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.”
Rehoboth Beach
BLUF leather social set for April 10 in Rehoboth
Attendees encouraged to wear appropriate gear
Diego’s in Rehoboth Beach hosts a monthly leather happy hour. April’s edition is scheduled for Friday, April 10, 5-7 p.m. Attendees are encouraged to wear appropriate gear. The event is billed as an official event of BLUF, the free community group for men interested in leather. After happy hour, the attendees are encouraged to reconvene at Local Bootlegging Company for dinner, which allows cigar smoking. There’s no cover charge for either event.
District of Columbia
Celebrations of life planned for Sean Bartel
Two memorial events scheduled in D.C.
Two celebrations of life are planned for Sean Christopher Bartel, 48, who was found deceased on a hiking trail in Argentina on or around March 15. Bartel began his career as a television news reporter and news anchor at stations in Louisville, Ky., and Evansville, Ind., before serving as Senior Video Producer for the D.C.-based International Brotherhood of Electrical Workers union from 2013 to 2024.
A memorial gathering is planned for Friday, April 10, 11:30 a.m.-1:30 p.m. at the IBEW International Office (900 7th St., N.W.), according to a statement by the DC Gay Flag Football League, where Bartel was a longtime member. A celebration of life is planned that same evening, 6-8 p.m. at Trade (1410 14th St., N.W.).
Puerto Rico
The ‘X’ returns to court
1st Circuit hears case over legal recognition of nonbinary Puerto Ricans
Eight months ago, I wrote about this issue at a time when it had not yet reached the judicial level it faces today. Back then, the conversation moved through administrative decisions, public debate, and political resistance. It was unresolved, but it had not yet reached this point.
That has now changed.
Lambda Legal appeared before the 1st U.S. Court of Appeals in Boston, urging the court to uphold a lower court ruling that requires the government of Puerto Rico to issue birth certificates that accurately reflect the identities of nonbinary individuals. The appeal follows a district court decision that found the denial of such recognition to be a violation of the U.S. Constitution.
This marks a turning point. The issue is no longer theoretical. A court has already determined that unequal treatment exists.
The argument presented by the plaintiffs is grounded in Puerto Rico’s own legal framework. Identity birth certificates are not static historical records. They are functional documents used in everyday life. They are required to access employment, education, and essential services. Their purpose is practical, not symbolic.
Within that framework, the exclusion of nonbinary individuals does not stem from a legal limitation. Puerto Rico already allows gender marker corrections on birth certificates for transgender individuals under the precedent established in Arroyo Gonzalez v. Rosselló Nevares. In addition, the current Civil Code recognizes the existence of identity documents that reflect a person’s lived identity beyond the original birth record.
The issue lies in how the law is applied.
Recognition is granted within specific categories, while those who do not identify within that binary structure remain excluded. That exclusion is now at the center of this case.
Lambda Legal’s position is straightforward. Requiring individuals to carry documents that do not reflect who they are forces them into misrepresentation in essential aspects of daily life. This creates practical barriers, exposes them to scrutiny, and places them in a constant state of vulnerability.
The plaintiffs, who were born in Puerto Rico, have made clear that access to accurate identification is not symbolic. It is a basic condition for moving through the world without contradiction imposed by the state.
The fact that this case is now being addressed in the federal court system adds another layer of significance. This is not a pending policy discussion or a legislative proposal. It is a constitutional question. The analysis is not about political preference, but about rights and equal protection under the law.
This case does not exist in isolation.
It unfolds within a broader context in which debates over identity and rights have increasingly been shaped by the growing influence of conservative perspectives in public policy, both in the United States and in Puerto Rico. At the local level, this influence has been reflected in legislative discussions where religious arguments have begun to intersect with decisions that should be grounded in constitutional principles. That intersection creates tension around the separation of church and state and has direct consequences for access to rights.
Recognizing this context is not an attack on faith or religious practice. It is an acknowledgment that when certain perspectives move into the realm of public authority, they can shape outcomes that affect specific communities.
From within Puerto Rico, this is not a distant debate. It is a lived reality. It is present in the difficulty of presenting identification that does not match one’s identity, and in the consequences that follow in workplaces, schools, and government spaces.
The progression of this case introduces the possibility of change within the applicable legal framework. Not because it resolves every tension surrounding the issue, but because it establishes a legal examination of a practice that has long operated under exclusion.
Eight months ago, the conversation centered on ongoing developments. Today, there is already a judicial finding that identifies a violation of rights. What remains is whether that finding will be upheld on appeal.
That process does not guarantee an immediate outcome, but it shifts the ground.
The debate is no longer theoretical.
It is now before the courts.
Calendar: April 10-16
BLUF leather social set for April 10 in Rehoboth
Celebrations of life planned for Sean Bartel
The ‘X’ returns to court
LGBTQ community explores arming up during heated political times
Risking it all for love during World War II
D.C. is the place for the Democratic Socialists of America
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