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.”
The White House
Trump tells Fox News he won the ‘gay vote’ — but polls tell a different story
Trump falsely claims LGBTQ support on Fox despite polling showing overwhelming opposition.
President Donald Trump claimed he won the “gay vote” in 2024, despite evidence showing otherwise.
While appearing by phone on Fox News’s panel show “The Five” on Thursday, Trump falsely claimed he performed particularly well among gay voters while discussing the ongoing war in Iran — a conflict he initiated without formal congressional approval.
“Now I think I did very well with the gay vote, OK? I even played the gay national anthem as my walk-off, OK?” Trump said on air.
“And I think it probably helped me. But I did great. No Republican’s ever gotten the gay vote like I did and I’m very proud of it, I think it’s great. Perhaps it’s because I’m from New York City, I don’t know…”
His claim contradicts 2024 polling from NBC News, which found that the GOP presidential ticket captured fewer than 1 in 5 LGBTQ male voters — a figure that may also include bisexual and transgender men. Trump’s support among LGBTQ female voters was even lower, at just 8%.
White LGBTQ voters favored Vice President Kamala Harris over Trump by a margin of 82% to 16%, while LGBTQ voters of color backed Harris by an even wider 91% to 5%.
Trump also used the appearance to criticize “Gays for Palestine,” saying: “Look at ‘Gays for Palestine’… they kill gays, they kill them instantly, they throw them off buildings, and I’m saying, ‘Who are the gays for Palestine?’”
He further pointed to his campaign’s use of the song “Y.M.C.A.” by the Village People — which he has repeatedly described as a “gay national anthem” — noting that it was frequently used as a walk-off song at rallies, as an indication that he and his campaign were supported by the gay community. The track, long associated with camp and hyper-masculine gay imagery, became a staple of Trump campaign events.
The Village People were later booked to perform at Turning Point USA’s inaugural ball celebrating Trump’s second inauguration. Lead singer Victor Willis previously criticized Trump’s use of the song dating back to 2020 and considered legal action to block it, but ultimately said there was “not much he can do about it.” He later acknowledged the renewed exposure was “beneficial” and “good for business,” boosting the song’s popularity and chart performance.
Despite Trump’s claims of strong support from gay voters, polling has consistently shown otherwise — even as several prominent gay men have held roles in or around his orbit, sometimes dubbed the “A-gays.” These include Richard Grenell, former executive director of the Kennedy Center and Special Presidential Envoy for Special Missions; Treasury Secretary Scott Bessent; Under Secretary of State Jacob Helberg; Department of Energy official Charles T. Moran; and longtime supporter Peter Thiel, co-founder and CEO of Palantir.
His efforts to portray himself as aligned with the gay community stand in conflict with policies advanced under his leadership. These include removing LGBTQ-related data from State Department reports, attempting to narrowly redefine gender identity in federal policy, restricting access to gender-affirming health care, and rolling back anti-discrimination protections. His administration also rescinded initiatives focused on LGBTQ health equity, data collection, and nondiscrimination in health care and education — moves advocates say contribute to stigma and worsen mental health outcomes.
Additionally, some HIV programs and community health centers have lost funding from the federal government after supporting initiatives inclusive of transgender people as a direct result of Trump-Vance policies.
National
Anti-trans visa ruling echoes Nazi regime destroying trans documents
Trump administration escalates attacks on queer community
The Lemkin Institute for Genocide Prevention and Human Security earlier this month released its third Red Flag Alert for the United States about the Trump administration’s anti-trans legislation. As the Lemkin Institute shared in the press release, “the Administration has moved from identifying transgender people as as threat to the family and to the nation’s military prowess to claiming that transgender people constitute a cosmic threat to the spiritual health of the nation and the great direct threat to the US national security in the world.”
The news came the same day that the State Department issued a new rule, “Enhancing Vetting and Combatting Fraud in the Immigrant Visa Program.” Under this new guidance, all visa applicants are required to disclose their “biological sex at birth” during all stages of the process, “even if that differs from the sex listed on the applicant’s foreign passport or identifying documentation.”
This rule also orders that applicants to the green card lottery program share their passport information, so in knowingly collecting passport information that the agency knows will not match a person’s biological sex at birth, it’s creating grounds to deny trans peoples’ biases on the basis of “fraud,” Aleksandra Vaca of Transitics explains.
As is written in the new ruling, “the Department is replacing ‘gender’ with ‘sex’ in accordance with E.O. 14168, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, which provides that the term ‘sex’ shall refer to an individual’s sex at birth. Only male and female sex options are available for entrants completing the Diversity Visa entry form.”
Along with outright denying the existence of nonbinary, genderqueer and gender expansive people, this policy creates a precedence for trans people to be stripped of their visas and deported because under 8 U.S.C. § 1182(a)(6)(C)(i), any foreigner found to have obtained or possess a visa “by fraud or willfully misrepresenting a material fact” will have their visa revoked and face deportation.
By requesting information on “biological sex at birth,” the State Department is forcing a mismatch between documents and enabling officials to accuse trans, nonbinary, and gender expansive immigrants of fraud. Thus, trans and nonbinary immigrants can have their visas revoked and can be deported, and information gathered from immigrants during the visa request process can be added to federal databases and used by immigration authorities, including ICE agents.
With the Supreme Court’s decision this past year allowing ICE officers to use racial profiling, Vaca argues that “now, The Trump administration has given ICE the reason it needs. Under this rule, ICE agents now have the enforcement rationale to assert that trans people–especially those belonging to racial minority groups–are more likely than cis people to have ‘misrepresented’ themselves during the visa process, and therefore, are more likely to enter the country ‘unlawfully.’”
This would enable ICE agents to target trans individuals specifically for being trans. If the goal of this were unclear, a day later the Trump administration released its statement for Women’s History Month 2026, writing that “we are keeping men out of women’s sports, enforcing Title IX as it was originally written and ensuring colleges preserve–and, where possible, expand–scholarships and roster opportunities for female athletes. We are restoring public safety and upholding the rule of law in every city so women, children, and families can feel safe and secure.”
And this is not the first time that ICE has targeted and harmed trans and nonbinary immigrants. Last June, Vera reported that ICE is not including trans people in detection in their public reports, and back in 2020, AFSC reported that trans people held in ICE detention faced “dreadful, ugly” conditions.
While it seems like a new development in Trump’s anti-trans escalation, it echoes a deeply upsetting history of denying and destroying transgender people’s documents following members of the Nazi party seizing power in 1933.
In the early 20th century, Weimar, Germany was an epicenter for gender affirming care with Maganus Hirschfeld’s Institute for Sexual Science. One of the first book burnings of the rising Nazi regime destroyed the Institute’s extensive clinical records and library on trans health and history by Nazi students and stormtroopers. In doing so, the Nazis effectively destroyed the world’s first trans health clinic and one of the richest and most comprehensive collective of information about trans healthcare.
Similarly, the Nazi government invalidated or refused to recognize what was called “transvestite passes,” or passing certificates that allowed trans people to avoid arrest under Paragraph 175 which prohibited cross-dressing. During the Weimar Republic — the regime that preceded the Third Reich — recognized and affirmed the identities of trans people (in limited ways) with specific documentation that helped prevent them from arrest. Invalidating and disregarding these passes allowed police and Nazi officials to target trans people and harass, extort and arrest them, and the record of passes themselves helped officials target trans people.
The changes to visa guidelines — alongside Kansas’s move to revoke trans drivers’ licenses last month — is reflective of this escalation of violence against trans people during the Nazi’s rise to power, which scholars like Dr. Laurie Marhoefer is just beginning to uncover. And along with the revocation of identification documents this past week, a recent Fourth Circuit Court ruled that states can deny Medicaid coverage for gender-affirming surgery.
The Fourth Circuit Court decision affirmed the Supreme Court’s decision in Skrmetti, which ruled that bans on gender affirming healthcare for young people are constitutional. This ruling extends this ban to include adult healthcare bans, allowing West Virginia’s exclusion of Medicaid coverage for adult gender affirming healthcare to take full effect. Even more upsetting was what the ruling itself said, calling gender affirming healthcare “dangerous.”
As was written in the Fourth Circuit Opinion, “it’s not irrational for a legislature to encourage citizens ‘to appreciate their sex’ and not ‘become disdainful of their sex’ by refusing to fund experimental procedures that may have the opposite effect.”
In reality, what this ruling and the opinion reflect, is the next step in government regulation and oversight over marginalized peoples’ bodies. From the overturn of Roe v. Wade, which removed federal protection of access to abortion, this next step represents the denial of people’s access to vital, lifesaving care–and to be clear, gender affirming care is not just for trans, nonbinary, and intersex people. It’s a dangerous escalation and one that echoes previous violence against trans people under fascist regimes; the Lemkin Institute is right to raise concern.
Japan
Japanese Supreme Court to consider marriage equality
Japan only G7 country that does not legally recognize same-sex couples
The Japanese Supreme Court on Wednesday said it will consider six marriage equality lawsuits.
NHK, the country’s public broadcaster, noted all 15 of the court’s justices will consider the case.
Japan is the only G7 country that does not legally recognize same-sex couples, despite several court rulings in recent years that found the denial of marriage benefits to gays and lesbians unconstitutional.
Tokyo High Court Judge Ayumi Higashi last November upheld Japan’s legal definition of a family as a man and a woman and their children.
Prime Minister Sanae Takaichi, who became the country’s first female head of government last October, opposes marriage rights for same-sex couples. She has also reiterated the constitution’s assertion that the family is an institution based around “the equal rights of husband and wife.”
Same-sex couples can legally marry in Taiwan, Nepal, and Thailand.
NHK reported the Supreme Court is expected to issue its ruling in early 2027.
