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.”
Lebanon
Lebanese LGBTQ group responds to latest war
Helem’s Beirut community center ‘a vital crisis hub’
A Lebanese advocacy group is providing support to LGBTQ people who have been displaced during the latest war between Israel and Hezbollah.
Helem Executive Director Sandy Mteirik on Monday told the Washington Blade her group, in partnership with another NGO, has “shifted our programs to focus entirely on emergency response.”
Helem has opened what Mteirik described as a “lifesaving, inclusive shelter specifically for transgender individuals who find collective shelters unsafe or inaccessible.”
Mteirik noted Helem’s community center in Beirut, the Lebanese capital, “now serves as a vital crisis hub where” LGBTQ people “can find physical safety, psychological support, and relief assistance.” she told the Blade that Helem is also offering “confidential emotional support, assessing immediate needs, and connecting individuals with emergency housing and protection services.”
“We also continue to monitor and document protection risks to prevent further exclusion and harm,” said Mteirik.
‘Displacement crisis has intensified’
The U.S. and Israel on Feb. 28 launched airstrikes against Iran. One of them killed Supreme Leader Ayatollah Ali Khamenei.
Hezbollah, an Iran-backed Shia militant group the U.S. has designated a terrorist organization, in response launched rockets into Israel. The Jewish State on March 2 began to carry out airstrikes against Hezbollah in Lebanon.
The Lebanese Health Ministry on Tuesday said Israeli airstrikes have killed 2,124 people and wounded 6,921 others. Lebanese officials have also indicated the war has displaced more than 1 million people in the country.
Israeli airstrikes in Beirut and elsewhere in the country on April 8 killed more than 300 people and injured upwards of 1,100.
President Donald Trump the day before said “a whole civilization will die tonight” if Iran did not agree to end the war and end its blockade of the Strait of Hormuz, a strategic waterway that connects the Persian Gulf and the Gulf of Oman through which roughly 20 percent of the world’s crude oil passes.
Trump less than two hours before the deadline announced a two-week ceasefire with Iran that Pakistan helped broker. Trump said the deal did not include Lebanon, even though Pakistan insisted it did.
Hamas militants on Oct. 7, 2023, killed upwards of 1,200 people when they launched a surprise attack against Israel from the Gaza Strip. Hezbollah the following day began to launch rockets into Israel.
An Israeli airstrike in Beirut on Sept. 27, 2024, killed Hassan Nasrallah, Hezbollah’s long-time leader. Iran four days later launched upwards of 200 ballistic missiles at Israel.
The U.S. helped broker a ceasefire between Israel and Lebanon that took effect on Nov. 27, 2024. Israel nevertheless continued to carry out airstrikes in Lebanon.
Lebanese Ambassador to the U.S. Nada Hamadeh Moawad met with Israeli Ambassador to the U.S. Yechiel Leiter on Tuesday at the State Department. The meeting is the first time the two countries have held direct diplomatic talks since 1993.
Mteirik told the Blade that Helem’s community center “has not been damaged yet” in the latest war. She said, however, the impact of the April 8 airstrikes “mirrors the ongoing war Lebanon has endured since 2024.”
“The intensity of these recent strikes and the resulting massacres in ‘relatively’ safe areas of Beirut have been devastating,” said Mteirik.
“With over 300 victims, the displacement crisis has intensified,” she added. “When state responses are not inclusive, LGBTQIA+ individuals face amplified risks, including exclusion from collective shelters, homelessness, exposure to violence, loss of income, and barriers to essential healthcare.”
Helem: Lebanese government war response must be LGBTQ-inclusive
Article 534 of Lebanon’s Penal Code states “any sexual intercourse contrary to the order of nature is punishable” by up to a year in prison. Several judges in recent years have opted not to use the statute to prosecute LGBTQ people who have been charged under it.
Helem on March 4 called upon the Lebanese government and international NGOs to develop a response to the Israeli airstrikes that is “comprehensive, fair, and inclusive of all groups, without exception or discrimination.” Helem’s specific requests include:
• Integrating a rights-based, non-discriminatory approach into all stages of emergency planning.
• Training response staff on protection principles regarding gender-based violence and discrimination.
• Reassessing the “traditional family” shelter model that systematically excludes non-traditional families and individuals.
• Involving specialized civil society organizations in the design and monitoring of response plans.
• Establishing clear accountability standards to prevent discriminatory practices.
“Past experiences show that state response plans often fail to include displaced LGBTQ+ individuals,” said Mteirik.
Mteirik conceded the “conclusion of this conflict remains uncertain.” She stressed Helem “remains committed to standing with our community.”
“In these difficult times, we reaffirm our call for humanitarian solidarity that transcends identities,” said Mteirik. “Our work is an extension of our rejection of violence, occupation, and the exploitation of individuals and their lives.”
Federal Government
Inside the LGBTQ records of Todd Blanche and Markwayne Mullin
Two men are acting attorney general, DHS secretary
President Donald Trump became famous for his use of the phrase “You’re fired!” while hosting the reality TV show “The Apprentice” in the early 2000s. However, during his time in the Oval Office, he has attempted to distance himself from that image.
Despite those efforts, the phrase once again comes to mind as Trump has fired two high-level female Cabinet members within the past month: Pam Bondi and Kristi Noem.
Their replacements — Todd Blanche at the Justice Department and Markwayne Mullin at the Department of Homeland Security — bring records that, while different in depth, both reflect limited support for LGBTQ protections and, in some cases, direct opposition.
Todd Blanche
Acting attorney general
Little has been found regarding Todd Blanche’s LGBTQ history prior to his role as acting head of the Department of Justice. Unlike those who have worked within the Justice Department’s Civil Rights Division or served as state attorneys general, he has not developed a public-facing legal ideology on LGBTQ issues.
Blanche attended American University for his undergraduate studies — like fellow Trump attorney Michael Cohen — where he met his future wife, Kristin, who was studying at nearby Catholic University in D.C.
He began his legal career as an intern at the U.S. Attorney’s Office in Washington, which eventually became a full-time position. He later worked as a paralegal in the U.S. Attorney’s Office for the Southern District of New York while attending Brooklyn Law School at night. Blanche graduated cum laude in 2003. He and his wife later married and had two children.
Blanche left the U.S. attorney’s office in 2014, taking a job in the Manhattan office of the law firm WilmerHale. In September 2017, he moved to Cadwalader, Wickersham & Taft LLP, where he was a partner in the White Collar Defense and Investigations practice.
In his personal capacity, he represented several figures associated with Donald Trump and former New York City Mayor Rudy Giuliani, including Trump’s former campaign manager Paul Manafort, businessman Igor Fruman, and attorney Boris Epshteyn.
In 2024, Blanche switched from Democrat to Republican, aligning himself with Trump’s political orbit. He later served as Trump’s personal defense attorney in the New York State case that led to Trump’s 2024 conviction on 34 felony counts of falsifying business records to cover up hush-money payments to bisexual adult film star Stormy Daniels.
Now the highest-ranking official at the Justice Department, Blanche has played a central role in overseeing the department and has been involved in leadership decisions tied to several controversial actions affecting LGBTQ people.
In a letter to New York Attorney General Letitia James, Blanche declared that the Justice Department “will not sit idly by while you attempt to use your office to force harmful procedures on our most vulnerable population,” if legal action were taken against NYU Langone. The hospital had “permanently” ended a program earlier that month after the Trump-Vance administration threatened to pull all federal funding if it continued prescribing puberty blockers and hormones to minors.
Blanche wrote that “the Justice Department believes the law is clear, and anti-discrimination laws cannot be used to force NYU Langone to perform sex-rejecting procedures on children.”
“As just one example, your office’s position would require a hospital to prescribe certain medications for certain diagnoses, regardless of the hospital’s or its doctors’ independent medical determination about the propriety of such treatment,” he said.
Blanche also echoed his predecessor’s public stance on limiting LGBTQ-related protections at the federal level, aligning with Bondi’s sentiments in June 2025 regarding the U.S. Supreme Court’s 6–3 decision that restricted LGBTQ history lessions in schools and limits lower federal courts from issuing nationwide injunctions — rulings that have often blocked Trump administration policies.
Calling it “another great decision that came down today,” Blanche argued that the ruling “restores parents’ rights to decide their child’s education,” adding: “It seems like a basic idea, but it took the Supreme Court to set the record straight, and we thank them for that. And now that ruling allows parents to opt out of dangerous trans ideology and make the decisions for their children that they believe is correct.”
In December 2025, a Justice Department memo stated that, “effective immediately,” prisons and jails would no longer be held responsible for violations of standards meant to protect LGBTQ people from harassment, abuse, and rape under the Prison Rape Elimination Act. The law, passed unanimously by Congress in 2003, requires that incarcerated people be screened for their risk of sexual assault, including consideration of LGBTQ status, and applies to all correctional facilities.
Additionally, when the Justice Department, under Blanche’s deputy leadership and at Trump’s behest, attempted to force Children’s National Hospital in D.C. to turn over medical records related to gender-affirming care, U.S. District Judge Julie R. Rubin ruled that the effort “appears to have no purpose other than to intimidate and harass.”
Blanche is also described as having a “strong belief in executive authority.”
Markwayne Mullin
Secretary of Homeland Security
While Blanche’s record is defined more by recent actions than a long paper trail, Markwayne Mullin brings a more established history on LGBTQ issues from his time in Congress.
The head of the Department of Homeland Security has served in Congress since 2013, in both the U.S. House of Representatives and U.S. Senate. He has been actively engaged in shaping restrictions and aligns with broader cultural rhetoric that frames anti-LGBTQ speech as protected expression.
In May 2016, Mullin criticized the Department of Education and the Justice Department’s “Dear Colleague” letter on transgender students, arguing that trans girls should not use girls’ restrooms in public schools.
By January 2021, Mullin and then-Hawaii Congresswoman Tulsi Gabbard had introduced a bill to prevent trans women from participating in women’s sports.
Mullin was not recorded as voting on the final passage of the Respect for Marriage Act, which codified federal recognition of same-sex and interracial marriage.
In 2023, Mullin received a rating of just 6 percent from the Human Rights Campaign.
While serving in the Senate and as a member of the Health, Education, Labor, and Pensions (HELP) Committee, Mullin has been a vocal critic of policies aimed at expanding LGBTQ inclusion in federal programs. He has participated in broader Republican efforts questioning equity-based implementation of the Older Americans Act, including guidance related to sexual orientation and gender identity in aging services, arguing such policies could have unintended consequences.
Mullin also makes history as the first Native American — and a citizen of the Cherokee Nation — to lead the Department of Homeland Security.
He was among the 147 Republicans who voted to overturn the 2020 presidential election results despite no evidence of widespread fraud, and was present in the House on Jan. 6.
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/
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