News
Post-DOMA rule proposed for hospice care, nursing homes
Administration seeks to ensure same-sex marriages recognized regardless of state of residence

The Centers for Medicare & Medicaid has proposed a new rule for hospice care and nursing homes. (Image public domain).
The Obama administration on Thursday announced a proposed rule that aims to ensure medical care for individuals in same-sex marriages — regardless of the state in which they live — following the Supreme Court decision against the Defense of Marriage Act.
The Centers for Medicare & Medicaid proposes the rule to change conditions for medical care providers and suppliers receiving support from Medicare and Medicaid, including hospitals and hospice care, as well as the requirements for long-term care facilities, or nursing homes.
The thrust of the proposed rule is to ensure same-sex marriages are recognized nationwide, even in states without marriage equality, for programs that in some aspects are administered by the states.
“This proposed rule addresses certain regulations governing Medicare and Medicaid participating providers and suppliers where current regulations look to state law in a matter that implicates (or may implicate) a marital relationship,” the rule states. “Our goal is to provide equal treatment to spouses, regardless of their sex, whenever the marriage was valid in the jurisdiction in which it was entered into, without regard to whether the marriage is also recognized in the state of residence or the jurisdiction in which the health care provider or supplier is located, and where the Medicare program explicitly or impliedly provides for specific treatment of spouses.”
The proposed rule, which can found here, is set for publication in the Federal Register on Friday. Once it’s published, comments must be received by 60 days to be assured consideration before the rule is made final.
Karen Loewy, senior attorney and seniors program strategist for the LGBT group Lambda Legal, said the proposed rules are “a very welcome development” and would “amend references to discriminatory state laws to provide equal treatment to spouses.”
“In practical terms, these changes will mean that a patient’s same-sex spouse will have the same right to access information, make decisions, and be part of admissions processes that a different-sex has in hospitals, hospice care, surgical care centers, long term care settings, labs, and community mental health centers that receive Medicare or Medicaid dollars, even when the laws of the state would not recognize their right to do so,” Loewy said. “These rules would provide important automatic protections for same-sex spouses, ensuring that a patient’s spouse gets to be by his or her side, be informed, and make those difficult decisions in vulnerable health care situations.”
In summary, the proposed rule seeks to established a same-sex spouse should be considered a person’s representative — regardless of state law — for the purposes for care from ambulatory surgical centers, hospice care, exercising a patient’s rights, informing patients of their rights, notification for laboratory services to screen blood and blood products for potentially infectious diseases like HIV and Hepatitis C, care in long-term facilities, pre-admission screening and resident review for long-term care, findings of these evaluations, care in Community Mental Health Centers and client rights at these facilities.
Mark Daley, a spokesperson for the National LGBTQ Task Force, said changes in proposed rule are “common-sense” and would help elders in the LGBT community ensure they receive equal care in medical facilities.
“These new policies help ensure that one of the most vulnerable populations in our country, LGBTQ elders, are able to access federal programs in the same way that non-LGBTQ people access programs,” Daley said. “This means ensuring that same-sex spouses will be treated exactly the same as different-sex spouses in programs like long-term care facilities, Hospice care, and hospitals. What this really means for LGBTQ folks is that same-sex spouses will be able to visit and make medical decisions on behalf of their spouse, just like different-sex couples. It means that LGBTQ elders will have legal rights in the health care context, regardless of whether your state continues to discriminate against you by refusing to recognize your marriage.”
After the Supreme Court decision against DOMA, the Centers for Medicare & Medicaid already issued guidance — once in September 2013 and again in May 2014 — to ensure same-sex marriages are recognized in determining eligibility for Medicaid and the Children’s Health Insurance Program. But the proposed rule says it’s needed because policies it addresses “are administered by different statutes and are administered by state Medicaid agencies and CMS.”
Sarah Warbelow, legal director for the Human Rights Campaign, said the proposed rule will help individuals in same-sex marriages in the medical care situations when they need assistance the most.
“When people are at their most vulnerable, from hospitals to hospice care to nursing homes, they need to know that their spouse will be fully informed, be able to help them make decisions, and be fully regarded as their spouse,” Warbelow said. “The rule proposed by the Centers for Medicare and Medicaid will help to ensure that the marriages of same-sex couples are treated equally regardless of where the couple lives.”
The White House
White House counterterrorism strategy targets ‘anti-American, radically pro-transgender’ groups
Administration released document last week
The White House released the “United States Counterterrorism Strategy” last week, introducing enforcement priorities that include references to people with “extreme transgender ideologies.”
The document is the first executive branch counterterrorism strategy released since former President Joe Biden’s 2021 “National Strategy for Countering Domestic Terrorism,” which largely focused on threats tied to domestic extremism and the Jan. 6 Capitol attack. The Trump-Vance administration’s new strategy instead centers heavily on cartels, Islamist organizations, and what it describes as “violent left-wing extremists.”
The report identifies three primary categories of terror threats facing the U.S.: “Narcoterrorists and Transnational Gangs,” “Legacy Islamist Terrorists,” and “Violent Left-Wing Extremists, including Anarchists and Anti-Fascists.” The strategy repeatedly frames those groups as existential threats to the U.S. and outlines a more aggressive, militarized counterterrorism posture.
The introduction to the report closes with a warning from President Donald Trump referencing counterterrorism operations carried out during his second administration: “We will find you and we will kill you.”
In the section outlining the administration’s counterterrorism priorities, the document argues that federal intelligence, and law enforcement agencies under prior administrations focused on the wrong threats while overlooking violence committed by left-wing extremists. The strategy specifically references transgender ideology while discussing political violence.
“As real threats were ignored or underplayed, Americans have witnessed the politically motivated killings of Christians and conservatives committed by violent left-wing extremists, including the assassination of Charlie Kirk by a radical who espoused extreme transgender ideologies.”
Claims tying a trans person to Kirk’s killing have been disputed, however, and multiple news outlets later retracted or corrected early reports that identified the shooter as trans.
The report later expands on that argument, saying the administration will prioritize targeting “violent secular political groups” it describes as anti-American and “radically pro-transgender.”
“In addition to cartels and Islamist terror groups, our national CT activities will also prioritize the rapid identification and neutralization of violent secular political groups whose ideology is anti-American, radically pro-transgender, and anarchist.”
The rhetoric mirrors claims frequently made by Trump allies and conservative commentators linking trans people and left-wing activism to political violence. However, data compiled by researchers and organizations tracking mass shootings does not support the idea that trans people are responsible for a significant share of such attacks.
Factcheck.org says rhetoric from Trump and several far-right political pundits contradicts available data, noting that the percentage of mass shootings committed by trans people is “exceedingly small.”
Despite the lack of evidence supporting generalized claims about trans people, the president’s son Donald Trump, Jr., told Fox News in September 2025 that he could not “name a mass shooting in the last year or two in America that wasn’t committed by, you know, a transgender lunatic.”
Factcheck.org also found that even if cases involving shooters with unclear gender identities were included in statistics about trans mass shooters, the number would still account for only a fraction of a percent.
Mark Bryant, founding executive director of the Gun Violence Archive, said the number of trans mass shooters could be as high as eight, but would still account for less than 0.1 percent of mass shootings over the last 12 years, according to GVA data. He added that the figure would remain below 0.2 percent even when examining incidents from 2018 to the present.
Beyond domestic extremism, the strategy frames the administration’s broader counterterrorism agenda through the lens of “America First” foreign policy and renewed U.S. dominance in the Western Hemisphere. The report repeatedly references the Monroe Doctrine, the nearly 200-year-old policy warning European powers against interference in the Americas.
“After years of neglect, the United States will reassert and enforce the Monroe Doctrine to restore American preeminence in the Western Hemisphere, and to protect our homeland” Trump said in the report.
The document also breaks down counterterrorism priorities by region, including the Middle East, where it argues the U.S. is “no longer as dependent” on the region because of increased domestic energy production.
“Our growing domestic energy production means the Middle East is no longer as central to America’s stability, yet threats from this region remain, and our counterterrorism goals continue to be specific and rooted in realistic threat analysis.”
The statement comes amid rising gas prices tied in part to instability surrounding the war involving Iran, with fuel costs reaching some of their highest levels since 2022. According to AAA, the national average price for gasoline climbed to $4.52 per gallon as the national average rose “$.25 for a second straight week.“
District of Columbia
Anti-LGBTQ violence prevention efforts highlighted at D.C. community fair
Mayor’s Office of LGBTQ Affairs organized May 8 event
Detailed advice on how LGBTQ people can avoid, defend themselves against, and prevent themselves and loved ones from becoming victims of violence, with a focus on domestic and intimate partner violence, was presented at a May 8 LGBTQIA+ Safety in Numbers Community Fair.
The event, organized by the D.C. Mayor’s Office of LGBTQ Affairs, included five workshop sessions and information tables set up by 14 LGBTQ-supportive organizations and D.C. government agencies or agency divisions, including the D.C. Metropolitan Police Department’s LGBT Liaison Unit and the D.C. LGBTQ+ Community Center.
Also playing a lead role in organizing the event was the D.C. LGBTQIA+ Violence Prevention and Response Team, or VPART, a coalition of D.C. officials and leaders of community-based organizations that work with the Office of LGBTQ Affairs.
The event was held in meeting space in the building where the Office of LGBTQ Affairs is located at 899 N. Capitol St., N.E.
The workshop topics included de-escalation training on healthy relationships, bystander intervention, self-defense training, violence prevention grants, and suicide prevention.
“This will be a public safety and violence prevention event where community partners will educate attendees on various methods of violence intervention and trauma-informed practices,” according to a statement released by the Mayor’s Office of LGBTQ Affairs prior to the start of the event.
The statement adds, “We will have live demos, interactive games, and workshops focused on strategies for self-defense, protecting vulnerable communities, increasing access to mental health resources, providing tools for recognizing domestic violence/intimate partner violence signs in intimate relationships, and assistance for substance abuse.”
Sonya Joseph, associate director of engagement for the Office of LGBTQ Affairs, told the Washington Blade that studies have shown rates of domestic or intimate partner violence are higher in the LGBTQ community than in the community at large.
“Domestic violence and intimate partner violence are two very big prevalent issues in the LGBTQ community,” she said, adding that some of the workshops at the event would be providing “training on healthy relationships and how to recognize and prevent intimate partner violence and the signs of it.”
About 35 to 40 people attended the workshop sessions.
Experts specializing in violence impacting the LGBTQ community have said domestic violence refers to violence among people in domestic relationships that can include spouses but also siblings, parents, cousins, and other relatives. Intimate partner violence, according to the experts, refers to violence perpetuated by a partner in a romantic or dating relationship.
These D.C. based organizations or agencies that participated in the LGBTQIA+ Safety in Numbers event, and which can be contacted for assistance, include:
• Defend Yourself
• DC LGBTQ+ Community Center
• American Foundation for Suicide Prevention
• Joseph’s House
• Us Helping Us, People into Living, Inc.
• MCSR (formerly known as Men Can Stop Rape)
• MPD LGBT Liaison Unit
• Volunteer Legal Advocates
• DC SAFE
• Destination Tomorrow
• D.C. Office of Victims Services and Justice Grants
• Life Enhancement Services
• ONYX Therapy Group
• U.S. Attorney’s Office for D.C.
Rehoboth Beach
Celebrated performer Rose Levine plays Rehoboth on May 15
Freddie’s to host Fire Island legend
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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