Connect with us

News

Obama admin says insurers can’t discriminate against gay unions

Prohibits discrimination even in non-marriage equality states

Published

on

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.”

Advertisement
FUND LGBTQ JOURNALISM
SIGN UP FOR E-BLAST

Netherlands

Amsterdam Pride Canal Parade draws hundreds of thousands

Gay Dutch Prime Minister Rob Jetten among participants

Published

on

A scene from the 2026 Amsterdam Pride Canal Parade. (Washington Blade photo by Michael Key)

Editor’s note: International News Editor Michael K. Lavers and Photo Editor Michael Key are on assignment in the Netherlands through Aug. 10.

AMSTERDAM — Hundreds of thousands of people lined Amsterdam’s canals on Saturday for the city’s annual Amsterdam Pride Canal Parade.

Dutch Prime Minister Rob Jetten, who is openly gay, is among those who participated in the parade that featured more than 80 boats. Participants held signs and posters that, among other things, read “proud to be intersex” and “lesbians love you and a free Palestine.”

The Washington Blade saw at least two attendees holding fans that read “fuck Trump.” One of the boats also compared President Donald Trump and Russian President Vladimir Putin as “the kissing couple.”

(Washington Blade photo by Michael K. Lavers)

(Washington Blade video by Michael K. Lavers)

(Washington Blade video by Michael K. Lavers)

The parade took place a week after a terrorist attack at Berlin’s Christopher Street Day left one person dead and more than two dozen others injured.

It passed the Homomonument, a memorial to gays and lesbians who have suffered persecution. The Homomonument has been transformed into a makeshift memorial to the victims of the July 25 terrorist attack in the German capital.

View on Threads

The Canal Parade took place during World Pride, which will end in Amsterdam on Aug. 9.

Continue Reading

European Union

Poland’s top court rejects recognition of same-sex marriages from other EU countries

Ruling sets up potential clash with bloc

Published

on

(Bigstock photo)

Poland’s top court this week rejected the recognition of same-sex marriages legally performed in other EU countries.

The EU Court of Justice in Luxembourg last November ruled in favor of a same-sex couple who challenged Poland’s refusal to recognize their German marriage. Poland’s Supreme Administrative Court in March reaffirmed the decision.

The couple, who lives in Poland, brought their case to Polish courts in 2019. The Supreme Administrative Court referred it to the EU Court of Justice.

The Polish government in May announced it will recognize same-sex marriages legally performed in other EU countries. Polish President Karol Nawrocki on July 17 vetoed bills that would have extended rights to same-sex couples.

The Constitutional Tribunal ruling, which it issued on July 28, was unanimous and final. It also sets up a potential clash between it and the EU Court of Justice.

Continue Reading

Taiwan

Taiwan’s government has failed to update process to change gender markers on ID documents

Interior Ministry’s 2008 directive remains in place

Published

on

(Photo by bRollGO/Bigstock)

More than four years after Taiwan began formally studying legislation to overhaul its legal gender recognition system, and despite repeated recommendations from international human rights experts, the government has yet to introduce a bill that would replace decades-old administrative rules governing how transgender people can change the gender marker on official documents.

On May 15, an independent international review committee examining Taiwan’s implementation of the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights urged the government to enact legislation governing legal gender recognition. The committee said Taiwan’s continued reliance on an administrative order, despite a 2023 Supreme Administrative Court ruling that mandatory gender-affirming surgery violates constitutional rights, has created legal uncertainty for transgender people, administrative authorities and judges.

In Taiwan, legal gender recognition has long been governed by a 2008 Interior Ministry administrative directive rather than legislation. 

Under the directive, applicants seeking to change the gender marker on their national identification documents are generally required to provide diagnoses of gender dysphoria from two psychiatrists and proof that they have undergone gender-affirming surgery. For trans men, this typically involves the removal of the breasts, uterus, and ovaries, while trans women generally must undergo the removal of the penis and testicles. Because these requirements are established through an administrative directive rather than a law enacted by the legislature, trans rights activists and human rights organizations have argued they violate human rights.

Although Taiwanese courts have increasingly allowed trans people to change the gender marker on their official documents without undergoing gender-affirming surgery, the Interior Ministry’s 2008 directive requiring surgery remains in force. As a result, Taiwan’s administrative rules and judicial decisions are no longer fully aligned.

In a landmark ruling in May 2024, the Taipei High Administrative Court ordered a household registration office to approve a trans man’s application to change the gender marker on his household registration without requiring gender-affirming surgery. The court held that the Interior Ministry’s 2008 administrative directive, which requires applicants to submit proof of surgery, cannot be treated as an absolute prerequisite for legal gender recognition. Instead, it found that the applicant had provided sufficient medical evidence of a stable and long-standing gender identity and that denying the application solely because he had not undergone surgery was unlawful.

The Executive Yuan began work on legislation in April 2020, when it decided to commission an academic study examining international legal gender recognition systems rather than immediately drafting a law. 

The government subsequently commissioned Shih Hsin University to prepare a report reviewing foreign legal models and developing legislative recommendations, including a bill. Since 2022, the Executive Yuan has held a series of inter-agency meetings involving multiple ministries to consider the study’s recommendations and legislation governing legal gender recognition, though no bill has yet been enacted.

In September 2023, Taiwan’s Supreme Administrative Court set aside a lower court ruling that had upheld the Interior Ministry’s refusal to change a trans person’s legal gender without proof of surgery and ordered the case to be reheard. 

The court held that the ministry’s 2008 administrative directive requiring surgery could not be treated as the controlling legal standard because it lacked a clear statutory basis and implicated constitutional protections, including bodily autonomy and personality rights. Rather than treating surgery as an automatic prerequisite, the court instructed the lower court to determine whether the applicant had established a stable gender identity based on the evidence presented.

“From our perspective, the primary goal should be lowering the barriers to legal gender recognition, particularly by abolishing the mandatory surgery requirement,” the Taiwan Tongzhi (LGBTQ+) Hotline Association, a nonprofit LGBTQ advocacy and support organization founded in 1998, said in an email to the Washington Blade.

The Taiwan Tongzhi (LGBTQ+) Hotline Association said several factors have stalled progress toward comprehensive legislation. 

The organization told the Blade the complexity of the issue and the lack of constructive dialogue are among the primary obstacles. It said legal gender recognition requires extensive discussion, with views differing even within the trans community itself. The Taiwan Tongzhi (LGBTQ+) Hotline Association added that opinions also vary widely within the legislature and across Taiwanese society, while effective channels for dialogue remain lacking.

The Taiwan Tongzhi (LGBTQ+) Hotline Association also attributed the lack of progress to what it described as a lack of political will and an over reliance on “social consensus.” 

According to the organization, the executive branch lacks the political momentum to advance legal gender recognition reforms. The Taiwan Tongzhi (LGBTQ+) Hotline Association said the Interior Ministry and other relevant agencies have often adopted a passive approach in the face of opposition from conservative groups, delaying progress by arguing that there is no social consensus or that further discussion is needed.

The Taiwan Tongzhi (LGBTQ+) Hotline Association also said progress has been hindered by what it described as a backlash following the legalization of same-sex marriage. According to the organization, groups opposed to gender equality and trans rights, including some conservative religious and anti-trans organizations, shifted their focus to trans issues after marriage equality became law. The Taiwan Tongzhi (LGBTQ+) Hotline Association said these groups have promoted fear-based narratives, including concerns about safety in public restrooms, leading many politicians to view trans rights as a politically risky issue and reducing momentum for legislative action.

“The existing system makes changing one’s legal gender marker extremely difficult. Forced surgical removal of reproductive organs imposes a heavy financial burden since it must be paid out-of-pocket, and not every trans person can afford, desires, or is medically advised to undergo organ removal,” the Taiwan Tongzhi (LGBTQ+) Hotline Association said. “Additionally, requiring psychiatric evaluations is problematic because specialized medical resources are scarce and concentrated in major cities. These obstacles severely impact transgender individuals in their daily lives.”

The Taiwan Tongzhi (LGBTQ+) Hotline Association said the continued reliance on an administrative directive rather than legislation has created systemic uncertainty for trans people. The organization said the absence of a statutory framework allows executive agencies to alter requirements without legislative oversight, leaving trans people uncertain whether future policies will become more restrictive or more permissive. The Taiwan Tongzhi (LGBTQ+) Hotline Association added that while several trans people have secured favorable court rulings since 2023, those decisions apply only to the individual cases before the courts and do not guarantee similar outcomes for others. The group also said pursuing litigation requires significant time, financial resources, and emotional investment, making it an inaccessible path for many trans people seeking legal recognition.

The Executive Yuan and the Interior Ministry did not respond to the Blade’s requests for comment.

Continue Reading

Popular