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.”
Virginia
McPike wins special election for Va. House of Delegates
Gay Alexandria City Council member becomes 8th LGBTQ member of legislature
Gay Alexandria City Council member Kirk McPike emerged as the decisive winner in a Feb. 10 special election for a seat in the Virginia House of Delegates representing Alexandria.
McPike, a Democrat, received 81.5 percent of the vote in his race against Republican Mason Butler, according to the local publication ALX Now.
He first won election to the Alexandria Council in 2021. He will be filling the House of Delegates seat being vacated by Del. Elizabeth Bennett-Parker (D-Alexandria), who won in another Feb. 10 special election for the Virginia State Senate seat being vacated by gay Sen. Adam Ebbin (D-Alexandria).
Ebbin is resigning from his Senate this week to take a position with Virginia Gov. Abigail Spanberger’s administration.
Upon taking his 5th District seat in the House of Delegate, McPike will become the eighth out LGBTQ member of the Virginia General Assembly. Among those he will be joining is Sen. Danica Roem (D-Manassas), who became the Virginia Legislature’s first transgender member when she won election to the House of Delegates in 2017 before being elected to the Senate in 2023.
“I look forward to continuing to work to address our housing crisis, the challenge of climate change, and the damaging impacts of the Trump administration on the immigrant families, LGBTQ+ Virginians, and federal employees who call Alexandria home,” McPike said in a statement after winning the Democratic nomination for the seat in a special primary held on Jan. 20.
McPike, a longtime LGBTQ rights advocate, has served for the past 13 years as chief of staff for gay U.S. Rep. Mark Takano (D-Calif.) and has remained in that position during his tenure on the Alexandria Council. He said he will resign from that position before taking office in the House of Delegates.
Congress
Top Democrats re-introduce trans bill of rights
Lawmakers spoke outside US Capitol on Wednesday
U.S. Sen. Ed Markey (D-Mass.) and U.S. Reps. Pramila Jayapal (D-Wash.), and Sara Jacobs (D-Calif.) announced the reintroduction of a “Trans Bill of Rights” on Wednesday.
Despite chilling winds and snow on the ground, transgender activists, LGBTQ rights advocates, and trans-supporting lawmakers gathered outside the U.S. Capitol to announce the reintroduction of the “Transgender Bill of Rights” resolution to protect trans Americans, as the Trump-Vance administration continues to target LGBTQ Americans.
About 30 people gathered outside to hear from legislators and individuals impacted by recent White House policies.
“Today we say loud and clear that trans rights are human rights, and they must be protected every single day of every single year,” Markey told the crowd. “We stand together in solidarity with the trans community and with those who have too often been left behind by a system that refuses to recognize their humanity. We are here to ensure that every trans and gender-diverse person in America can live freely and safely and authentically. That’s what the Trans Bill of Rights is all about.”
Markey is leading the resolution on the Senate side, while Jayapal is pushing it forward in the House.
“With the Trans Bill of Rights, we are laying out a comprehensive vision to provide protections for transgender and nonbinary people — a vision that ensures every single person has a chance to thrive,” Jayapal said. “A vision that says: you are us, you belong, and you are worthy of the same rights as everyone else. This bill supports amending the Civil Rights Act to ensure that trans people have the same rights and protections as all other Americans. It creates a level playing field where trans people no longer have to fight tooth and nail to get the same treatment as their cisgender friends.”
The resolution for House and the Senate reads:
“Recognizing that it is the duty of the federal government to develop and implement a Transgender Bill of Rights to protect and codify the rights of transgender and nonbinary people under the law and ensure their access to medical care, shelter, safety, and economic security.”
Trans Legislation Tracker, an independent research organization that collects data on anti-trans legislation from the hyper-local level to the floor of the U.S. Senate, found that in 2025, 1,022 measures were proposed across the country to restrict the rights of trans Americans — from health care removals to bathroom bans.
Markey directly called out those lawmakers for what he described as discriminatory actions taken against trans Americans who, as he pointed out, are fighting for rights that everyone else is inherently given.
“Trump and MAGA Republicans have used the power of government to spread fear and hate across our country. They have tried to ban lifesaving and medically necessary health care, strip anti-discrimination protections, and turn trans lives into political talking points for their benefit. Well, we have a message for them: we are louder, we are stronger, and we are not going anywhere. We’re in this fight for the long term,” the Massachusetts senator said.
Jacobs, a co-chair of the Transgender Equality Task Force within the Congressional Equality Caucus, also spoke at the event.
“Trans Americans are being targeted just for being who they are — by laws and court decisions that try to erase them from classrooms, from courts and fields, from health care and public life. These attacks aren’t about safety or fairness,” Jacobs said. “They’re about hatred and instilling fear. And we know how quickly fear can warp into suspicion and violence with deadly consequences.”
In addition to lawmakers, trans Americans and supporters spoke.
Olivia Hunt from Advocates for Trans Equality, LaLa Zannell from the American Civil Liberties Union, as well as three additional people who have been actively harmed by the ongoing wave of anti-trans legislation, shared their stories.
Hunt emphasized the staggeringly high number of anti-trans bills being introduced in statehouses across the country — despite trans adults making up less than 1 percent of the population, according to the Williams Institute’s 2025 data.
“Since 2020, thousands of anti-LGBTQIA+ bills have been introduced in statehouses across the country,” Hunt said. “It’s a veritable tidal wave of political bullying disguised as legislation, and most of these bills specifically target transgender and nonbinary people — especially trans youth and their families. This is a moment that demands action.”
Hunt, who is trans, helps trans people in D.C. obtain legal documents that match their gender identity — something the Trump-Vance administration has stopped.
“Trans youth deserve to be protected by their government. They shouldn’t have to be protected from their government,” she said. “It’s long past time that our federal laws reflect and protect the reality and dignity of all people. Trans people have always existed — we are your neighbors, your family members, your community — and we belong.”
Zannell, who spoke proudly about her trans identity, explained why the bill is necessary and how it would protect trans people in all facets of their lives.
“I stand here as an unapologetic Black trans woman who has led this movement for over a decade to get us to moments like this. The reintroduction of the Trans Bill of Rights will aim to protect access to gender-affirming care, prevent discrimination in housing and public spaces, and preserve legal recognition,” Zannell said. “My hope is that this affirms our government’s duty to protect all trans and nonbinary people.”
The Transgender Bill of Rights is cosponsored in the Senate by U.S. Sens. Jeff Merkley (D-Ore.), Elizabeth Warren (D-Mass.), Mazie Hirono (D-Hawaii), Ron Wyden (D-Ore.), Martin Heinrich (D-N.M.), Alex Padilla (D-Calif.), Bernie Sanders (I-Vt.), and Peter Welch (D-Vt.).
In the U.S. House of Representatives, the resolution is led by Jayapal, co-led by Jacobs and U.S. Rep. Mark Takano (D-Calif.), with nearly 100 other representatives signing on as co-sponsors.
“To all trans people across the United States: you are seen, you are valued, and you are loved,” said Markey. “And I want you to know there are people who will fight for you every single day on the floor of the House and Senate to win those rights for you.”
Senegal
A dozen Senegalese men arrested for ‘unnatural acts’
Popular journalist and musician among those taken into custody
Senegalese police have charged a dozen men with committing “unnatural acts.”
The New York Times reported Pape Cheikh Diallo, a popular television reporter, and Djiby Dramé, a musician, are among the men who authorities arrested. They appeared in court in Dakar, the Senegalese capital, on Monday.
Le Soleil, a Senegalese newspaper, reported authorities arrested the men on Feb. 6 “for intentional transmission of HIV, unnatural acts, criminal conspiracy, and endangering others.” The newspaper further notes the men have been placed in “pre-trial detention.”
Senegal is among the countries in which consensual same-sex sexual relations remain criminalized.
Police in Kaolack, a town that is roughly 135 miles southeast of Dakar, in 2015 arrested 11 people who allegedly engaged in same-sex sexual acts during “a celebration of a gay marriage.” The National Assembly in 2021 rejected a bill that would have further criminalized homosexuality in the country.
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