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.”
Cuba
Trans parent charged with kidnapping, allegedly fled to Cuba with child
Cuban authorities helped locate Rose Inessa-Ethington
Federal authorities have charged a transgender woman with kidnapping after she allegedly fled to Cuba with her 10-year-old child.
An affidavit that Federal Bureau of Investigation Special Agent Jennifer Waterfield filed in U.S. District Court for the District of Utah on April 16 notes the child is a “biological male who identifies as a female” and “splits time living with divorced parents who share custody” in Cache County, Utah.
Waterfield notes the child on March 28 “was supposed to be traveling by car to” Calgary, Alberta, “for a planned camping trip with his transgender mother, Rose Inessa-Ethington, Rose’s partner, Blue Inessa-Ethington, and Blue’s 3-year-old child.”
The affidavit notes the group instead flew from Vancouver, British Columbia, to Mexico City on March 29. Waterfield writes the Inessa-Ethingtons and the two children then flew from Mérida, Mexico, to Havana on April 1.
The 10-year-old child called her biological mother on March 28 after they arrived in Canada. The custody agreement, according to the affidavit, required Rose Inessa-Ethington to return the child to her former spouse on April 3.
“Interviews of MV [Minor Victim] 1’s family members provided significant concerns for MV 1’s well-being, as MV 1 was born a male, however, identifies as a female child, which is largely believed to be due to manipulation by Rose Inessa-Ethington,” reads the affidavit. “Concerns exist that MV 1 was transported to Cuba for gender reassignment surgery prior to puberty.”
The affidavit indicates authorities found a note in the Inessa-Ethingtons’ home with “instruction from a mental health therapist located in Washington, D.C., including instruction to send the therapist the $10,000.00 and instructions on gender-affirming medical care for children.”
The affidavit does not identify the specific “mental health therapist” in D.C.
A Utah judge on April 13 ordered Rose Inessa-Ethington to “immediately” return the child to her former spouse. The former spouse also received sole custody.
“Your affiant believes that due to the extensive planning and preparation exhibited by both Rose Inessa-Ethington and Blue Inessa-Ethington to isolate MV 1 and take MV 1 to Havana, Cuba, without notifying or requesting permission from MV 1’s mother indicates they are likely not planning to return to the United States,” wrote Waterfield.
The affidavit notes Cuban authorities found the Inessa-Ethingtons and the child.
A press release the U.S. Attorney’s Office for the District of Utah issued notes the Inessa-Ethingtons “were deported from Cuba” on Monday “with the assistance of the FBI.”
The couple has been charged with International Parental Kidnapping. The Inessa-Ethingtons were arraigned in Richmond, Va., on Monday. The press release notes a federal court in Salt Lake City will soon handle the case.
The New York Times reported the child is now back with their biological mother.
“We are grateful to law enforcement for working swiftly to return the child to the biological mother,” said First Assistant U.S. Attorney Melissa Holyoak of the District of Utah in the press release.
The case is unfolding against the backdrop of increased tensions between Washington and Havana after U.S. forces on Jan. 3 seized now former Venezuelan President Nicolás Maduro and his wife, Cilia Flores.
President Donald Trump shortly after he took office in January 2025 issued an executive order that directed the federal government to only recognize two genders: male and female. A second White House directive banned federally-funded gender-affirming care for anyone under 19.
The U.S. Supreme Court last year in the Skrmetti decision upheld a Tennessee law that bans gender-affirming care for minors.
Cuba’s national health care system has offered free sex-reassignment surgeries since 2008.
Activists who are critical of Mariela Castro, the daughter of former President Raúl Castro who spearheads LGBTQ issues as director of Cuba’s National Center for Sexual Education, have previously told the Washington Blade that access to these procedures is limited. The Blade on Wednesday asked a contact in Havana to clarify whether Cuban law currently allows minors to undergo sex-reassignment surgery.
Rehoboth Beach
Rehoboth Summer Kickoff Party set for May 15 with Ashley Biden
The Washington Blade’s 19th annual Summer Kickoff Party is scheduled for Friday, May 15 in Rehoboth Beach, Del.
Ashley Biden, daughter of President Joe Biden, has joined the list of speakers, the Blade announced. She will accept an award on behalf of her brother Beau Biden for his LGBTQ advocacy work as Delaware attorney general. (Her appearance was rescheduled from last year.)
The event, to be held this year at Diego’s (37298 Rehoboth Ave. Ext.) from 5-7 p.m., is a fundraiser for the Blade Foundation’s Steve Elkins Memorial Fellowship in Journalism, which funds a summer position reporting on LGBTQ news in Delaware. This year’s recipient will be introduced at the event.
The event will also feature remarks from state Rep. Claire Snyder-Hall. New CAMP Rehoboth Executive Director Dr. Robin Brennan and Blade editor Kevin Naff will also speak. The event is generously sponsored by Realtor Justin Noble, The Avenue Inn & Spa, and Diego’s.
A suggested donation of $25 is partially tax deductible and includes a drink ticket and light appetizers. Tickets are available in advance at bladefoundation.org/rehoboth or at the door.
District of Columbia
Curve magazine honors Washington Blade publisher
Lynne Brown named to 2026 Power List
Washington Blade Publisher Lynne Brown has been named to the 2026 Curve Power List celebrating LGBTQ+ women and nonbinary individuals in North America who are blazing trails in their chosen fields.
“From sports and entertainment icons to corporate leaders and lawmakers, these individuals are breaking barriers, challenging norms, and shaping the future,” Curve Foundation/Curve magazine said in announcing this year’s list, which includes ABC newscaster Robin Roberts, comedian/actress Hannah Einbinder, and singer/actress Renee Rapp, among others.
Brown has worked for the Washington Blade for nearly 40 years. She was named publisher in 2007 before becoming a co-owner in 2010.
“I am honored to be recognized by Curve magazine during Lesbian Visibility Week,” Brown said. “Receiving this Curve honor is twofold. I was an early subscriber to Curve. I enjoy the product and know its history. Its journalism, layout and humorous features have inspired me.
“As an owner/publisher, receiving recognition from a similar source acknowledges my work and efforts, with a sincerity I truly appreciate. Franco Stevens, the publisher of Curve, is a business person of duration, experience, and purpose. The fact that they are in the media business, and honoring me and my publication makes it a tiny bit sweeter.”
Nominations for the Curve Power List come from the community: peers, mentors, fans, and employers.
Curve explained the significance of the list in its announcement: “An annual, publicly nominated list of impactful LGBTQ+ women and nonbinary changemakers is crucial in current times to counter discrimination, legislative rollbacks, hostility, and the invisibility of queer women within mainstream and marginal spaces and endeavors. Such a list also fosters encouragement and solidarity, and elevates voices and achievements—from high-profile roles to under appreciated areas of life.”
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