 6 fundraising benefit for Whitman-Walker’s Legal Services Program. She said the event will take place at the offices of the DC law firm Baker McKenzie and ticket availability can be accessed here: https://www.whitman-walker.org/gtem-2026/
Noticias en Español
La X vuelve al tribunal
Primer Circuito examina caso del reconocimiento de personas no binarias en Puerto Rico
Hace ocho meses escribí sobre este tema cuando todavía no había llegado al nivel judicial en el que se encuentra hoy. En ese momento, la discusión se movía entre decisiones administrativas, debates públicos y resistencias políticas. No era un asunto cerrado, pero tampoco había alcanzado el punto actual.
Hoy el escenario es distinto.
La organización Lambda Legal compareció ante el Tribunal de Apelaciones del Primer Circuito en Boston para solicitar que se confirme una decisión que obliga al gobierno de Puerto Rico a emitir certificados de nacimiento que reflejen la identidad de las personas no binarias. La apelación se produce luego de que un tribunal de distrito concluyera que negar esa posibilidad constituye una violación a la Constitución de Estados Unidos.
Este elemento marca la diferencia. Ya no se trata de una discusión conceptual. Existe una determinación judicial que identificó un trato desigual.
El planteamiento de la parte demandante se sostiene en el propio marco legal vigente en Puerto Rico. Los certificados de nacimiento de identidad no son registros históricos inmutables. Son documentos utilizados para fines actuales y esenciales. Permiten acceder a empleo, educación y servicios, y son requeridos en múltiples gestiones ante el Estado. Su función es operativa.
En ese contexto, la exclusión de las personas no binarias no responde a una limitación jurídica. Puerto Rico permite la corrección de marcadores de género en certificados de nacimiento para personas trans binarias desde el caso Arroyo González v. Rosselló Nevares. Además, el Código Civil reconoce la existencia de certificados que reflejan la identidad de la persona más allá del registro original.
La diferencia radica en la aplicación.
El reconocimiento se concede dentro de categorías específicas, mientras que se excluye a quienes no se identifican dentro de ese esquema. Esa exclusión es el eje de la controversia actual.
El argumento presentado por Lambda Legal es preciso. Obligar a una persona a utilizar documentos que no reflejan su identidad implica someterla a una representación incorrecta en procesos fundamentales de la vida cotidiana. Esto puede generar dificultades prácticas, exposición innecesaria y situaciones de vulnerabilidad.
Las personas demandantes, nacidas en Puerto Rico, han planteado que el acceso a documentos precisos no es una cuestión simbólica, sino una necesidad básica para poder desenvolverse sin contradicciones impuestas por el propio Estado.
El hecho de que este caso se encuentre en el sistema federal introduce una dimensión adicional. No se trata de un proyecto legislativo ni de una política pública en discusión. Es una controversia constitucional. El análisis gira en torno a derechos y a la aplicación equitativa de las leyes.
Este proceso tampoco ocurre en aislamiento.
Se desarrolla en un contexto donde los debates sobre identidad y derechos han estado marcados por una mayor presencia de posturas conservadoras en la esfera pública, tanto en Estados Unidos como en Puerto Rico. En el ámbito local, esa influencia ha sido visible en discusiones legislativas recientes, donde argumentos de carácter religioso han comenzado a formar parte del debate sobre política pública. Esa intersección introduce tensiones en torno a la separación entre iglesia y Estado y tiene efectos concretos en el acceso a derechos.
Señalar este contexto no implica cuestionar la fe ni la práctica religiosa. Implica reconocer que, cuando determinados argumentos se trasladan al ejercicio del poder público, pueden incidir en decisiones que afectan a sectores específicos de la población.
Desde Puerto Rico, esta situación no se observa a distancia. Se experimenta en la práctica diaria. En la necesidad de presentar documentos que no corresponden con la identidad de quien los porta. En las implicaciones que esto tiene en espacios laborales, educativos y administrativos.
El avance de este caso abre una posibilidad de cambio en el marco legal aplicable. No porque resuelva de inmediato todas las tensiones en torno al tema, sino porque establece un punto de análisis jurídico sobre una práctica que hasta ahora ha operado bajo criterios restrictivos.
A diferencia de hace ocho meses, el escenario actual incluye una determinación judicial que ya identificó una violación de derechos. Lo que corresponde ahora es evaluar si esa determinación se sostiene en una instancia superior.
Ese proceso no define un resultado inmediato, pero sí establece un nuevo punto de referencia.
El debate ya no es teórico.
Ahora es judicial.
New York
Court orders Pride flag to return to Stonewall
Lambda Legal, Washington Litigation Group filed federal lawsuit
The Pride flag will once again fly over the Stonewall National Monument in New York following a court order requiring the National Park Service to raise it over the site.
The decision follows a lawsuit filed by Lambda Legal and the Washington Litigation Group in the U.S. District Court for the Southern District of New York, which challenged the removal as unconstitutional under the Administrative Procedure Act and argued that the government unlawfully targeted the LGBTQ community.
In February, the NPS removed the Pride flag from the Stonewall National Monument, the first national monument dedicated to LGBTQ rights and history in the U.S. The move followed a Jan. 21 memorandum issued by President Donald Trump-appointed NPS Director Jessica Bowron restricting which flags may be flown at national parks. The directive limited displays to official government flags, with narrow exceptions for those deemed to serve an “official purpose.”
Plaintiffs successfully argued that the Pride flag meets that standard, given Stonewall’s status as the birthplace of the modern LGBTQ rights movement. They also contended that the policy violated the APA by bypassing required public input and improperly applying agency rules.
The lawsuit named Interior Secretary Doug Burgum, Bowron, and Amy Sebring, superintendent of Manhattan sites for the NPS, as defendants. Plaintiffs included the Gilbert Baker Foundation, Village Preservation, Equality New York, and several individuals.
The court found that the memorandum — while allowing limited exceptions for historical context purposes — was applied unlawfully in this case. As part of the settlement, the NPS is required to rehang the Pride flag on the monument’s official flagpole within seven days, where it will remain permanently.
“The sudden, arbitrary, and capricious removal of the Pride flag from the Stonewall National Monument was yet another act by this administration to erase the LGBTQ+ community,” said Karen Loewy, co-counsel for plaintiffs and Lambda Legal’s Senior Counsel and Director of Constitutional Law Practice. “Today, the government has pledged to restore this important symbol back to where it belongs.”
“This is a complete victory for our clients and for the LGBTQ+ community,” said Alexander Kristofcak, lead counsel for plaintiffs and a lawyer with Washington Litigation Group. “The government has acknowledged what we argued from day one: the Pride flag belongs at Stonewall. The flag will be restored and it will fly officially and permanently. And we will remain vigilant to ensure that the government sticks to the deal.”
“Gilbert Baker created the Rainbow Pride flag as a symbol of hope and liberation,” said Charles Beal, president of the Gilbert Baker Foundation. “Today, that symbol is restored to the place where it belongs, standing watch over the birthplace of the modern LGBTQ+ rights movement.”
“The government tried to erase an important symbol of the LGBTQ+ community, and the community said no,” said Amanda Babine, executive director of Equality New York. “Today’s accomplishment proves that when we stand together and fight back, we win.”
“The removal of the Pride flag from Stonewall was an attempt to erase LGBTQ+ history and undermine the rule of law,” said Andrew Berman, executive director of Village Preservation. “This settlement restores both.”
With Loewy on the complaint are Douglas F. Curtis, Camilla B. Taylor, Omar Gonzalez-Pagan, Kenneth D. Upton Jr., Jennifer C. Pizer, and Nephetari Smith from Lambda Legal. With Kristofcak on the complaint are Mary L. Dohrmann, Sydney Foster, Kyle Freeny, James I. Pearce, and Nathaniel Zelinsky from Washington Litigation Group.
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