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.”
Federal Government
DOE investigates Smith College’s trans-inclusive policy
New investigation into the historic, exclusive all-women’s college signals a ramp-up by the Trump administration in rolling back transgender rights.
The U.S. Department of Education announced on Monday that it opened an investigation into Smith College for admitting transgender women.
Smith College, a private and famously all-women’s college in Northampton, Mass., established in 1871 and opened in 1875, has a long list of women who make up its historic alumni — including first ladies, influential political figures, and cultural leaders.
The DOE released a statement about the investigation into the institution through the Department’s Office for Civil Rights, saying it was looking into the possibility that Title IX of the Education Amendments of 1972 was violated by allowing trans women, referred to in the statement as “biological males,” into women’s intimate spaces protected by IX.
The statement explicitly highlighted that this stems from trans women being granted “access to women-only spaces, including dormitories, bathrooms, locker rooms, and athletic teams” while also allowing their audience into the school itself.
This is the first time the Trump-Vance administration has taken a step into admissions processes, a stark jump past investigating policies that allowed trans women to participate in women’s sports and use women’s bathrooms, and allows for the administration to go more after trans acceptance policy as a whole.
Smith’s admission policy allows for “any applicants who self-identify as women,” including “cis, trans, and nonbinary women,” according to the college’s website, and has since 2015, when it updated its policy.
“The college is fully committed to its institutional values, including compliance with civil rights laws,” Smith’s statement in response to the DOE’s investigation said. “The college does not comment on pending government investigations.”
“An all-women’s college loses all meaning if it is admitting biological males,” said Assistant Secretary for Civil Rights Kimberly Richey. “Allowing biological males into spaces designed for women raises serious concerns about privacy, fairness, and compliance under federal law. The Trump administration will continue to uphold the law and fight to restore common sense.”
This move continues to align with actions the Trump-Vance administration has taken to curtail LGBTQ — and specifically trans — rights in America, as members of the administration attempt to break down safeguards and protections that have long been used to protect marginalized communities.
Since Trump took office in his second term, there have been significant legal challenges. According to the National LGBTQ+ Bar Association, there are over 35 court cases that have emerged since his second swearing-in that directly relate to the administration’s attempts to minimize the rights and protections of trans Americans — from medical care and educational protections to military policy.
Much of this anti-trans policy direction was outlined beginning in 2022 with the Project 2025 playbook, which Trump officials have used as a guide to scale back protections for LGBTQ people, Black Americans, poor and Indigenous communities, while also increasing costs for lower-income Americans and providing tax cuts to the wealthy and ultra-wealthy. The plans also “erode” Americans’ freedoms and remove crucial checks and balances that have allowed the executive branch to remain in line with the Constitution without becoming too powerful over either the courts or the legislative branch.
Ukraine
Ukrainian MPs advance new Civil Code without protections for same-sex couples
Advocacy groups say proposal would ‘contradict European standards’
Ukrainian lawmakers have advanced a proposed new Civil Code that does not contain legal protections for same-sex couples.
The Kyiv Independent reported the proposal passed on its first reading on April 28 by a 254-2 vote margin.
The newspaper notes more than two dozen advocacy groups in a statement said some of the proposed Civil Code’s provisions “contradict European standards” and “violate Ukraine’s commitments under its EU accession process.”
“The most worrying provisions are those that make it impossible for a court to recognize the existence of a family relationship between people of the same sex,” the statement reads. “This overturns the already established case law on this issue, and closes the only legal avenue that allows partners to somehow protect their rights in individual cases.”
“Moreover, the draft completely ignores the obligations that Ukraine should have already fulfilled as part of its accession to the EU, as it lacks provisions that would allow people of the same sex to register their relationships,” it adds.
“The provisions also stipulate that all marriages concluded by people who have changed their gender automatically become invalid,” the statement further notes. “This is not just stagnation in the field of human rights or lack of progress on the path to European integration, but an actual setback in the legal sphere.”
Olena Shevchenko, chair of Insight, a Ukrainian LGBTQ advocacy group, in an April 28 Facebook post said the new Civil Code “is a step back on upholding the rights of women and the LGBT+ community in Ukraine.”
The Ukrainian constitution defines marriage as between a man and a woman.
President Volodymyr Zelenskyy in 2022 publicly backed civil partnerships for same-sex couples.
The Ukrainian Supreme Court on Feb. 25 recognized Zoryan Kis and Tymur Levchuk — a gay couple who has lived together since 2013 and married in the U.S. in 2021 — as a family. Ukraine the day before marked four years since Russia began its war against the country.
New York
Gay ICE detainee freed after 150 days in detention
Cayman Islands native taken into custody before green card interview
Following nearly half a year in U.S. Immigration and Customs Enforcement detention, Allan Marrero has been released and is back home with his husband in New York.
Marrero spent 150 days in ICE custody, held in multiple detention centers across the U.S. after missing an immigration court hearing while in a rehabilitation program for alcohol addiction — a circumstance widely considered “good cause” for failing to appear.
The Washington Blade first reported on Marrero’s case in March after the Cayman Islands native was detained by ICE officers during what was supposed to be a routine marriage-based green card interview at 26 Federal Plaza in New York City.
Marrero had been married to his husband, Matthew Marrero, for two years at the time of the interview. But almost immediately, the experience turned hostile.
The Rev. Amanda Hambrick Ashcraft, a minister at Middle Church in Manhattan who accompanied the couple to provide spiritual support, later described the process as “dehumanizing” and “barbaric.”
During the interview, it became clear the couple was facing an uphill battle. At one point, when asked how they met, Matthew Marrero instinctively looked over at his husband and was “snapped at” and told not to look at him. As the interview continued, the outlook only grew more grim.
Unaware that he had a prior removal order tied to the missed court date while he was in rehab, Allan Marrero was detained on the spot.
Over the following months, Allan Marrero was transferred through multiple detention facilities, including centers in Arizona and Texas, the Everglades Detention Facility — also known as “Alligator Alcatraz,” which has been described as having “unsanitary inadequate conditions” — and ultimately a detention center in Mississippi.
While in custody, Allan Marrero was denied access to prescription medication and, according to advocates, was psychologically pressured by ICE agents to self-deport rather than remain detained while his legal case proceeded.
Although a judge later reopened his case and granted bond after Allan Marrero provided proof that he had been in rehab — a valid medical reason for missing his court date — ICE used procedural mechanisms to keep him detained. A separate judge later issued a ruling denying relief, leaving Allan Marrero in custody.
On the outside, Matthew Marrero said his life felt as though it had been put on pause so ICE could meet enforcement quotas.
“[It feels like] somebody came in and kidnapped someone close to you and took away all of your control and power,” Matthew Marrero told the Blade on March 7. “You shouldn’t be able to have this much control over somebody’s life, especially if they are trying to do the right thing … You’re not going after criminals, you’re not going after the worst of the worst. You’re trying to fill a quota.”
Alexandra Rizio, Allan Marrero’s attorney with Make the Road New York, a progressive grassroots immigrant-led organization, told the Blade that “there seems to be an underlying element of cruelty baked into not only this administration, but everything.”
“It didn’t have to go down that way,” Rizio continued. “If someone goes in for a green card interview and their marriage interview, and they learn that they have a removal order, what the USCIS officer could have done is say, ‘Look, you have a removal order in your name. You need to go hire an attorney right away to get this taken care of. I can’t adjudicate your green card…’ And if you hire a lawyer, you know, you might be able to get it straightened out. Of course, that’s not what happened. And so ICE, which was in the building, were called and they did arrest Allan.”
The Marreros are scheduled to hold a press conference on Tuesday at Middle Church, where Allan Marrero will speak publicly for the first time about his detention.
For additional information on the press conference please visit middlechurch.org.
DOE investigates Smith College’s trans-inclusive policy
A reign defined by commitment and human impact
Ukrainian MPs advance new Civil Code without protections for same-sex couples
Gay ICE detainee freed after 150 days in detention
How do you vote a child out of their future?
Republicans attach five anti-LGBTQ riders to State Department funding bill
Tennessee’s trans data bill a frightening omen
New Zealand blood donation rules shift
The university that refuses to let go
