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
Hundreds protest ICE killing of Renee Nicole Good in D.C.
Married queer woman shot in Minneapolis on Wednesday
Hundreds of people took to the streets of D. C. on Thursday night to protest the killing of a U.S. citizen by a U.S. Immigration and Customs Enforcement agent.
Protests began at the busy — and increasingly queer — intersection of 14th and U Streets, N.W. There, hundreds of people held signs, shouted, and made their way to the White House to voice their dissent over the Trump-Vance administration’s choice to increase law enforcement presence across the country.
The protest, which also occurred simultaneously in cities large and small across the country, comes in the wake of the death of Minneapolis resident Renne Nicole Good at the hands of ICE Agent Jonathan Ross. Good left behind two children and a wife, Rebecca Good.
Records obtained by the Associated Press found that Ross was an Iraq War veteran and nearly two decades into his career with U.S. Border Patrol and ICE.
Good was gunned down just blocks away from where George Floyd was killed by police in 2020, sparking weeks of national protests. Minnesota officials say the FBI has blocked their access to an investigation into the fatal shooting, according to a BBC story published on Friday.
In the nation’s capital, protesters marched from the intersection of 14th and U Street to Lafayette Square, right outside the White House. Multiple D.C. organizations led the protest, most notably Free DC, a nonprofit that works to ensure the right of “self-determination” for District residents, as many local laws can be reviewed, modified, or overturned by Congress. Free DC had organized multiple protests since the Trump-Vance administration was elected.
The Washington Blade spoke to multiple protesters towards the tail end of the protest about why they came out.
Franco Molinari, from Woodbridge, Va., crossed the Potomac to partake in his first-ever protest.
“I don’t appreciate ICE and the use of federal agents being pretty much militarized against America,” Molinari said while holding a “Justice for Renee” sign. “The video of Renee being executed cartel style in her car was enough for me to want to come out, to at least do something.”
Molinari, like many others the Blade spoke with, found out about the protest on Instagram.
“It was my friend there, Sarah … had sent a link regarding the protest to a group chat. I saw it in the morning, and I thought, ‘You know what, after work, I’m head out.’”
He also shared why protesting at the White House was important.
“I already saw the response that the president gave towards the murder of Renee, and it was largely very antagonizing,” Molinari said.
President Donald Trump, along with federal leaders under him, claimed that Good “violently, willfully and viciously ran over the ICE officer.” The president’s claims have been widely discredited through multiple videos of the incident, which show Good was attempting to leave the scene rather than attacking the officer.
“I hope that anybody would be able to see that and see the response and see for themselves that it just is not correct,” Molinari said.
The Blade also spoke with leftist influencer Dave the Viking, who has more than 52,000 followers on TikTok, where he posts anti-fascist and anti-Trump videos.
“We’re out here to make sure that this regime can’t rewrite history in real time, because we all know what we saw … we’re not going to allow them to run with this narrative that they [ICE agents] were stuck in the snow and that that poor woman tried to weaponize her car, because we all saw video footage that proves otherwise,” he told the Blade. “We’re not going to let this regime, the media, or right-wing influencers try to rewrite history in real time and try to convince us we didn’t all see what we know we saw.”
Dave the Viking continued, saying he believes the perceived power of ICE and other law enforcement to act — oftentimes in deadly and unjustifiable ways — is a product of the Trump-Vance administration.
“There’s a line between fascism and anti-fascism. These motherfuckers have been pushing that envelope, trying to label an idea a terrorist organization, to the point of yesterday, crossing that line hardcore. You face the point of looking at history and saying there was this 1989, 2003 America, where we’re just going in, raiding resources. Where is this fucking 1930s Germany, where we’re going in and we’re about to just start clearing shit and pulling knots? Yeah, nope. We proved that shit yesterday.”
Two people were injured in another shooting involving federal agents, this time Border Patrol in Portland, Ore., on Thursday afternoon.
KC Lynch, who lives near American University, also spoke about her choice to protest with a group.
“I came out today because everything that ICE has done is absolutely unacceptable, not only killing this one woman, but also the fact that they’ve been imprisoning people in places that are literally, that have been literally on record by international organizations shown to be human rights violating. It’s unbelievably evil.”
Lynch also echoed Dave’s opinion about parallels between the Trump-Vance administration and the rise of Adolf Hitler in Nazi Germany.
“It’s literally what happened before the Holocaust. We should all be scared. We should all be angry. I’m so angry about it … even talking about it — I’m sorry,” she said before getting choked up.
Lynch emphasized that despite the circumstances in which people were protesting together, the sense of community was strong and powerful.
“I feel like it’s important for people to know that we’re angry, even if no policy changes come out of it, and it’s just nice to yell and be angry about it, because I feel like we’ve probably all been feeling this way, and it’s nice to be around people that are like minded and to like have a sense of community.”
Venezuela
AHF client in Venezuela welcomes Maduro’s ouster
‘This is truly something we’ve been waiting for’ for decades
An AIDS Healthcare Foundation client who lives in Venezuela told the Washington Blade he welcomes the ouster of his country’s former president.
The client, who asked the Blade to remain anonymous, on Thursday said he felt “joy” when he heard the news that American forces seized Nicolás Maduro and his wife, Cilia Flores, at their home in Caracas, the Venezuelan capital, during an overnight operation on Jan. 3.
“This is truly something we’ve been waiting for for 26 or 27 years,” the AHF client told the Blade.
Hugo Chávez became Venezuela’s president in 1999. Maduro succeeded him in 2013 after he died.
“I’ve always been in opposition,” said the AHF client, who stressed he was speaking to the Blade in his personal capacity and not as an AHF representative. “I’ve never agreed with the government. When I heard the news, well, you can imagine.”
He added he has “high hopes that this country will truly change, which is what it needed.”
“This means getting rid of this regime, so that American and foreign companies can invest here and Venezuela can become what it used to be, the Venezuela of the past,” he said.
The AHF client lives near the Colombia-Venezuela border. He is among the hundreds of Venezuelans who receive care at AHF’s clinic in Cúcuta, a Colombian city near the Táchira River that marks the border between the two countries.
The Simón Bolívar Bridge on the Colombia-Venezuela border on May 14, 2019. (Washington Blade video by Michael K. Lavers)
The AHF client praised U.S. President Donald Trump and reiterated his support for the Jan. 3 operation.
“It was the only way that they could go,” he said.
The Venezuelan National Assembly on Jan. 4 swore in Delcy Rodríguez, who was Maduro’s vice president, as the country’s acting president. The AHF client with whom the Blade spoke said he is “very optimistic” about Venezuela’s future, even though the regime remains in power.
“With Maduro leaving, the regime has a certain air about it,” he said. “I think this will be a huge improvement for everyone.”
“We’re watching,” he added. “The actions that the United States government is going to implement regarding Venezuela give us hope that things will change.”
Minnesota
Reports say woman killed by ICE was part of LGBTQ community
Renee Nicole Good shot in Minneapolis on Wednesday
A U.S. Immigration and Customs Enforcement agent shot and killed a woman in Minneapolis as she attempted to drive away from law enforcement during a protest on Wednesday.
The Star Tribune newspaper identified the victim as Renee Nicole Good, 37, a Minneapolis resident who lived blocks from where she was shot in the Central neighborhood, according to reports. Donna Ganger, Good’s mother, told the Star Tribune that her daughter lived in the Twin Cities with her wife.
Multiple videos of the shooting have gone viral on social media, showing various angles of the fatal incident — including footage that shows Good getting into her car and attempting to drive away from law enforcement officers, who had their weapons drawn.
In the videos, ICE agents can be heard telling Good to “get out of the fucking car” as they attempted to arrest her. Good, who press reports say was married to a woman, ended up crashing her car into an electric pole and other vehicles. She was later transported from the scene of the shooting and died at the hospital.
President Donald Trump defended the ICE agent on Truth Social, saying the officer was “viciously” run over — a claim that coincides with Homeland Security Secretary Kristi Noem’s assessment of the situation. Noem, a South Dakota Republican, insisted the officer “fired defensive shots” at Good after she attempted to run over law enforcement agents “in an attempt to kill them — an act of domestic terrorism.”
Multiple state and local officials disputed claims that the shooting was carried out in self-defense at the same time Noem was making those assertions.
An Instagram account that appears to belong to Good describes her as a “poet and writer and wife and mom and shitty guitar strummer from Colorado; experiencing Minneapolis, MN,” accompanied by a rainbow flag emoji.
A video posted to X after the shooting shows a woman, reportedly her wife, sitting on the ground, crying and saying, “They killed my wife. I don’t know what to do.”
“We’ve dreaded this moment since the early stages of this ICE presence in Minneapolis,” Mayor Jacob Frey said during a Wednesday press conference. “Having seen the video myself, I want to tell everybody directly that [the DHS’s claim of self-defense] is bullshit. This was an agent recklessly using power that resulted in somebody dying, getting killed.”
“I have a message for ICE. To ICE, get the fuck out of Minneapolis,” Frey continued. “We do not want you here. Your stated reason for being in this city is to create some kind of safety, and you are doing exactly the opposite. People are being hurt. Families are being ripped apart. Long-term Minneapolis residents that have contributed so greatly to our city, to our culture, to our economy are being terrorized, and now somebody is dead. That’s on you, and it’s also on you to leave.”
Across the Capitol, members of the House and the Senate condemned the actions of the officer.
“There’s no indication she’s a protester, there’s nothing that at least you can see on the video, and therefore nothing that the officers on the ground could see that identify her as someone who’s set out to try to do harm to an ICE officer,” U.S. Sen. Elizabeth Warren (D-Mass.) said Wednesday night on MS NOW’s “The Weeknight.”
“There is no evidence that has been presented to justify this killing,” House Minority Leader Hakeem Jeffries (D-N.Y.) said in a statement on his website. “The masked ICE agent who pulled the trigger should be criminally investigated to the full extent of the law for acting with depraved indifference to human life.”
“ICE just killed someone in Minneapolis,” U.S. Rep. Robert Garcia (D-Calif.) the highest-ranking Democrat on the House Oversight Committee, posted on X. “This administration’s violence against communities across our country is horrific and dangerous. Oversight Democrats are demanding answers on what happened today. We need an investigation immediately.”
In a statement to the Advocate, Human Rights Campaign President Kelley Robinson wrote, “Today, a woman was senselessly killed in Minneapolis during an ICE action — a brutal reminder that this agency and the Trump regime put every community at risk, spreading fear instead of safety. Reports that she may have been part of the LGBTQ+ community underscore how often the most vulnerable pay the highest price.”
National LGBTQ Task Force President Kierra Johnson also responded to Good’s death.
“We recognize and mourn the loss of Renee Nicole Good and extend our condolences to her family, loved ones, and community,” said Johnson in a statement. “This loss of life was preventable and reprehensible, particularly coming at the hands of federal agents.”
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