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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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Rehoboth Beach

Celebrated performer Rose Levine plays Rehoboth on May 15

Freddie’s to host Fire Island legend

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Rose Levine performs May 15 at Freddie’s in Rehoboth Beach.

Rose Levine is a celebrated entertainer best known for her longstanding performances in Cherry Grove, Fire Island, since 1955 where she has become a beloved fixture of the community’s vibrant arts and nightlife scene. With a career spanning decades, Levine has captivated audiences with her cabaret singing shows full of charisma, classic numbers, humor, and unmistakable stage presence—proving that some stars don’t fade, they simply get better lighting.

Levine is also closely associated with the legendary Fire Island Invasion of the Pines, the annual Fourth of July spectacle in which performers and revelers make their grand (and gloriously over-the-top) entrance by boat from Cherry Grove to Fire Island Pines, now a 50-year tradition. Her role in launching and sustaining this tradition has helped make it one of the most iconic—and entertaining—events of the summer season.

A consummate storyteller, Levine brings audiences along for a glittering ride through entertainment history. Rose will sing her Broadway melodies by Jerry Herman, Irving Berlin, Cy Coleman, Cole Porter, and others. With music direction by Mark Hartman the one-night-only event will celebrate Levine’s legendary life in drag, featuring signature crowd-pleasers and celebrity stories. A friend of Broadway composer Jerry Herman, she shares delicious stories of legends like Ethel Merman and recalls a young Barbra Streisand before she became Barbra Streisand while both performing at the famed singing contests at Greenwich Village’s famed Lion nightclub before her big break at the Bon Soir. Her shows are a mix of music, mischief, and memories of old New York and Fire Island — back when Cherry Grove didn’t even have electricity, but somehow still had better nightlife than most cities today.

Her legendary Fire Island home, Roseland, has hosted its fair share of unforgettable gatherings (and likely a few stories that can’t be printed in a family newspaper), making it a cornerstone of the community’s social scene. Levine splits her time between Manhattan and her summer perch on Fire Island—though audiences across the country are grateful she travels.

In fact, she performs at The Green Room and 54 Below in Manhattan, Cherry Grove in Fire Island, Act 2 and The Palm in Puerto Vallarta, Red Dot Cabaret in Hudson, N.Y., and now Freddie’s in Rehoboth Beach—because retirement, frankly, sounds boring. Her place in the Guinness Book of World Records as the oldest continuously performing drag queen in the world only adds to the legend and gives her bragging rights she fully intends to use.

And now, Rehoboth—consider yourself warned.

Don’t miss Rose Levine live on May 15 at Freddie’s Beach Bar. Dinner begins at 6:30 p.m., with the show at 7 p.m. Come for the cocktails, stay for the stories, and leave wondering how one person can have that many fabulous decades.

Levine’s legacy is defined not only by her remarkable career, but by her ability to connect with audiences across generations—usually while making them laugh, gasp, and occasionally blush. Don’t miss this show.

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Federal Government

Senate Democrats press DOJ over anti-trans prison directives

Markey joins other lawmakers in demanding reversal of policies

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(Photo by Andrushko Galyna/Bigstock)

U.S. Sen. Edward Markey (D-Mass.) is urging acting Attorney General Todd Blanche and William Marshall III, director of the Federal Bureau of Prisons, to reverse a policy affecting transgender inmates that lawmakers say is “endangering” their “health and safety.”

Markey, along with U.S. Sens. Jeffrey A. Merkley (D-Ore.) and Mazie K. Hirono (D-Hawaii), sent the letter that the Washington Blade verified on Monday.

The letter is a direct response to a change in prison policy that went into effect in February 2025, rolling back Biden-era protections for trans inmates. The senators described how President Trump’s Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” forced a policy shift they argue is rooted more in political rhetoric than in medical research or evidence-based correctional practices.

In the letter, the lawmakers wrote “On Feb. 21, 2025, the BOP issued a memo to implement President Trump’s EO, requiring BOP staff to ‘refer to individuals by their legal name or pronouns corresponding to their biological sex,’ banning the use of funds for any ‘items that align with transgender ideology,’ and suspending clothing accommodations, pat search accommodations, and support programs offered to transgender individuals.”

“In a second memo, issued one week later, the BOP banned the use of federal funds for ‘any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.’ These changes have resulted in the denial — or threatened denial — of hormone treatment and gender-affirming accommodations for transgender individuals in BOP custody.”

“On Feb. 19, 2026, the BOP escalated its attacks, issuing a program statement titled, ‘Management of Inmates with Gender Dysphoria.’ It prohibits incarcerated people from receiving gender-affirming care, even if paid for with private funds. This practice forces incarcerated people to discontinue care, regardless of medical recommendations.”

The senators continued, “The agency has repeatedly enacted policies that strip transgender individuals of their gender identity and dignity. This includes requiring staff to refer to transgender individuals by pronouns that ‘align with their biological sex’ rather than gender identity and to confiscate gender-affirming items, such as undergarments, clothing, cosmetics, and wigs.”

“These policies risk triggering mental health crises, including increased suicidality, among incarcerated people with gender dysphoria. The BOP’s repeated guidance to roll back gender-affirming protections — despite a federal court order finding that the BOP’s actions to discontinue gender-affirming care are likely unlawful — generate confusion about the current state of regulations and convey the BOP’s indifference to court orders and the rule of law.”

“By stripping away appropriate medical and psychiatric care, safety protections, and measures to provide dignity, the BOP is exposing transgender individuals to significant harm.”

The Marshall Project, a nonprofit newsroom focused on the U.S. criminal justice system and immigration enforcement through data-driven reporting, also reported on the policy change. The outlet spoke with Shana Knizhnik, an attorney with the American Civil Liberties Union, about the impact of the changes.

“It’s clear that this new policy is a ban on gender affirming healthcare,” Knizhnik, who works for the nationwide chapter of the ACLU said. “This is a policy that disregards the medical needs of our plaintiffs.”

The letter also asked the BOP and the DOJ specific questions regarding why the policy went into effect, as lawmakers suggested the changes appear politically motivated rather than based on new medical evidence regarding treatment for trans inmates.

The senators requested answers to these trans policy-specific questions by May 21, including:

“Does the BOP plan to monitor and assess the impacts of recent policies that eliminate gender-affirming medical and psychiatric care?”

“Since January 20, 2025, how many transgender, nonbinary, intersex, and gender-diverse individuals have been transferred to a different facility to meet the EO’s goal of housing individuals ‘according to their biological sex?’”

“Given that the BOP has stopped enforcing Prison Rape Elimination Act regulations related to gender identity and collecting data on gender identity, how will the BOP protect the physical and emotional health and safety of incarcerated transgender individuals?”

“How does the BOP plan to monitor and assess the impact of eliminating protections against sexual violence for this population?”

“Does the BOP plan to institute a specific process by which transgender individuals may seek assistance or lodge complaints regarding harms they experience from the recent BOP policies and actions implementing President Trump’s EO?”

“Describe the specific criteria the BOP intends to use to determine whether it will allow a ‘social accommodation’ for gender dysphoria.”

Markey also included a personal statement to the Blade explaining why he is using his position on Capitol Hill to push for more information and advocate for reversing the policy.

“This administration continuously shows their contempt for trans people and a total disregard for their rights and humanity. As part of this cruel campaign, the Bureau of Prisons has systematically stripped health care access and basic protections from trans people, abandoning its duty to the people in its custody. I won’t stop fighting until this administration’s hateful anti-trans policies are reversed and trans people’s rights are secured.”

The Blade reached out to the DOJ and the BOP for comment but had not received a response at press time.

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Arts & Entertainment

Washington Blade’s Pride on the Pier returns June 13 to kick off D.C. Pride week

Pride on the Pier officially launches Pride Week in D.C.

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The Washington Blade’s annual Pride on the Pier celebration returns to The Wharf on Saturday, June 13, 2026 from 4-9 p.m., bringing thousands of LGBTQ community members and allies together for an unforgettable waterfront celebration to kick off Pride week in Washington, D.C.

Now in its eighth year, Washington Blade Pride on the Pier extends the city’s annual celebration of LGBTQ visibility to the bustling Wharf waterfront with an exciting array of activities and entertainment for all ages. The District Pier will offer DJs, dancing, drag, and other entertainment. Alcoholic beverages will be available for purchase for those 21 and older.

“Pride on the Pier has become one of the signature moments of Pride in D.C.,” said Lynne Brown, publisher of the Washington Blade. “There’s nothing like watching our community come together on the waterfront with live music and incredible energy as we kick off Pride week.”

Pride on the Pier is free and open to the public, with VIP tickets available for exclusive pier access to the Dockmaster Building. To purchase VIP tickets visit www.prideonthepierdc.com/vip

Additional entertainment announcements, sponsor activations, and event details will be released in the coming weeks.

Event Details:

📍 Location: District Pier at The Wharf (101 District Sq SW, Washington, DC)
📅 Dates: Friday, 13, 2026 

⏱️ 4-9PM
🎟️ VIP Tickets: www.PrideOnThePierDC.com/VIP

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