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Post-DOMA rule proposed for hospice care, nursing homes

Administration seeks to ensure same-sex marriages recognized regardless of state of residence

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Centers for Medicare & Medicaid Services, gay news, Washington Blade

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.”

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Hungary

New Hungarian prime minister takes office

Péter Magyar’s party defeated anti-LGBTQ Viktor Orbán last month

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Péter Magyar votes in Budapest, Hungary on April 12, 2026. He has been sworn in as the country's new prime minister. (Screen capture via APT/YouTube)

Hungarian Prime Minister Péter Magyar took office on Saturday.

Magyar’s center-right Tisza party on April 12 defeated then-Prime Minister Viktor Orbán’s Fidesz-KDNP coalition. Vice President JD Vance less than a week before the election traveled to Budapest, the Hungarian capital, and urged Hungarians to support Orbán.

Orbán had been in office since 2010. He and his government faced widespread criticism over its anti-LGBTQ crackdown.

The European Commission in 2022 sued Hungary, which is a member of the EU, over the country’s anti-LGBTQ propaganda law. The European Union’s top court, the EU Court of Justice, on April 21 struck down the statute.

The EU while Orbán was office withheld upwards of €35 billion ($41.26) in funds to Hungary in response to concerns over corruption, rule of law, and other issues.

Hungarian lawmakers in March 2025 passed a bill that banned Pride events and allowed authorities to use facial recognition technology to identify those who participate in them. MPs later amended the Hungarian constitution to ban public LGBTQ events.

Upwards of 100,000 people last June defied the ban and marched in Budapest’s annual Pride parade.

“Congratulations to [Péter Magyar] on becoming prime minister of Hungary,” said European Commission President Ursula von der Leyen on X.

“This Europe Day, our hearts are in Budapest,” she added. “The hope and promise of renewal is a powerful signal in these challenging times.”

“We have important work ahead of us,” noted von der Leyen. “For Hungary and for Europe, we are moving forward together.”

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Comings & Goings

Whitman-Walker honors Rep. Sarah McBride

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U.S. Rep. Sarah McBride (D-Del.) (Washington Blade photo by Michael Key)

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 Congresswoman Sarah McBride (D-Del.) on being honored with this year’s Stonewall Award from Whitman-Walker Health. Amy Nelson, senior director of Legal Services, said, “Congresswoman Sarah McBride is working to make healthcare accessible to all, and this award recognizes her support of healthcare as a human right. Our legal program supports families facing unprecedented challenges to stay healthy and safe – families that Congresswoman McBride champions with a deep understanding of the issues they face and the legislative expertise of how to support them.”  

McBride, in a press release, said, “I am honored to accept this year’s Stonewall Award from Whitman-Walker Health — an organization that has spent 40 years doing vital work to ensure every person can access the dignity of care. In the wealthiest and most developed nation on earth, the ability to receive care should not be a matter of luck—it should be the law of the land. I am proud to be recognized as a partner in this work and to support Whitman-Walker Health in their mission to build a healthier society for all.”

Congratulations also to Wes Drummond who will join Clear Space Theatre Company in Rehoboth Beach, Del., as its third artistic director. Managing Director Joe Gfaller said, “This is an exciting moment of growth for Clear Space as we welcome Wes to join our remarkable team. I am confident he will be an excellent partner as we work with our entire staff, board, and committed team of volunteers, to ensure Clear Space can achieve its full potential in pursuit of our mission to unite and enrich our community through every production on stage, and every arts-based learning program we offer throughout our community.” 

On accepting the position Drummond said, “I’m honored to join Clear Space Theatre Company as artistic director, and beyond excited for what we’re about to create together. Clear Space has established itself as a vital and vibrant part of the cultural life of coastal Delaware, and I feel incredibly fortunate to step into this next chapter alongside such a passionate and dedicated team. Rehoboth Beach is a place defined by creativity and community, and I look forward to listening, learning, and building meaningful relationships across the region in the months ahead. My vision is to help Clear Space continue to grow as a bold, forward-thinking, cultural force, that champions fearless storytelling.”

Wes Drummond

Drummond served in leadership roles at Duluth Playhouse in Duluth, Minn., from 2021 to 2026, including four years as executive director followed by one year as executive producing artistic director, guiding the organization through a period of significant transformation and stability in the wake of the COVID-19 pandemic. As a director, he has worked extensively in New York City, Chicago, and at regional theaters across the country, directing both musical theater and plays with a focus on storytelling that bridges classical works with contemporary perspectives. He has collaborated with leading figures in the industry, including Tony Award-winning director Matthew Warchus, and Tony-nominated director Michael Greif. He is an associate member of the Stage Directors and Choreographers Society.

Wes earned his MFA in directing, Penn State University, where he studied under Tony-nominated director, Susan H. Schulman. 

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Virginia

Va. Supreme Court invalidates Democrat-backed redistricting plan

Voters narrowly approved new congressional districts last month

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Virginia Supreme Court (Photo by sainaniritu/Bigstock)

The Virginia Supreme Court on Friday struck down a Democrat-backed redistricting plan that voters approved last month.

Ten of 11 of Virginia’s congressional districts favor Democrats in the plan that passed by a 51-48 vote margin in last month’s referendum.

The Human Rights Campaign PAC is among the groups that support it. The court by a 4-3 majority invalidated the referendum results.

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