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.”
Colombia
Gay Venezuelan opposition leader: Country’s future uncertain after Maduro ouster
Yendri Rodríguez fled to Colombia in 2024 after authorities ‘arbitrarily detained’ him
A gay Venezuelan opposition leader who currently lives in Colombia says his country’s future is uncertain in the wake of now former President Nicolás Maduro’s ouster.
The Washington Blade spoke with Yendri Rodríguez on Thursday, 12 days after American forces seized Maduro and his wife, Cilia Flores, at their home in Caracas, the Venezuelan capital, during an overnight operation.
Maduro and Flores on Jan. 5 pleaded not guilty to federal drug charges in New York. The Venezuelan National Assembly the day before swore in Delcy Rodríguez, who was Maduro’s vice president, as the country’s acting president.
Rodríguez, who lives in the Colombian capital of Bogotá, described the events surrounding Maduro’s ouster as “very confusing.”
“It was a very surprising thing that left me in shock,” Rodríguez told the Blade. “We also thought, at least from the perspective of human rights, that the United States was going to respect international law and not go to the extreme of bombing and extracting Maduro.”
“Other questions also arise,” he added. “What could have been done? What else could have been done to avoid reaching this point? That is the biggest question posed to the international community, to other countries, to the human rights mechanisms we established before Trump violated international law, precisely to preserve these mechanisms and protect the human rights of Venezuelan people and those of us who have been forced to flee.”
Rodríguez three years ago founded the Venezuelan Observatory of LGBTIQ+ Violence. He also worked with Tamara Adrián, a lawyer who in 2015 became the first openly transgender woman elected to the Venezuelan National Assembly, for more than a decade.
Members of Venezuela’s military counterintelligence agency, known by the Spanish acronym DGCIM, on Aug. 3, 2024, “arbitrarily detained” Rodríguez as he was trying to leave the country to attend a U.N. human rights event in Geneva.
Rodríguez told the Blade he was “forcibly disappeared” for nearly nine hours and suffered “psychological torture.” He fled to Colombia upon his release.
Two men on Oct. 14, 2025, shot Rodríguez and Luis Peche Arteaga, a Venezuelan political consultant, as they left a Bogotá building.
The assailants shot Rodríguez eight times, leaving him with a fractured arm and hip. Rodríguez told the Blade he has undergone multiple surgeries and has had to learn how to walk again.
“This recovery has been quite fast, better than we expected, but I still need to finish the healing process for a fractured arm and complete the physical therapy for the hip replacement I had to undergo as a result of these gunshots,” he said.
María Corina Machado, who won the 2025 Nobel Peace Prize, and other Venezuelan opposition leaders said Maduro’s government targeted Rodríguez and Peche. Colombian President Gustavo Petro and his government also condemned the attack.
Colombian authorities have yet to arrest anyone in connection with the attack.
Rodríguez noted to the Blade he couldn’t sleep on Jan. 3 because “of the aches and pains” from the shooting. He said a friend who is “helping me out and looking after my things” was the one who told him about the operation the U.S. carried out to seize Maduro and Flores.
“He said, ‘Look at this! They’re bombing Caracas! And I was like, ‘What is this?'” recalled Rodríguez.
White House ‘not necessarily’ promoting human rights agenda
Rodríguez noted Delcy Rodríguez “is and forms part of the mechanisms of repression” that includes DGCIM and other “repressive state forces that have not only repressed, but also tortured, imprisoned, and disappeared people simply for defending the right to vote in (the) 2024 (election), simply for protesting, simply for accompanying family members.” Yendri Rodríguez told the Blade that “there isn’t much hope that things will change” in Venezuela with Delcy Rodríguez as president.
“Let’s hope that countries and the international community can establish the necessary dialogues, with the necessary intervention and pressure, diplomatically, with this interim government,” said Yendri Rodríguez, who noted hundreds of political prisoners remain in custody.
He told the Blade the Trump-Vance administration does not “not necessarily” have “an agenda committed to human rights. And we’ve seen this in their actions domestically, but also in their dealings with other countries.”
“Our hope is that the rest of the international community, more than the U.S. government, will take action,” said Yendri Rodríguez. “This is a crucial moment to preserve democratic institutions worldwide, to preserve human rights.”
Yendri Rodríguez specifically urged the European Union, Colombia, Brazil, and other Latin American countries “to stop turning a blind eye to what is happening and to establish bridges and channels of communication that guarantee a human rights agenda” and to try “to curb the military advances that the United States may still be considering.”
Yendri Rodríguez told the Blade he also plans to return to Venezuela when it is safe for him to do so.
“My plan will always be to return to Venezuela, at least when it’s no longer a risk,” he said. “The conditions aren’t right for me to return because this interim government is a continuation of Maduro’s government.”
Editor’s note: International News Editor Michael K. Lavers was on assignment in Bogotá, Colombia, from Jan. 5-10.
Maryland
Layoffs and confusion at Pride Center of Maryland after federal grants cut, reinstated
Trump administration move panicked addiction and mental health programs
By ALISSA ZHU | After learning it had abruptly lost $2 million in federal funding, the Pride Center of Maryland moved to lay off a dozen employees, or about a third of its workforce, the Baltimore nonprofit’s leader said Thursday.
The group is one of thousands nationwide that reportedly received letters late Tuesday from the Trump administration. Their mental health and addiction grants had been terminated, effective immediately, the letters said.
By Wednesday night, federal officials moved to reverse the funding cuts by the Substance Abuse and Mental Health Services Administration, estimated to total $2 billion, according to national media reports. But the Pride Center of Maryland’s CEO Cleo Manago said as of Thursday morning he had not heard anything from the federal government confirming those reports.
The rest of this article can be read on the Baltimore Banner’s website.
The Comings & Goings column is about sharing the professional successes of our community. We want to recognize those landing new jobs, new clients for their business, joining boards of organizations and other achievements. Please share your successes with us at [email protected].
Congratulations to Vida Rangel, JD/MPP on her promotion to Deputy Director of the Mayor’s Office of Talent and Appointments. Rangel is now the highest-ranking transgender official in the history of District government. On accepting the position Rangel said, “I am proud to step into this leadership role and to continue serving my communities. Our District is full of passionate and knowledgeable people who are committed to public service, and it is an honor to help them explore opportunities to serve their neighbors.”
Rangel has previously served in this office as Director of Operations. Prior to this as Bargaining Committee Chair, Organizing Committee, NCTE United, Nonprofit Professional Employees Union IFTPE Local 70. As Policy Counsel, National Center for Transgender Equality; and Elizabeth Warren for President, lead organizer, Illinois 4th Congressional District. She has worked with, and served on boards of, The Black & Pink National, Federal City Performing Arts Assoc., and LAGBAC.
Rangel earned her bachelor’s in sociology from Sam Houston State University; master’s of Public Policy from Loyola University, Chicago; and Juris Doctor, Loyola University, Chicago.
Congratulations also to James Conlon new PFLAG vice president of Development & Philanthropic Partnerships. Upon his appointment Conlon said, “It is an absolute privilege to join PFLAG National and lead their Development & Philanthropic Partner team into a new era. Right now, LGBTQ+ people and their families are terrified of what the future might bring, and PFLAG must continue to be there. My job is to ensure PFLAG strongly endures and thrives, because never has there been a clearer time for our community to unite in fighting for the dignity and well-being of every LGBTQ+ person.”
Brian Bond, CEO, PFLAG National, said, “At a time when PFLAG National programs and participation in them have grown significantly, even as corporate giving has left a $1.3M gap in our funding, James is a critical new addition to the team. With his vast expertise, James will drive our growth and ensure that PFLAG continues meeting the needs of families and communities across the country.”
Conlon is a seasoned fundraiser who has spent extensive time working with advocates, supporters, and leaders, of the LGBTQ+ movement to understand how to effectively support the community. He began his career as an intern in the Massachusetts State House. He has helped raise more than $60 million for critical causes and candidates. Prior to joining PFLAG James oversaw LGBTQ+ investments and fundraising, with the Democratic National Committee (DNC). Prior to that he served in the same role for Harris-Walz 2024, and additionally served in senior fundraising positions for the Senate Majority PAC, as well as for Representatives Josh Gottheimer, and Conor Lamb.
Conlon earned his bachelor’s degree in political science and government from the University of Massachusetts, Amherst.
Gay Venezuelan opposition leader: Country’s future uncertain after Maduro ouster
Layoffs and confusion at Pride Center of Maryland after federal grants cut, reinstated
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