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.”
U.S. Supreme Court
Supreme Court to consider bans on trans athletes in school sports
27 states have passed laws limiting participation in athletics programs

The U.S. Supreme Court on Thursday agreed to hear two cases involving transgender youth challenging bans prohibiting them from participating in school sports.
In Little v. Hecox, plaintiffs represented by the ACLU, Legal Voice, and the law firm Cooley are challenging Idaho’s 2020 ban, which requires sex testing to adjudicate questions of an athlete’s eligibility.
The 9th U.S. Circuit Court of Appeals described the process in a 2023 decision halting the policy’s enforcement pending an outcome in the litigation. The “sex dispute verification process, whereby any individual can ‘dispute’ the sex of any female student athlete in the state of Idaho,” the court wrote, would “require her to undergo intrusive medical procedures to verify her sex, including gynecological exams.”
In West Virginia v. B.P.J., Lambda Legal, the ACLU, the ACLU of West Virginia, and Cooley are representing a trans middle school student challenging the Mountain State’s 2021 ban on trans athletes.
The plaintiff was participating in cross country when the law was passed, taking puberty blockers that would have significantly reduced the chances that she could have a physiological advantage over cisgender peers.
“Like any other educational program, school athletic programs should be accessible for everyone regardless of their sex or transgender status,” said Joshua Block, senior counsel for the ACLU’s LGBTQ and HIV Project. “Trans kids play sports for the same reasons their peers do — to learn perseverance, dedication, teamwork, and to simply have fun with their friends,” Block said.
He added, “Categorically excluding kids from school sports just because they are transgender will only make our schools less safe and more hurtful places for all youth. We believe the lower courts were right to block these discriminatory laws, and we will continue to defend the freedom of all kids to play.”
“Our client just wants to play sports with her friends and peers,” said Lambda Legal Senior Counsel Tara Borelli. “Everyone understands the value of participating in team athletics, for fitness, leadership, socialization, and myriad other benefits.”
Borelli continued, “The U.S. Court of Appeals for the Fourth Circuit last April issued a thoughtful and thorough ruling allowing B.P.J. to continue participating in track events. That well-reasoned decision should stand the test of time, and we stand ready to defend it.”
Shortly after taking control of both legislative chambers, Republican members of Congress tried — unsuccessfully — to pass a national ban like those now enforced in 27 states since 2020.
Virginia
Va. court allows conversion therapy despite law banning it
Judge in June 30 ruling cited religious freedom.

In 2020, the state of Virginia had banned the practice of conversion therapy, but on Monday, a county judge ruled the ban violates the Virginia Constitution and Religious Freedom Restoration Act, allowing the therapy to start once more.
The conversion therapy ban, which can be seen in Va. Code § 54.1-2409.5 and 18VAC115-20-130.14, was overturned on June 30 as a result of two Christian counselors who argued that their — and all Virginia parents’ — constitutional right to freedom of religion had been encroached upon when the state legislature passed the ban.
A Henrico County Circuit Court judge sided with John and Janet Raymond, two Christian counselors represented by the Founding Freedoms Law Center, a conservative organization founded in 2020 following Virginia’s conversion therapy ban. Virginia’s Office of the Attorney General entered a consent decree with FFLC, saying state officials will not discipline counselors who engage in talk conversion therapy.
Conversion therapy, as the legislation described it, is considered to be “any practice or treatment that seeks to change an individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.” The ban’s reversal will now allow parents to subject their children to these practices to make them align better with their religion.
This decision comes despite advice and concern from many medical and pediatric organizations — including the American Psychiatric Association, American Psychological Association, American Association for Marriage and Family Therapy, and the American Counseling Association, to name a few — all of which denounce conversion therapy as dangerous and harmful to those subjected to it.
The American Medical Association, the largest and only national association that convenes more than 190 state and specialty medical societies, says that “these techniques are the assumption that any non-heterosexual, non-cisgender identities are mental disorders, and that sexual orientation and gender identity can and should be changed. This assumption is not based on medical and scientific evidence,” with attached data indicating people subjected to conversion therapy are more likely to develop “significant long-term harm” as a result of the therapy.
The AMA goes as far as to say that they outright “oppose the use of reparative or conversion therapy for sexual orientation or gender identity.”
FFLC has a clear goal of promoting — if not requiring — conservative ideology under the guise of religious freedom in the Virginia General Assembly. On their website, the FFLC argues that some progressive policies passed by the Assembly, like that of freedom from conversion therapy, are a violation of some Virginians’ “God-given foundational freedoms.”
The FFLC has argued that when conservative notions are not abided by in state law — especially when it involves “God’s design for male and female, the nuclear family, and parental rights” — that the law violates Virginians’ religious freedom.
A statement on the FFLC’s website calls gender dysphoria among children a “contagion” and upholds “faith-based insights” from counselors as equal — in the eyes of the law — to those who use medical-based insights. This, once again, is despite overwhelming medical evidence that indicates conversion therapy is harmful.
One study showed that 77 percent of those who received “sexual orientation change efforts,” or conversion therapy, experienced “significant harm.” This harm includes depression, anxiety, lowered self-esteem, and internalized homophobia. In addition, the study found that young LGBTQ adults with high levels of parental or caregiver rejection are “8.4 times more likely to report having attempted suicide,” with another study finding that “nearly 30 percent of individuals who underwent SOCE reported suicidal attempts.”
Virginia Senate Majority Leader Scott Surovell, a Democrat representing Fairfax, said that the overturning of the ban on religious merit disregards the entire concept of having professionally licensed counselors.
“I have no problem if somebody wants to go look at religious counseling from their priest or their minister, their rabbi, their imam — that’s perfectly fine,” Surovell told the Virginia Mercury. “When somebody goes to get therapy from somebody licensed by the commonwealth of Virginia, there’s a different set of rules applied. You can’t just say whatever you want because you have a license. That’s why we have professional standards, that’s why we have statutes.”
Obituary
Longtime DC resident Thomas Walsh dies at 87
Pa. native’s husband was by his side when he passed away

Long-time D.C. resident Thomas Walsh died on May 16. He was 87.
Walsh was born on Sept. 17, 1937, in Scranton, Pa. His family later moved to Levittown, Pa.
Walsh met his husband, Anthony Carcaldi, at the Blue Note, a gay bar in Asbury Park, N.J., in 1964.
“I walked in the bar with friends from New York City,” recalled Carcaldi. “I looked at the piano and this person was singing … and all I noticed were his blue eyes.”
Walsh was singing “Because of You.”
“I walked up to the piano while Tom was singing and stared at him, which caused him to forget the words,” said Carcaldi. “He composed himself and started from the beginning.”
Carcaldi and Walsh became a couple in 1965, a year after they met, when they moved to Philadelphia.
“We moved in together and have been together ever since,” said Carcaldi.
Walsh was a freelance graphic designer until he accepted a job in Temple University’s audiovisual department. Walsh and Carcaldi moved to D.C. in 1980.
Walsh began a graphic design business and counted Booz Allen as among his clients. Carcaldi said one of his husband’s “main loves was painting,” and became a fine artist in 2005.
Walsh showed his art at the Nevin Kelly Gallery on U Street, the Martha Spak Studio near the Wharf, and at the Wexler Gallery in Philadelphia. Walsh also sang with the Gay Men’s Chorus of Washington.
Walsh and Carcaldi married at D.C. City Hall in 2014.
“Tom and I have been together since 1964 until his death,” said Carcaldi. “Tom died peacefully with me at his side in bed on May 16, 2025, holding Tom in my arms as he made the transition out of life.”
A celebration of life will take place in September.
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