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PDAB: A mysterious acronym that could affect your health

We must make medications affordable without sacrificing access

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(Photo by Ackley Road Photos/Bigstock)

As the executive directors of LGBTQ+ advocacy orgs in nearby states, we share an unshakeable commitment to the wellbeing of our communities. This commitment drives us and our organizations to advocate for health care affordability and accessibility, whether for gender-affirming health care and HIV treatment, or simple prevention measures and non-discrimination. And, it is why we oppose giving unaccountable advisory boards the power to set prices, and therefore threaten access, to critical, life-saving drugs such as HIV treatment medication. 

The LGBTQ+ community loves acronyms, but there’s one that we wish more people knew about: PDAB. A Prescription Drug Affordability Board is an appointed board that reviews the cost of some prescription drugs and determines if they are affordable. While this sounds good, the reality is that these boards may actually limit access to some important drugs, or even cause new affordability problems for patients. Plus, they have done little to consider patient or community input or demonstrate true accountability to the communities affected by their decisions – like our friends and family members living with HIV. 

Our organizations continue to raise concerns about PDABs and their expansion because of our serious concerns about their potential impact on LGBTQ+ people and people living with HIV and other chronic conditions. In fact, Virginia’s governor recently vetoed a bill that would have created a prescription drug affordability board. In his veto statement, Gov. Youngkin said: “This legislation risks limiting patient access to essential medication by prioritizing costs over medical necessity. Affordability of prescription drugs is a critical issue, but this proposal would instead compromise patient welfare in the Commonwealth of Virginia.”

Maryland’s PDAB was created in 2019 and has yet to bring down costs, even for those in the state health plans. FreeState Justice advocated against expanding the board’s scope to potentially set “upper payment limits” or UPLs for drugs purchased by state and local government health plans. UPLs can easily backfire and decrease access for many patients. We are particularly concerned about the potential unintended consequences of actions by these boards.

Because LGBTQ+ communities are disproportionately affected by HIV, our organizations advocate for the rights, equality, and well-being of people living with HIV. Thanks to significant advancements in science and treatment, HIV is now a manageable chronic illness. But only if we maintain access to the medications that people living with HIV rely on.

Beyond HIV, LGBTQ+ people experience higher needs for health care and steeper barriers to access than other populations. Almost half, or 47 percent, of LGBTQ+ people have a medical condition that requires monitoring or medication. And, LGBTQ+ people are more likely to delay or go without care due to cost issues. That is why PDABs, and in particular, upper payment limits, could exacerbate health disparities for the LGBTQ+ community.

In the handful of states with PDABs, these boards have made decisions that impact patients living with chronic conditions, including HIV– often without considering comments from advocates, patients and providers, or the programs that support patients in accessing and affording these treatments. 

Programs like the AIDS Drug Assistance Program and other supports help make the cost of HIV treatments affordable for patients. These programs were hard-won by advocates, who for years have held fast to the mantra: nothing about us, without us. This principle of HIV advocacy is directly opposite of what PDABs do: empower an appointed board of experts to make decisions about the affordability of HIV medications without any input from people living with HIV. 

In February, the Oregon PDAB heard many stakeholder comments on the importance of preserving access to HIV treatment. Advocates explained how drug assistance programs work and why patients need access to as many treatment options as possible. Despite this strong testimony, the board chose to review an HIV medication, Odesfey, against community recommendations.

Today many communities including people living with HIV are concerned and fearful about the serious impacts of federal funding cuts to health care. State PDABs are a costly tool, and they have not produced the savings they promised. This is a moment to preserve access and stabilize the system, and avoid any changes that could jeopardize the care people need.

There’s so much at stake for our communities when it comes to access to health care. We do need to address the high cost of prescription drugs, but there are better ways to do it that earnestly incorporate community input and take a more comprehensive look at the complex health care system. Our organizations are ready to bring LGBTQ+ people and people living with HIV into the discussion. By bringing patients, healthcare providers, and policymakers to the same table, we can come up with better solutions that truly make medications affordable without sacrificing access. Our north star is clear: a healthcare system that listens to all voices and makes sure everyone gets the care we need to thrive.


Phillip Westry is executive director of FreeState Justice in Maryland and Narissa Rahaman is executive director of Equality Virginia.

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Do not forget that Renee Good was queer

Far-right media link shooting victim’s sexuality to her protest of ICE

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(Washington Blade photo by Michael Key)

Please do not forget that Renee Nicole Good was a queer woman. 

Last week, Good, a 37-year-old American citizen, was shot and killed by a United States Immigration and Customs Enforcement agent in Minneapolis. Her wife Rebecca Good was present when the ICE agent shot her, standing outside their car. In the immediate aftermath, Minneapolis erupted with protests aimed at ICE in the city and Republican officials, including President Donald Trump and Vice President JD Vance, who argued the shooting was justified as an act of self-defense. 

In a press conference held this past Thursday, Vance told reporters that Good was “a victim of left-wing ideology.” “I can believe that her death is a tragedy,” Vance said,” while also recognizing that it is a tragedy of her own making.” Many criticized Vance’s statement, especially given how he blamed “left-wing extremism” for Charlie Kirk’s death in September on a Utah campus and Vance himself doubled down on condemning those who were celebrating the far-right podcaster’s fatal shooting.

Department of Homeland Security Secretary Kristi Noem implied that Good was a domestic terrorist while Fox News host Jesse Watters said that “the woman who lost her life was a self-proclaimed poet from Colorado with pronouns in her bio.” 

Laura Loomer, another far-right Trump supporter, tweeted, “‘She/her.’ Literally every time,” in response to what is believed to be Good’s Instagram account. Loomer and Watters both pointed out her pronouns are somehow part of the reason she was tied to ICE-related violence. 

As these comments from far right pundits show, far-right media coverage was quick to connect Good’s queerness to her work to inhibit ICE activity in Minneapolis. 

But while far-right news outlets highlighting Good’s queerness, centrist and even leftist news outlets also erased her wife’s experience, featuring interviews with Good’s mom and ex-husband but not her wife who was present for the shooting, feeding into the narrative that she was an “innocent” white mother while denying Good’s own agency in mobilizing for immigrants in her community. 

Nobody should be shot by government agencies ever, and these news outlets do not need to play into the construction of an “innocent” white woman for people to be outraged by her death. In fact, in doing so and denying Good’s queerness, they deny the way in which Good’s identity likely affected the way she interacted with the police. For queer and trans people, police are not safe people–in fact, Good’s last words deescalating the situation reflect the ways that homophobia and misogyny prime queer women, and all women to placate men’s emotions.

And it still didn’t work. After shooting her, the ICE agent called her a “fucking bitch,” in front of her wife who was kept away from Good while she bled out in her car.

When the media reinforces the narrative that she was an “innocent” mother, it reinforces the same sexism and racism that allows police brutality to continue. 

In an interview, author of the book After Purity released this past December, Sara Moslener said that “White womanhood has been constructed to require that white women sort of maintain purity within themselves as a way to maintain the purity within themselves as a way to maintain the purity of, the innocence of, the nation state. When the purity movement resurfaced in the 1990s, it was this recapitulation of the 19th century nation of sexual purity that was highly racialized.”

“It wasn’t something that was accessible to enslaved women, to other women of color, to immigrant women. It was this ideal of true womanhood that became connected to this idea of a strong nationstate. That rhetoric was then used to justify racial terror lynchings. If white women were threatened, you know, physically, bodily, culturally, they have the right to claim things. This was often used as a guise to justify violence and murder, especially against Black men. It even ties to the concept of Karen and the entitlement of white women, where they can weaponize their vulnerability,” Moslener said. 

Good’s shooting for many people was a breaking point for this very reason — because it represented the first time that they had witnessed a white person killed by an ICE agent or a member of the police. 

For some, their whiteness had been a source of safety because of the privilege of their skin color, or so they thought until Good’s murder this past week. In the aftermath, they are rethinking if this privilege will continue to protect them and what it can mean in a world where violence against white women’s bodies has long caused social backlash.

This is not a reason to stop fighting — Good was not the first person killed by ICE, not even the first person killed by ICE in 2026, but her whiteness is one of the central reasons that it incited outrage — because of a society that privileges and protects white women’s bodies. To describe Good as solely an “innocent” white woman, to deny her queerness, is to play into this performance of outrage about the brutalization of white women’s bodies.

If discussions of Good’s queerness — and persistent queerphobia against queer women — is not considered in our outrage, in our protests, we feed right into the same narratives that mean some police brutality, especially that against queer and trans people and people of color, goes completely unreported and unchallenged. 

This is state-sanctioned violence, and in the immediate aftermath of Good’s death, the Trump administration has demanded that people deny the evidence of their eyes and ears, has pushed the narrative that Good weaponized her vehicle against an ICE agent and that agent fatally shooting her was an act of self defense. This is categorically false but denying what we know to be true, what we can witness ourselves and understand, is the final step in fascism armed and funded by the government. 

But let’s be frank: This is not the first time that the American police or a government agent has murdered an unarmed person. Just under six years ago, George Floyd was murdered by police officers in the same city — his death was a breaking point for many who had witnessed police brutality against people of color. 

While people are eager to say Good’s name, we cannot say or remember her without remembering and saying the names of Black and Brown men and women, especially disabled people of color, who have been murdered in the hundreds by the police. Their names are often said, their murders often go unquestioned. 

People have been and will continue to say Good’s name largely because she was a white woman but the names of Black and Brown people go unsaid and unrecognized because of a system that performs outrage about violence against white bodies. What Good’s murder realized was how a system built on the protection of white women — a Christian nationalism committed to Social Purity — will still sacrifice white women who refuse to fall in line. 

Six federal prosecutors in Minnesota resigned this week over the Justice Department’s push to investigate Good’s widow. Among them was Joseph Thompson, a career federal prosecutor, who objected to investigating Good’s wife as well as the department’s refusal to investigate whether the shooting was lawful. 

In the signs, in the protests, in the prayers and pleas that you say and make in the aftermath of Good’s murder, do not deny her queerness, do not deny who she was and do not deny the work she did because in performing outrage against the murder of an “innocent” white mother we replicate the same systems of harm that hurt us all. 


Emma Cieslik is a museum worker and public historian.

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D.C. electoral bumper car season is in full swing

More than a dozen candidates running for incumbent Eleanor Holmes Norton’s seat

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Del. Eleanor Holmes Norton (D-D.C.) (Washington Blade photo by Michael Key)

The District of Columbia has entered into a challenging time not seen since Dr. Martin Luther King was murdered, the city burned and rioted and risked home rule being taken away. While statehood has twice passed the U.S. House of Representatives, the dream of being the 51st star on the American flag stagnates, to say the least. 

Currently according to Politics 1.com, there are already 14 Democrats including two sitting members of the City Council (At-Large Robert White and Ward 2’s Brooke Pinto)  and one Republican who have declared their candidacy to become the new voice in Congress. Unfortunately Congresswoman Eleanor Holmes Norton has refused to either announce her intentions to run for re-election again or gracefully acknowledge her time is over and she is ready to hand over the reins to continue the battles inflicted upon our home city. Congressional representation by press releases has simply got to stop as soon as possible!

Rank choice voting is going to be implemented in this 2026 cycle despite efforts to overturn or delay its implementation. Regardless of your thoughts on the new system, this will be one very interesting contest year to say the least. Rank choice … ready or not … here it comes!

Needless to say, the race for the Congressional seat is not the only major contest. Let us not forget the other positions up for election: the mayor, the attorney general, the chairman of the City Council, several ward and at-large races for the council. Add all these up and you will be looking at more moves on the political chess board than seen in the first Harry Potter film with the same results too. (As an aside, while the District of Columbia has no elected senators, it should be pointed out that any elected House member AND the District mayor have Senate floor privileges when in session.)

Before the June primary, it would be wise to make sure your voting registration is still current at the D.C. Board of Elections. Also, please urge friends not registered to do so as soon as possible. May we have the strength and will power to take back our city and stand up to those who want to destroy it.

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Zach Wahls stood up for us, now let’s stand with him

Young Iowa Democrat running for U.S. Senate

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Iowa state Sen. Zach Wahls (Photo courtesy of Wahls for Iowa)

It was 15 years ago, on Jan. 30, 2011, that a college student, Zach Wahls, bravely stood in front of the Iowa Legislature, and spoke out, defending the marriage rights of his two moms. On Jan. 28 we will celebrate the 15th anniversary of that speech. That was the first time I, and millions of others, heard of Zach Wahls. I know Zach had no idea that speech would propel him to national prominence. It went viral, and Zach was invited to appear on the Ellen DeGeneres show, among other appearances. 

At the time, he was an engineering student at the University of Iowa. As he has said, when he prepared his notes over the weekend for his Monday speech to the legislature, he had no idea where this would lead him. Today, so many of us, not just his moms, have the chance to repay him for what he did that day, when he defended all our rights in Iowa. In the past 15 years, Zach has never stopped standing up for the rights of his moms, and for all of us in the LGBTQ community. 

I first met Zach at an event in Washington, D.C., when he was leading the fight to allow gay men to be leaders in the Boy Scouts of America. Having been a Boy Scout myself, and an Explorer adviser, and having promoted scouting for the handicapped (the term we used back in those days) this was an important fight for me. I was both honored to meet Zach, and have the chance to join him in that fight. Since then, I have followed his career. First as he went to Princeton for his graduate degree, and then back to Iowa, he is a sixth generation Iowan, to run for, and win, a seat in the Iowa State Senate. He was then elected to the post of minority leader. Today, Zach is running to become the United States Senator from Iowa. Zach is a member of the younger generation so many of us want to see serving in Congress. 

As soon as I heard Zach was running, I endorsed him. Many of you may have read my endorsement column in the Blade. He was recently in Washington, D.C. for a fundraiser held at the Women’s National Democratic Club, where I had the pleasure of meeting his wife, and his absolutely adorable son. I kidded him he should never go campaigning without them. Now, it’s important to remember, he is running in Iowa. Not an easy race to win. He has a primary to win, which I firmly believe he will, and then his likely opponent is the ultra MAGA Republican Congresswoman Ashley Hinson (R-Iowa). A poll done just before Sen. Joni Ernst (R-Iowa) said she would not run again, had Zach leading her. That may have been part of the reason she dropped out. If you followed Zach’s career in Iowa, you understand why Iowans would vote for him. If you haven’t, take a look at his website, to get an idea of where Zach stands on the issues, and the things he has been doing to fight for all Iowans. His proposed federal legislation, Keep the Promise Act, would strengthen Social Security. Zach understands we need to defeat the fascists working with the felon in the White House, before they totally destroy our country. He understands we need to fight for affordable healthcare for all, for his constituents in rural Iowa, who are getting hit the hardest by the felon’s policies. Iowa farmers are losing their farms because of the felon’s policies. While continuing to fight for the LGBTQ community, Zach has always understood, we are part of the broader community he is now fighting for. 

I hope those of you who read this column, will join with me, support Zach, and be part of the Zoom call on Wednesday, Jan. 28, to celebrate the 15th anniversary of Zach’s speech to the Iowa Legislature. To join, click on this link, and sign up. I also ask you to share this link with everyone you know. Our community owes something to Zach, but everyone will benefit, if Zach Wahls ends up in the United States Senate. He will make us all proud. 


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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