Opinions
The ongoing march for LGB health care equality
Turning Supreme Court victories into real change

(Washington Blade photo by Michael Key)
By TIMOTHY M. WESTMORELAND
& JEFFREY S. CROWLEY
Two Supreme Court rulings this summer helped assure that the lesbian, gay, and bisexual (LGB) community reaches health care equality with their non-LGB peers.
The King v. Burwell case upheld the federal subsidies created by the Affordable Care Act (ACA) to help all income-eligible people access affordable private plan insurance in the ACA’s health care marketplaces. Consequently, nearly nine out of 10 LGB adults (88.9 percent) now have some form of health insurance up from just 78.2 percent before the ACA was implemented. These gains mirror those made across other segments of the population.
The ACA also includes provisions that prevent insurers and providers from discriminating against people based on sexual orientation or gender identity. This provision was not directly under question in the King v. Burwell case. If, however, the Court had ruled in favor of the law’s opponents, it is likely these protections would have reached far fewer people.
The second case, Obergefell v. Hodges—which established a Constitutional guarantee for marriage equality across the United States—also had an impact on health care in the LGB community. For the first time for many same-sex couples, a legally recognized marriage meant having access to a spouse’s health insurance. This is to say nothing of what the ruling clears up for same-sex couples when it comes to hospital visits, do-not-resuscitate orders, and the general effects on an individual’s mental and physical health of not having to worry about whether or not the government accepts the validity of a couple’s relationship.
But as was evident from the court battle over a Kentucky clerk’s responsibilities to issue marriage licenses to same-sex couples, compliance with the Supreme Court’s rulings does not always come immediately or easily. Further, despite the newfound marriage equality enshrined in law, the LGB community still faces barriers to accessing health care at equal rates as straight individuals. A new study of survey data, published in the October issue of Health Affairs and authored by researchers at the Urban Institute in Washington, D.C., illustrates that despite recent landmark cases moving the needle on LGB rights and quality, there is still work to be done.
The authors of the study find that even with the increase in the number of LGB adults with health insurance, nearly a quarter of all LGB adults (24.4 percent) reported having problems accessing care over the past year compared to just 16.1 percent of non-LGB adults reporting the same problems. This could be because many of the newly insured had yet to find a doctor or they had so many health issues that went untreated while they were uninsured that it has simply taken more than 12 months to access all the care that they require. Even more troubling is the finding that more than four in 10 LGB adults (42.6 percent) reported having an unmet care need as a direct result of costs over the last twelve months, compared to just 32.4 percent on non-LGB adults reporting the same problem.
While these gaps may lessen, this is no time for complacency. Now that the barrier of health coverage has been reduced, the LGB community and their providers must refocus efforts on eliminating other access barriers in order to eliminate disparities in knowledge of HIV status; adapting the health system to promote widespread, affordable access to pre-exposure prophylaxis to prevent HIV infection; working to ensure early and sustained access to antiretroviral therapy that leads to viral suppression; and routinely screening and treating for other sexually transmitted infections. It also means addressing a broader array of issues directly affecting LGB people including access to breast and cervical cancer screening and tobacco cessation services, among others. Before we turn our attention away from making the ACA work more effectively, however, ongoing advocacy and awareness-raising efforts are also needed in the LGB community about what health insurance options are available, and which plans best suit different individuals and families and their specific health needs.
Though the federal government and the court system have written some aspects of equality into law, the march is not over yet. It is now time to turn law into reality.
Timothy Westmoreland is professor from practice at the Georgetown University Law Center, as well as a senior scholar at the Law Center’s O’Neill Institute for National and Global Health Law. Jeffrey S. Crowley is a distinguished scholar and program director of the National HIV/AIDS Initiative at the O’Neill Institute.
Commentary
Washington Blade responds to concerns over White House pool duties
Inaccurate media reports create confusion but we stand with our colleagues
Last week, President Trump announced his unconstitutional ban of CNN, MSNow, and Politico from the White House. Coincidentally, on Monday, it was the Washington Blade’s turn to serve as the print pool reporter on duty covering the president’s actions that day. This important responsibility is shared and rotated among the print members with each serving roughly once per month. The Blade is the only LGBTQ outlet with a seat in the briefing room, a slot in the pool rotation, and membership in the White House Correspondents’ Association, something we fought for decades to secure after enduring years of discrimination, ridicule, and resistance to openly queer journalists working inside the White House. We take our responsibilities there seriously.
There are two pools that cover the president: broadcast and print. The other four members of the broadcast pool — ABC, CBS, NBC, and Fox News — agreed to boycott their pool duties. There has been no boycott among the print pool, which is a separate entity. I called the president of the White House Correspondents’ Association on Monday to confirm that no outlets in the print pool were boycotting.
A boycott by the Blade would set us back and lead to our expulsion from the pool and briefing room and our replacement by a right-wing outlet sympathetic to President Trump’s approach to attacking the media. The LGBTQ community is far better served with the Blade in the room than a far-right blogger taking our seat.
Let’s be clear: the Blade stands for diversity, equity, and inclusion and we stand for the First Amendment and freedom of the press. In solidarity with the broadcast pool, we made two important decisions on Monday — the first day anyone had to think about any of this. First, we refused to take or share any videos or still photos of the president, which would have undermined the broadcast boycott. Second, when Politico’s turn comes up for pool duty in mid-October, the Blade will not fill in and cover for them while they are banned. Politico must be readmitted and allowed to do their job.
After a rough day navigating and reporting on all of this, the Advocate published a reckless and inaccurate story suggesting that the Blade had crossed a picket line. Not true, as there is no print pool boycott. They claimed that I wouldn’t talk to their reporter. Also not true. I called their reporter within 90 minutes of receiving his message and he didn’t take the call or call me back. Their story named me and our White House reporter, immediately exposing us to public criticism and worse. The environment in D.C. is so toxic and even violent these days that subjecting our staff to unfair and false accusations like this invites harassment, doxxing, and worse. To do that without even talking to us is next level irresponsible and the antithesis of journalism.
On Tuesday, I talked to two reporters and an editor at the Advocate but they refused to retract anything in their inaccurate story. If the reporter had returned my call, I could have explained all of this but they are more concerned with clickbait and sensational headlines, a dangerous practice in these troubled times.
Back to the pool. The Blade was in the briefing room in the Reagan era, when Press Secretary Larry Speakes made jokes about AIDS and the reporters in the room laughed out loud. We endured all of that abuse and worse for decades, always standing in the back of the room and never being called on. The Blade’s journalists persevered. When President George W. Bush was re-elected in 2004, the Blade’s White House credentials were revoked amid an earlier press crackdown. Notably, no one boycotted or stood up for us. When Barack Obama won election in 2008, I received an email from his communications director informing me that effective midnight on Jan. 20, 2009, the Blade’s credentials would be restored.
So we have had quite a ride navigating administrations and their changing requirements for gaining access but always playing the long game. As Barney Frank used to say, “If you’re not at the table, then you’re probably on the menu.” The Blade is at the table and we do our best to ensure the LGBTQ community’s issues are addressed by both parties.
Thanks for reading and supporting the Blade’s work. If you have questions about our approach, you can reach me at [email protected].
Kevin Naff is editor of the Washington Blade. Reach him at [email protected].
Opinions
Young people should know history of the fight for human rights
Trump is working to erase contributions of marginalized people
When talking with otherwise really smart young people, I am amazed how little knowledge many of them have about the fight for human rights in the United States. Our country was founded by white men, who didn’t think about giving full rights to Black Americans, women, the LGBTQ community (what they knew of it, or called it). They wrote in the Declaration of Independence, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” But that referred to all white men, and intentionally didn’t mention women. For 250 years, the country has been trying to make up for that, and making progress in fits and starts. We have yet to fully succeed. Today the felon, and his fascist aides, in the White House, are working daily to take us backwards.
For that reason alone, it is important for younger generations to understand the fight for human rights, know who was fighting for those rights, and understand it is an ongoing fight. Often, when listening to some millennials speak, one would think the world began with them. They either forgot, or never learned, about all those who fought for the rights they now have. I realize this was true for previous generations as well. In 2016 I co-hosted a fundraiser for Pete Buttigieg during his run for president. He is an undeniably brilliant guy. Yet when he spoke of marriage equality, he just thanked Justice Kennedy for it. I reminded him after he spoke, while it’s nice to thank Kennedy for his vote, it shouldn’t be done without acknowledging the many activists who worked for decades, to get to the point that allowed Kennedy to cast that vote. In the same way it was clear to me during the Hillary Clinton campaign for president, many young women didn’t understand the work many of their own mothers had done, to fight for their right to control their own healthcare, and women’s rights in general. They took for granted the rights they had. Now, after losing some of them, many will realize the fight for their rights is never-ending.
When I speak to younger members of the LGBTQ community, I am amazed how many don’t know the history of the AIDS epidemic, many thinking it was always a disease you could deal with by taking medication. They don’t understand the work so many activists did to bring attention to this devastating disease, and get the healthcare so many needed. Those like Cleve Jones, Larry Kramer, Dr. Anthony Fauci, and so many others. Recently, I realized how many young women don’t know the names of Gloria Steinem, Betty Friedan, Shirley Chisholm, Bella Abzug — women who fought for their rights. And this is just recent history, no less knowing about the Suffragettes, the strong women who fought for their right to vote. I’ve met young women who don’t know what the ERA is, and others who think it passed. Many don’t know the nation couldn’t get 38 states to approve an amendment to include them in the Constitution. The same for young members of the LGBTQ community who don’t know what the Equality Act is. Others think it passed, and are shocked when told it didn’t and in 27 states, they can be married on Sunday, and kicked out of their home, and fired from their job, on Monday. They don’t know names like Frank Kameny, Harvey Milk, Barney Frank, or the history of the Mattachine Society, or the Stonewall Riots.
Our current president is trying to wipe out all this history, and reverse any progress that has been made. Knowing this, it makes it even more important for school systems across the nation to fight to educate our children. We should ensure no child can graduate high school, without taking a course called “The 250-year fight for human rights in the United States.” They need to understand the history, and learn about the people who fought for their rights. They need to know how far we have come in 250 years, and understand, as we begin the next 250, how far we still have to go, to ensure real, full equality, for all.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Commentary
What LGBTQ veterans are building after ‘Don’t Ask, Don’t Tell’
DADT repeal took effect on Sept. 20, 2011. Trans servicemember ban reinstated
Fifteen years ago this month, the repeal of “Don’t Ask, Don’t Tell” took effect. At the time, the importance of the change was obvious: gay, lesbian, and bisexual Americans would no longer have to hide who they were to wear the uniform. What was harder to see was what would follow: a generation of LGBTQ veterans able to carry their service openly into American civic life.
Earlier this month, Alaska state Rep. Andrew Gray, an Army veteran, stood before the Anchorage Assembly and asked the city to recognize Sept. 20 as LGBTQ Veterans Day.
His former command sergeant major, Mike Grunst, followed him to the microphone. A 35-year veteran who had served in combat, Grunst called troops who had served while hiding who they were “the bravest I have ever served with.”
Then Denise Sudbeck stepped forward. A Vietnam-era Navy veteran, she thanked the country for the privilege of serving and asked that the next generation have the same chance.
The Assembly approved the recognition.
Nothing about the scene required a new vocabulary. A veteran made a request of his community. A commander vouched for those who served beside him. Another veteran asked that younger Americans inherit the opportunity she valued. They entered the civic record simply as veterans.
That identity can do more than win recognition.
When federal policy abruptly ended the careers of transgender servicemembers this year, veterans and servicemembers in California began asking a practical question: What happens when those Americans come home?
Republican Assemblyman Jeff Gonzalez, a Marine combat veteran, began one hearing with questions about transgender military service. He listened as veterans explained how the military handles medical care and deployment case by case.
Then the discussion turned to separation.
“I don’t wanna see any veteran homeless,” Gonzalez said. Before the hearing ended, he was asking: “How can I help? How can I understand? How can I be a good advocate?”
The legislation that followed would provide housing, employment and transition assistance to discharged servicemembers. Republican state Sen. Shannon Grove spoke for it. The Senate passed it 32 to 0.
Americans have plainly not settled their disagreements over transgender people. Nor should military service be a prerequisite for rights that belong to every citizen.
But military service creates relationships that are difficult to reduce to the abstractions of the culture war. Before a legislature, “the transgender issue” can become a veteran who deployed, an officer who led troops, or the person who once stood beside you.
The political question changes because the human relationship has already changed.
The pattern is beginning to appear across the country. Kansas is among the states recognizing LGBTQ Veterans Day for the first time this year. New York and Virginia are pursuing broader state-level programs for LGBTQ veterans.
Sept. 20 is deliberate. On that day in 2011, “Don’t Ask, Don’t Tell” ended.
We usually remember repeal for what LGBTQ Americans gained: the ability to serve openly. Fifteen years later, we can also see what the country gained.
A gay veteran can stand before his local government beside the commander who once led him. A transgender servicemember can sit before a legislator who begins with doubts and ends by asking how he can help. A veteran from an older generation can ask her neighbors to give those who follow her the same chance to serve.
This is citizenship in practice.
The enduring legacy of “Don’t Ask, Don’t Tell” repeal is not only that Americans were finally allowed to serve openly. It is also what they can now build after coming home.
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