Local
Will health reform make AIDS groups obsolete?
HIV clinics face new competition as clients obtain insurance by 2014
‘Health care reform has been a real motivator around us improving the quality of what we do because we know we’re going to have to get better,’ said Don Blanchon, executive director of Whitman-Walker Clinic. (Washington Blade photo by Michael Key)
When the AIDS epidemic burst on the scene in the 1980s, a cadre of volunteers –many from the LGBT community — emerged to provide compassionate and dedicated care for the sick and dying, services that government agencies and existing charitable groups were not providing.
Since that time, the mostly volunteer-driven, community-based AIDS clinics and advocacy groups created back then have evolved into professionally run facilities receiving millions of dollars in state and federal funds. Like the Whitman-Walker Clinic in D.C., many of the clinics and advocacy groups provide a vast array of services for people with HIV and AIDS, most of whom can’t afford private health insurance.
But in March, Congress approved and President Obama signed into law a sweeping health care reform measure called the Patient Protection and Affordable Care Act. Obama administration officials say it will result in more than 94 percent of all Americans being covered by some form of private or public health insurance by 2014.
Although most AIDS activists and officials with local and national AIDS organizations have hailed the health care reform measure as an unprecedented benefit to people with HIV and AIDS, some believe the law could prompt large numbers of patients to leave the community-based clinics and seek medical care elsewhere.
With a possible loss of clients, community AIDS clinics would be in jeopardy of losing government funding, which is based on the number of clients served. It would be ironic, some have said, if the benefits of healthcare reform result in the closing of community institutions that have served people with AIDS during a time of need.
“The LGBT community and people living with HIV are going to have options that they may not have now,” said Don Blanchon, executive director of the Whitman-Walker Clinic, which has served people with HIV and AIDS since the epidemic began.
“And so for us, health care reform has been a real motivator around us improving the quality of what we do because we know we’re going to have to get better,” Blanchon said. “We know at some point in time almost every District resident is going to have some type of public or private insurance, which means they, in theory, are going to be able to go to a lot of different places for their care.”
Blanchon noted that a financial crisis that Whitman-Walker faced four years ago forced it to take steps that have placed it in an excellent position to flourish under the health care reform law. The Clinic’s board hired Blanchon, a managed care expert, to help the Clinic survive at a time when private donations and fundraising efforts were faltering.
With the board’s full approval and over the objections of some of the Clinic’s longtime supporters and volunteers, Blanchon transformed the Clinic from a volunteer model operation into a managed care type facility with the status known as a “federally qualified health center look alike.”
According to Blanchon and other Clinic officials, the new status enables the Clinic to accept a greater number of Medicaid patients as well as patients with a wide range of private health insurance. Patients covered by these programs allow the Clinic to obtain reimbursement for its services by doctors, its own pharmacy, and other service providers, eliminating the need to rely more on private donors.
Unlike other community-based AIDS clinics, Whitman-Walker will be in an excellent position to take on new patients or retain its existing ones as the new health care reform measure enables the majority of patients to obtain private insurance or Medicaid.
Under the Patient Protection and Affordable Care Act, all lower income individuals, including people with HIV, will be eligible for Medicaid coverage if they fall below 133 percent of the federal poverty level, where an individual has an income of about $15,000 a year or lower.
Under current federal law, low-income people with full-blown AIDS are already eligible for Medicaid coverage. For years, Congress has declined to pass legislation proposed by AIDS advocacy groups calling for Medicaid coverage for low-income people with HIV, with the intent of providing medical services to prevent them from advancing to AIDS.
The new law makes that legislation unnecessary after 2014, when the Medicaid provision takes effect.
Jeffrey Crowley, director of the White House Office of National AIDS Policy, calls the Patient Protection and Affordable Care Act one of the nation’s most significant advances for the care and treatment for people with HIV/AIDS.
“It will fundamentally expand access to insurance coverage for people living with HIV,” he said. “Much of that will be through the mandatory expansion of the Medicaid program.”
He said that similar to all Americans, people with HIV will also be eligible for private insurance coverage through a variety of options based on their income. Among the options will be the purchase of insurance coverage through competitive insurance exchanges. He noted that by 2014, no insurance company can deny coverage based on pre-existing conditions such as HIV or other illnesses.
Keith Maley, a spokesperson for the U.S. Department of Health and Human Services, which will administer most of the provisions of the new health care law, said people with HIV and other illnesses could be immediately eligible for private insurance coverage through high-risk pools.
Those eligible for the immediate coverage must show that they have had no health insurance coverage for six consecutive months, have a chronic health condition, and are not eligible for employer provided insurance or Medicaid.
Crowley noted that the new law has other immediate benefits for people with HIV and other chronic health conditions. As of July 1, private health insurers can no longer use a rescission, a practice that cancels a policy when someone gets sick and needs expensive treatment.
He said the law also immediately prohibits insurers from imposing a lifetime “cap” on insurance benefits. Annual limits on coverage or benefits will end in 2014, he said.
Crowley, a gay man who previously worked for the National Association of People with AIDS before joining the White House staff, said he expects most community-based AIDS clinics and local and national AIDS advocacy organizations to continue to exist after the health care law is fully implemented in 2014. However, he said most will have to change the way they do business.
“I think we know from our experience with HIV that we’ve built up a great HIV workforce,” he said. “We have a lot of expertise. I want to make sure as we build and expand an insurance system through the Affordable Care Act that these HIV medical providers are making sure that they’re part of this new system.”
“Some of them might only receive funding through the Ryan White programs, and I would say they need to look at their future and say that they need to be part of the new insurance system,” he said. “But there’s no question that we’re going to need their expertise and commitment at providing medical care going forward.”
Crowley’s reference to the Ryan White CARE Act, the largest existing federal program created to provide care for low-income people with HIV/AIDS, is expected to change significantly following the full implementation of the Patient Protection and Affordable Care Act, according to officials with a number of national AIDS groups.
Nearly everyone, including Crowley, agrees that the Ryan White program should remain, but most likely in a scaled back form. Congress passed the act in the 1990s as a means of helping cities and states that were grappling with the enormous burden of providing care for people with HIV/AIDS who lacked health insurance coverage and were overwhelming local and state hospitals and health care facilities.
Carl Schmid, director of federal affairs for the AIDS Institute, a national advocacy organization; Michael Weinstein, executive director of the AIDS Healthcare Foundation, the nation’s largest AIDS-related medical care provider; and Jose Zuniga, executive director of the International Association of Physicians in AIDS Care, each said they believe the Ryan White program will be needed for at least some services the new law does not provide.
“It will not solve all of our access issues,” said Schmid of the new health care measure.
Weinstein said that state programs to expand health insurance have been slow to enroll as many people as expected for a variety of reasons, some bureaucratic in nature.
“So I wouldn’t expect an overnight change in 2014,” he said, pointing to a need to keep the Ryan White program operating for some time after 2014.
Weinstein said that in some states, including California, Medicaid reimbursement for medical services is far lower than that provided by private insurance companies. He predicted that people with HIV or AIDS who obtain coverage under the new law through Medicaid might be turned away by private doctors who declined to take all Medicaid patients.
“The reimbursement that we receive from Medicaid or from private insurance is far below our cost and far below what we get from Ryan White,” he said of the AIDS Healthcare Foundation. “So we will suffer a hit in that regard as well as most providers.”
Weinstein said his organization has a wide variety of income streams and the lower reimbursements under the new law “won’t be a fatal blow to us.”
Blanchon of Whitman-Walker said the benefits of the new law greatly outweigh its possible shortfalls.
“Health care reform is going to be a real help to our patients and clearly to the Clinic because more of our patients are going to be insured under more comprehensive benefit programs,” he said.
“And what that means at the end of the day is the Clinic is not going to have to shell out as much free care. So we’re going to be in a position to be able to offer more services to more patients and keep them healthy, and ultimately that’s what we’re here for.”
The Comings & Goings column is about sharing the professional successes of our community. We want to recognize those landing new jobs, new clients for their business, joining boards of organizations and other achievements. Please share your successes with us at [email protected].
The Comings & Goings column also invites LGBTQ+ college students to share their successes with us. If you have been elected to a student government position, gotten an exciting internship, or are graduating and beginning your career with a great job, let us know so we can share your success.
Congratulations to R. Warren Gill III, M.Div., M.A. on being appointed as the development manager at HIPS. Upon his appointment, Gill said, “For as long as I’ve lived in Washington, D.C., I’ve followed and admired the life-saving work HIPS does in our communities. I’m proud to join the staff and help strengthen the financial support that sustains this work.”
Gill will lead fundraising strategy, donor engagement, and institutional partnerships. HIPS promotes the health, rights, and dignity of individuals and communities impacted by sexual exchange and/or drug use due to choice, coercion, or circumstance. HIPS provides compassionate harm reduction services, advocacy, and community engagement that is respectful, non-judgmental, and affirms and honors individual power and agency.
Gill has built a career at the intersection of progressive politics, advocacy, and nonprofit leadership. Previously he served as director of communications at AIDS United, supporting national efforts to end the HIV epidemic. Prior to that he had roles including; being press secretary for Sen. Bernie Sanders during the 2016 presidential primary, and working with the General Board of Church and Society, the United Methodist Church, the denomination’s social justice and advocacy arm.
Gill earned his bachelor’s degree in philosophy and religious studies, Jewish Studies, Stockton University; his master’s degree in political communication from American University, where his graduate research focused on values-based messaging and cognitive linguistics; and his master of Divinity degree from the Pacific School of Religion.
District of Columbia
Judge denies D.C. request to dismiss gay police captain’s anti-bias lawsuit
MPD accused of illegally demoting officer for taking family leave to care for newborn child
A U.S. District Court judge on Jan. 21 denied a request by attorneys representing the D.C. Metropolitan Police Department to dismiss a lawsuit filed by a gay captain accusing police officials of illegally demoting him for taking parental leave to join his husband in caring for their newborn son.
The lawsuit filed by Capt. Paul Hrebenak charges that police officials violated the U.S. Family and Medical Leave Act, a similar D.C. family leave law, and the Constitution’s Equal Protection Clause by refusing to allow him to return to his position as director of the department’s School Safety Division upon his return from parental leave.
It says police officials transferred Hrebenak to another police division against his wishes, which was a far less desirable job and was the equivalent of a demotion, even though it had the same pay grade as his earlier job.
In response to a motion filed by attorneys with the Office of the D.C. Attorney General, which represents and defends D.C. government agencies against lawsuits, Judge Randolph D. Moss agreed to dismiss seven of the lawsuit’s 14 counts or claims but left in place six counts.
Scott Lempert, the attorney representing Hrebenak, said he and Hrebenak agreed to drop one of the 14 counts prior to the Jan. 21 court hearing.
“He did not dismiss the essential claims in this case,” Lempert told the Washington Blade. “So, we won is the short answer. We defeated the motion to dismiss the case.”
Gabriel Shoglow, a spokesperson for the Office of the D.C. Attorney General, said the office has a policy of not commenting on pending litigation and it would not comment on the judge’s ruling upholding six of the lawsuit’s initial 14 counts.
In issuing his ruling from the bench, Moss gave Lempert the option of filing an amended complaint by March 6 to seek the reinstatement of the counts he dismissed. He gave attorneys for the D.C. attorney general’s office a deadline of March 20 to file a response to an amended complaint.
Lempert told the Blade he and Hrebenak have yet to decide whether to file an amended complaint or whether to ask the judge to move the case ahead to a jury trial, which they initially requested.
In its 26-page motion calling for dismissal of the case, filed on May 30, 2025, D.C. Office of the Attorney General attorneys argue that the police department has legal authority to transfer its officers, including captains, to a different job. It says that Hrebenak’s transfer to a position of watch commander at the department’s First District was fully equivalent in status to his job as director of the School Safety Division.
“The Watch Commander position is not alleged to have changed plaintiff’s rank of captain or his benefits or pay, and thus plaintiff has not plausibly alleged that he was put in a non-equivalent position,” the motion to dismiss states.
“Thus, his reassignment is not a demotion,” it says. “And the fact that his shift changed does not mean that the position is not equivalent to his prior position. The law does not require that every single aspect of the positions be the same.”
Hrebenak’s lawsuit states that “straight” police officers have routinely taken similar family and parental leave to care for a newborn child and have not been transferred to a different job. According to the lawsuit, the School Safety Division assignment allowed him to work a day shift, a needed shift for his recognized disability of Crohn’s Disease, which the lawsuit says is exacerbated by working late hours at night.
The lawsuit points out that Hrebenak disclosed he had Crohn’s Disease at the time he applied for his police job, and it was determined he could carry out his duties as an officer despite this ailment, which was listed as a disability.
Among other things, the lawsuit notes that Hrebenak had a designated reserved parking space for his earlier job and lost the parking space for the job to which he was transferred.
“Plaintiff’s removal as director at MPD’s School Safety Division was a targeted, premeditated punishment for his taking statutorily protected leave as a gay man,” the lawsuit states. “There was no operational need by MPD to remove plaintiff as director of MPD’s School Safety Division, a position in which plaintiff very successfully served for years,” it says.
In another action to strengthen Hrebenak’s opposition to the city’s motion to dismiss the case, Lempert filed with the court on Jan. 15 a “Notice of Supplemental Authority” that included two controversial reports that Lempert said showed that former D.C. Police Chief Pamela Smith put in place a policy of involuntary police transfers “to effectively demote and end careers of personnel who had displeased Chief Smith and or others in MPD leadership.”
One of the reports was prepared by the Republican members of the House Oversight and Government Reform Committee and the other was prepared by the office of Jeanine Pirro, the U.S. attorney for D.C. appointed by President Donald Trump.
Both reports allege that Smith, who resigned from her position as chief effective Dec. 31, pressured police officials to change crime reporting data to make it appear that the number of violent crimes was significantly lower than it actually was by threatening to transfer them to undesirable positions in the department. Smith has denied those claims.
“These findings support plaintiff’s arguments that it was the policy or custom of MPD to inflect involuntary transfers on MPD personnel as retaliation for doing or saying something in which leadership disapproved,” Lempert says in his court filing submitting the two reports.
“As shown, many officers suffered under this pervasive custom, including Capt. Hrebenak,” he stated. “Accordingly, by definition, transferred positions were not equivalent to officers’ previous positions,” he added.
Virginia
LGBTQ rights at forefront of 2026 legislative session in Va.
Repeal of state’s marriage amendment a top priority
With 2026 ramping up, LGBTQ rights are at the forefront of Virginia politics.
The repeal of Virginia’s constitutional amendment that defines marriage as between a man and a woman is a top legislative priority for activists and advocacy groups.
The Virginia Senate on Jan. 17 by a 26-13 vote margin approved outgoing state Sen. Adam Ebbin (D-Alexandria)’s resolution that would repeal the Marshall-Newman Amendment. The Virginia House of Delegates earlier this month passed it.
Two successive legislatures must approve the resolution before it can go to the ballot.
The resolution passed in 2025. Voters are expected to consider repealing the amendment on Nov. 3.
The Virginia General Assembly opened with an introduction of a two-year budget — Virginia’s budget runs biannually.
In 2024 some funding was allocated to LGBTQ causes, and others were passed over. This year’s proposed budget leaves room for funding for a host of LGBTQ opportunities. One specific priority that Equality Virginia is promoting would ensure the state budget expands healthcare for LGBTQ individuals and extending gender affirming care.
Equality Virginia Communications Director Reed Williams told the Washington Blade the organization is also focused on passing three main budget amendments, and ensuring “LGBTQ+ students and their teachers have resources to navigate and address mental health challenges in K-12 schools.”
Along with ensuring school training, the organization wants funding in hopes of “establishing enhanced competency training for Virginia’s 988 Lifeline counselors and support staff to provide affirming care for LGBTQ+ youth.” This comes after the Trump-Vance administration shut down the specific hotline for LGBTQ young people that callers could previously reach if they called 988.
On a federal level, protections and health care access for LGBTQ people has taken a hit, as the Trump-Vance administration has continued to issue executive orders affecting the health care system. LGBTQ people no longer have federal legal health care protections, so local and state politics has become even more important for LGBTQ rights groups.
Equality Virginia has urged its supporters to call their local senators and stress the importance of voting to expand health care protections for LGBTQ people. The organization also plans to hold information sessions and a lobby day on Feb. 2.
Equality Virginia is tracking bills on its website.
Convert rent check into an automatic investment, Marjorie!
Swing actor Thomas Netter covers five principal parts in ‘Clue’
Queer liberation is your liberation
A ‘Battle’ we can’t avoid
LGBTQ Ugandans targeted ahead of country’s elections
McPike prevails in ‘firehouse’ Dem primary for Va. House of Delegates
Faith programming remains key part of Creating Change Conference
LGBTQ Iranians join anti-government protests
The power of no
