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.”
Politics
Trump’s war threats trigger rare 25th Amendment discussion
President threatened to destroy Iranian civilization in Truth Social post
Following multiple brazen Truth Social posts this week related to the ongoing war with Iran — one which he said he could wipe out “a whole civilization,” — Democrats are seizing the opportunity to gain momentum in ousting President Donald Trump from office.
As the war with Iran continues to unfold, Trump appears increasingly frustrated — and willing — to use any means necessary to achieve his goals of ending the country’s nuclear capabilities, destroying its military, and ushering in regime change. So far, none of these goals have been met. As his frustration grows, so do calls to invoke a never-before-used safeguard for the nation—the 25th Amendment.
“A whole civilization will die tonight, never to be brought back again,” Trump posted on Truth Social on Tuesday morning. “I don’t want that to happen, but it probably will.”
This came only days after Trump posted a now-deleted, expletive-filled demand for the country to reopen the Strait of Hormuz on Easter Sunday, saying, “Open the Fuckin’ Strait, you crazy bastards, or you’ll be living in Hell.” On the same day, Trump told The Hill he would not rule out sending ground troops. And he told Fox News Sunday that he’s “considering blowing everything up and taking over the oil” if Iran doesn’t accept his deal.
The president then set a new deadline of 8 p.m. ET on Tuesday for Iran to reach a deal with the U.S., marking yet another extension, which did lead to a two-week ceasefire.
Since the president’s tirade, Democratic legislators in federal office have condemned his words, while Republicans are quietly standing behind him. Former Trump allies are among the loudest voices advocating for invoking the 25th Amendment, as some in international government organizations have sharply called Trump’s threats illegal.
“If there’s an attack on clearly civilian infrastructure, that is not allowed under international humanitarian law,” Stéphane Dujarric, spokesman for the United Nations secretary-general, said last week.
That concern is heightened by the broader human rights landscape in Iran, where violations of international legal standards are already well documented — particularly when it comes to LGBTQ people.
Iran has some of the harshest laws in the world regarding LGBTQ rights, policies that human rights advocates say are themselves in violation of international law.
Under the country’s legal system, all sexual activity outside a traditional Islamic marriage is illegal, including same-sex relations. Sexual activity between members of the same sex is criminalized and, in some cases, punishable by death under Iran’s Islamic Penal Code.
With international officials raising concerns about the legality of Trump’s threats, the conversation in Washington has increasingly shifted from condemnation to potential consequences, namely, whether the 25th Amendment could be used to hold him accountable.
“Section 4 of the 25th Amendment, which has never been invoked, allows for the vice president and a majority of Cabinet secretaries (or another body as Congress may provide) to declare the president unable to discharge the powers and duties of the office,” according to the Bipartisan Policy Center. “The vice president would then immediately assume the role of acting president.”
Although there seems to be momentum from Trump adversaries, this is unlikely, according to PolitiFact.
“For all of the partisan chatter, it is highly unlikely this legal procedure to remove a president will happen,” Louis Jacobson and Amy Sherman wrote for the nonprofit political fact-checking website that is operated by the Poynter Institute.”Trump has the support of Vice President JD Vance, his Cabinet and the majority of Republicans in Congress.”
Delaware Congresswoman — and the first transgender legislator on Capitol Hill — Sarah McBride issued a statement in response to Trump’s words.
“In a political career defined by grotesque statements, this president’s horrifying, illegal, and genocidal threat this morning is among the most dangerous and appalling,” McBride said. “You can’t shout ‘fire’ in a crowded theater, and a president cannot be allowed to threaten genocide with the United States military. Threats of war crimes and disregard for human life must be met with accountability under the law.”
She then, like many others, called for removing the president from office to protect the American people.
“Trump must go — and Republicans, whether in the Cabinet or Congress, must join Democrats in using any and all constitutional powers at our collective disposal to end this illegal war and take the gun out of this madman’s hands,” said McBride, the Congressional Democratic Women’s Caucus whip.
Mark Takano, the first openly gay person of color elected to Congress, pointed out that Trump’s ceasefire is only temporary, and does not ensure that Americans won’t be called to fight in a war they didn’t ask for.
“We heard no plan to end this war and no commitment to keep American boots out of Iran,” Takano said on X.
U.S. Sen. Tammy Baldwin (D-Wis.), the first openly gay member elected to the U.S. Senate, used her platform to remind Trump — and the world — that diplomacy remains critical.
“Diplomacy has always been the answer, which is why the president shouldn’t have gotten us into this war of choice,” a statement read on X. “It’s been reckless, cost U.S. soldiers their lives, and is raising prices on families. A ceasefire is a start, but Congress needs to do our jobs and end this war.”
“The House must pass articles of impeachment, and then the Senate must vote to convict and remove the President,” U.S. Sen. Ed Markey (D-Mass.), vocal supporter of LGBTQ rights wrote in a statement on X. “Or, the Cabinet and vice president, with congressional concurrence, must invoke the 25th Amendment and remove Trump.”
“Donald Trump’s instability is more clear and dangerous than ever,” said former House Speaker Nancy Pelosi (D-Calif.).
Multiple other Democrats also called for removing the president for violating international and constitutional law. U.S. Rep. Ilhan Omar (D-Minn.) called for “this unhinged lunatic” to “be removed from office.” U.S. Rep. Ro Khanna (D-Calif.), said, “Threatening war crimes is a blatant violation of our Constitution and the Geneva Conventions.” U.S. Rep. Yassamin Ansari (D-Ariz.), told Midas Touch Journalist Scott MacFarlane “In the last 48 hours alone, the rhetoric has crossed every line.”
In addition to Democrats, some staunch Trump supporters have also been loudly criticizing the president’s handling of the Iran war.
Conspiracy theorist, former Trump confidant, and $1.3 billion defamation case loser for spreading far-right lies, Alex Jones, asked “How do we 25th Amendment his ass?” on Monday’s InfoWars show.
Georgia Republican, former member of the House of Representatives, and former high-profile MAGA ally Marjorie Taylor Greene called Trump’s post about destroying civilizations “evil and madness” and posted a simple “25TH AMENDMENT!!!”
The White House
Report: Grenell wants Russian ambassadorship
Country’s anti-LGBTQ record a reported barrier
Richard Grenell, President Donald Trump’s special envoy for “special missions,” is making it known that he is interested in the Russian ambassadorship.
According to reporting by the Daily Mail, Grenell has “floated” his interest in the role to coworkers, but issues surrounding the former German ambassador’s sexuality have made securing the position more difficult.
“He had an interest in the job — or at least he floated the idea to select colleagues. But Putin’s regime is extremely anti–LGBTQ, so I’m sure they didn’t take that thought too seriously,” one source close to Grenell told the Daily Mail. “That would never happen anyway.”
Grenell has long been one of Trump’s closest allies and was the first openly gay person to hold a Cabinet-level position. He was ousted last month as acting director of the Kennedy Center, a position he had held since Trump reestablished the board to be composed of his political supporters in 2025.
In addition to leading the nation’s cultural arts center, Grenell previously served as the U.S. ambassador to Germany from 2018 to 2020, and as the special presidential envoy for Serbia and Kosovo peace negotiations from 2019 to 2021. He was also a State Department spokesperson to the U.N. under the George W. Bush administration and a Fox News contributor.
Russia has a longstanding history of being anti-LGBTQ.
In 2013, the country passed a law banning any public endorsement of “nontraditional sexual relations” among minors. In December 2022, Putin signed legislation expanding the ban, making it illegal to promote same-sex relationships or suggest that non-heterosexual orientations are “normal” for people of any age, widening censorship across media and public life.
The Russian courts have also supported the restriction of LGBTQ identity in the country. In November 2023, Russia’s Supreme Court granted a request from the Justice Ministry to outlaw the “international LGBT movement” as “extremist,” allowing authorities to criminalize advocacy and potentially prosecute individuals for expressions of LGBTQ+ identity or support.
In addition to LGBTQ rights issues, the war between Russia and Ukraine has become a global concern. Ukraine, which was part of the former Soviet Union, includes the territory known as Crimea, which Russia annexed in 2014. The annexation remains a major point of international dispute over sovereignty. Since 2022, Russia’s large-scale invasion of Ukraine has escalated the conflict, drawing global attention and sanctions while straining U.S.-Russia relations.
The U.S. has spent $188 billion in total related to the war in Ukraine since the Russian invasion in February 2022, according to the Council on Foreign Relations.
The Russian ambassadorship seems to be a difficult role to fill, according to additional information presented by the Daily Mail. With Trump already being seen as relatively positive by Russian President Vladimir Putin, and with close ties to members of his Cabinet and family — like son-in-law Jared Kushner — the ambassadorship is complicated and viewed as less critical than in previous administrations.
“There is no rush to fill that role because it has now been deemed unnecessary,” another source told the U.K.-based publication.
Bob Foresman, a seasoned businessman with decades-long ties to the Kremlin, was reportedly once the frontrunner, according to the Daily Mail. Foresman served as vice chair of UBS Investment Bank and Deputy Chairman of Renaissance Capital between 2006 and 2009, and earlier led investment banking for Russia at Dresdner Kleinwort Wasserstein from 1997 to 2000.
“This is a pattern, especially in the Trump administration — special envoys big–footing the ambassadors,” a source told the Daily Mail. “It is shocking that we are already in April and we don’t have an ambassador to one of the most important countries in the world.”
Politics
Log Cabin Republicans to honor Scott Presler
Event to take place at Capitol Hill Club on Friday
The Log Cabin Republicans, a group representing LGBTQ conservatives and their allies within the Republican Party, is set to honor gay conservative commentator and activist Scott Presler on Friday.
Presler will receive the organization’s 2026 “Game Changer Award” during its Spring Forward Cocktail Reception at the Capitol Hill Club, a private club steps from the U.S. Capitol that regularly hosts Republican political events.
Presler has risen to prominence through a combination of pro-LGBTQ conservative activism, political organizing, and a series of controversial affiliations.
He first gained national attention in 2017 for organizing the “March Against Sharia” rallies across the country. The demonstrations came amid heightened tensions in Portland, Ore., following a deadly attack on a metro train, in which Jeremy Joseph Christian killed two people and injured others after harassing Muslim women for wearing a hijab.
The rallies were organized in partnership with ACT for America, which advocates against what it describes as “the threat of radical Islam” in the U.S. and has been labeled a hate group by the Southern Poverty Law Center. Presler volunteered with the organization for three months.
He has said he was first motivated to “fight Muslim extremism” following the Pulse nightclub massacre, he told NPR, in which a gunman who pledged allegiance to ISIS killed 49 people at an LGBTQ nightclub in Orlando, Fla. The site now serves as a memorial to the victims of the attack.
Born May 15, 1988, in Jacksonville, Fla., Presler is the son of a U.S. Navy captain and was raised in both Florida and Fairfax County. He later attended George Mason University, where he earned a degree in criminal justice.
In addition to his anti-Islam activism, Presler has been involved in a number of other high-profile and controversial efforts. He co-founded “Gays for Trump” and attended their 2017 DeploraBall in Maryland for the first inauguration of Trump. According to a 2021 report from Media Matters for America, he also promoted the QAnon conspiracy movement through social media posts in 2018 and 2019.
He has also faced criticism tied to his early political work. According to a 2023 report from Politico Playbook, Presler’s work with the Republican Party of Virginia in 2016 ended after he allegedly engaged in sexual activity in a shared office space and posted explicit images online.
Beyond ideological activism, Presler has also organized community-focused initiatives. In 2019, he led a widely publicized cleanup effort in Baltimore that drew more than 100 volunteers and resulted in approximately 29 tons of trash being removed. The event was a result of criticism from President Donald Trump, calling the area, represented by then-U.S. Rep. Elijah Cummings (D-Md.) a “rodent infested mess.”
Presler has also been active in election-related organizing, leading a two-day “Stop the Steal” demonstration at the Pennsylvania State Capitol following the 2020 presidential election. He has appeared on the “War Room” podcast hosted by former Trump strategist and well-known right-wing populist conspiracy theorist Steve Bannon.
He has also expressed a controversial stance within the LGBTQ community for supporting then-candidate Trump for President over Hillary Clinton. He told prioritizing Second Amendment rights over certain LGBTQ policy goals, saying he is more supportive of gun rights than efforts to codify same-sex marriage, and adding, “I 100 percent believe in the notion that armed gays don’t get bashed. It is our right to feel safe.”
Presler voiced his support for the Florida Parental Rights in Education Act, more commonly referred to as the “Don’t Say Gay” law, signed into law by Republican Gov. Ron DeSantis in 2022.
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