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.”
Local
D.C., Va., Md. to commemorate World AIDS Day
Cathedral of St. Matthew the Apostle will hold a Mass, candlelight prayer vigil
The D.C. area will observe World AIDS Day on Dec. 1 through a variety of community events.
Established by the World Health Organization in 1988, World AIDS Day aims to raise awareness about HIV/AIDS and honor the individuals affected by the epidemic. The global theme for 2025 is “overcoming disruption, transforming the AIDS response.”
Washington
DC Health will host a World AIDS Day event at the Martin Luther King, Jr. Library from noon to 9 p.m on Dec. 1. Attendees can expect live performances, free food and free HIV testing.
The all-day event will also feature community resources from DC Health, DC Public Library, DC Health Link, Serve DC, and the Mayor’s Office of LGBTQ Affairs.
The Lily and Earle M. Pilgrim Art Foundation is partnering with Visual AIDS, a New York-based non-profit that uses art to fight AIDS, to reflect on World AIDS Day with a film screening on Dec. 1.
The David Bethuel Jamieson Studio House at Walbridge in Mount Pleasant will premiere “Meet Us Where We’re At,” an hour-long collection of six videos. The free screening highlights the complexity of drug use in intersection with the global HIV epidemic.
The videos, commissioned by artists in Brazil, Germany, Nigeria, Puerto Rico and Vietnam, showcase the firsthand experience of drug users, harm reduction programs, and personal narratives. The program intends to showcase drug users as key individuals in the global response to HIV.
In addition to streaming the videos, the event will include an evening potluck and conversation led by Peter Stebbins from 6-8 p.m.
The Cathedral of St. Matthew the Apostle will hold a 5:30 p.m. Mass and candlelight prayer vigil at 6 p.m. in honor of World AIDS Day on Dec. 1. The event is open to all and includes a subsequent reception at 6:30 p.m.
The Capital Jewish Museum is hosting a speaker series on Dec. 2 from 6:30-8 p.m. that explores the response to AIDS within the Jewish community. Speakers include LGBTQ psychiatrist Jeffrey Akman, physician assistant Barbara Lewis and Larry Neff, lay service leader at Bet Mishpachah, a synagogue founded by LGBTQ Washingtonians. Heather Alt, deputy director of nursing at Whitman-Walker Health, will moderate the event.
The program is free for museum members. General admission is $10 and Chai tickets, which help subsidize the cost of general admission, are $18. Tickets include access to LGBT Jews in the Federal City, a temporary exhibition that collectively explores Washington, Judaism, and LGBTQ history. The exhibition is on view through Jan. 4, 2026.
Virginia
Alexandria Mayor Alyia Gaskins and local residents will commemorate World AIDS Day on Dec. 1 at the Lee Center.
The event, which is free to attend, will include music, choir performances, educational moments and more. The commemoration will be held from 6:30-8:30 p.m.
Maryland
The Frederick Center will host talks, tabling and a raffle in honor of World AIDS Day. The Frederick County Health Department will conduct free HIV testing.
The event, which is free to attend, will be held on Nov. 30 from 1-4 p.m. The Frederick County Health Department always offers free, walk-in HIV testing on Tuesdays and Fridays from 9 a.m. to 3 p.m.
The Prince George’s County Alumnae Chapter of Delta Sigma Theta Sorority will host a community day of awareness in honor of World AIDS Day on Dec. 6 from 1 a.m. to 2 p.m. The free event will feature free, confidential HIV testing, private talks with medical professionals and health workshops.
The event will be held at Suitland Community Center in Forestville and will include breakfast and snacks.
Damien Ministries is commemorating World AIDS Day on Dec. 1 through the grand opening of the We the People Community & Wellness Collaborative. The event, held at 11:30 a.m. at 4061 Minnesota Avenue, N.E., is free to attend.
Damien Ministries is a faith-based non-profit committed to supporting those with HIV/AIDS.
Begin Anew, a Baltimore non-profit that provides education, outreach and resources to improve public health, wellness and economic stability, is hosting its 4th Annual World AIDS Day Community Celebration on Dec. 1 alongside community partners.
Hosted at the University of Maryland BioPark from noon to 3 p.m., the program will feature keynote speaker Jason E. Farley of the Johns Hopkins School of Medicine. The celebration will also dedicate awards to local heroes focused on fighting HIV/AIDS and promoting health equity.
The free event includes lunch, live entertainment and networking opportunities with health advocates and partners.
District of Columbia
Bowser announces she will not seek fourth term as mayor
‘It has been the honor of my life to be your mayor’
D.C. Mayor Muriel Bowser, a longtime vocal supporter of the LGBTQ community, announced on Nov. 25 that she will not run for a fourth term.
Since first taking office as mayor in January 2015, Bowser has been an outspoken supporter on a wide range of LGBTQ related issues, including marriage equality and services for LGBTQ youth and seniors.
Local LGBTQ advocates have also praised Bowser for playing a leading role in arranging for widespread city support in the city’s role as host for World Pride 2025 in May and June, when dozens of LGBTQ events took place throughout the city.
She has also been credited with expanding the size and funding for the Mayor’s Office of LGBTQ Affairs, which was put in place as a Cabinet level office by the D.C. Council in 2006 under the administration of then-Mayor Anthony Williams.
It was initially called the Office of Gay, Lesbian, and Transgender Affairs. At Bowser’s request, the D.C. Council in 2016 agreed to change the name as part of the fiscal year 2016 budget bill to the Office of Lesbian, Gay, Bisexual, Transgender, and Questioning Affairs.
As she has in numerous past appearances at LGBTQ events, Bowser last month greeted the thousands of people who attended the annual LGBTQ Halloween 17th Street High Heel Race from a stage by shouting that D.C. is the “gayest city in the world.”
In a statement released after she announced she would not run for a fourth term in office; Bowser reflected on her years as mayor.
“It has been the honor of my life to be your mayor,” she said. “When you placed your trust in me 10 years ago, you gave me an extraordinary opportunity to have a positive impact on my hometown,” her statement continues.
“Together, you and I have built a legacy of success of which I am immensely proud. My term will end on Jan. 2, 2027. But until then, let’s run through the tape and keep winning for D.C,” her statement concludes.
Among the LGBTQ advocates commenting on Bowser’s decision not to run again for mayor was Howard Garrett, president of D.C.’s Capital Stonewall Democrats, one of the city’s largest local LGBTQ political groups.
“I will say from a personal capacity that Mayor Bowser has been very supportive of the LGBTQ community,” Garrett told the Washington Blade. “I think she has done a great job with ensuring that our community has been protected and making sure we have the resources needed to be protected when it comes to housing, public safety and other areas.”
Garrett also praised Bowser’s appointment of LGBTQ advocate Japer Bowles as director of the Office of LGBTQ Affairs,
“Under the leadership of the mayor, Japer has done a fantastic job in ensuring that we have what we need and other organizations have what they need to prosper,” Garrett said.
Cesar Toledo, executive director of the D.C. based Wanda Alston Foundation, which provides housing services for homeless LGBTQ youth, credits Bowser with transforming the Office of LGBTQ Affairs “into the largest and most influential community affairs agency of its kind in the nation, annually investing more than $1 million into life-saving programs.”
Toledo added, “Because of the consistent support of Mayor Bowser and her administration, the Wanda Alston Foundation has strengthened and expanded its housing and counseling programs, ensuring that more at-risk queer and trans youth receive the safety, stability, and life-saving care they deserve.”
Gay Democratic activist Peter Rosenstein is among those who have said they have mixed reactions to Bowser’s decision not to run again.
“I am sorry for the city but happy for her that she will now be able to focus on her family, and her incredible daughter,” Rosenstein said.
“She has worked hard, and done great things for D.C,” Rosenstein added. “Those include being a stalwart supporter of the LGBTQ community, working to rebuild our schools, recreation centers, libraries, gaining the RFK site for the city, and maintaining home rule. She will be a very hard act to follow.”
Local gay activist David Hoffman is among those in the city who have criticized Bowser for not taking a stronger and more vocal position critical of President Donald Trump on a wide range of issues, including Trump’s deployment of National Guard soldiers to patrol D.C. streets. Prior to Bowser’s announcement that she is not running again for mayor, Hoffman said he would not support Bowser’s re-election and would urge the LGBTQ community to support another candidate for mayor.
Bowser supporters have argued that Bowser’s interactions with the Trump-Vance administration, including her caution about denouncing the president, were based on her and other city officials’ desire to protect the interests of D.C. and D.C.’s home rule government. They point out that Trump supporters, including Republican members of Congress, have called on Trump to curtail or even end D.C. home rule.
Most political observers are predicting a highly competitive race among a sizable number of candidates expected to run for mayor in the 2026 D.C. election. Two D.C. Council members have said they were considering a run for mayor before Bowser’s withdrawal.
They include Councilmember Janeese Lewis George (D-Ward 4), who identifies as a democratic socialist, and Councilmember Kenyan McDuffie (I-At-Large), who is considered a political moderate supportive of community-based businesses. Both have expressed strong support for the LGBTQ community.
The Washington Post reports that Bowser declined to say in an interview whether she will endorse a candidate to succeed her or what she plans to do after she leaves office as mayor.
Among her reasons for not running again, she told the Post, was “we’ve accomplished what we set out to accomplish.”
District of Columbia
Fadi Jaber’s Middle Eastern background shapes Adams Morgan bakery
The Cakeroom is on 18th Street, N.W.
Fadi Jaber is the gay owner behind the Cakeroom’s bright pink facade on 18th Street, N.W. He combines his Middle Eastern background and American flavors to bring a nostalgic spread of desserts to Adams Morgan.
Born and raised in a U.S. compound in Saudi Arabia, Jaber first unlocked an interest in classic American desserts from his classmates.
“I was jealous that their moms would bring these delicious cupcakes to school when it was their birthdays, and my mom never made stuff like that. It was just grape leaves and hummus and very good Arabic food,” Jaber said.
After years of making boxed cake mixes in Saudi Arabia, Jaber tried a carrot cake from a friend’s wife from the U.S. He soon decided to make the recipe himself. When letting his parents sample the treat, Jaber’s mother suggested adding dates instead of carrots.
Now, Jaber sells the same date cake at the Cakeroom.
Jaber solidified his appreciation for American baked goods after a friend took him to Magnolia’s Bakery in New York. The visit inspired him to enroll in the Institute of Culinary Education.
“I just fell in love with the concept, and it was very much up my alley,” Jaber said. “I was already baking from scratch and making homemade style desserts that weren’t super chichi and elegant, but more just delicious and fun and nostalgic, and a throwback to people’s childhood.”
Upon leaving culinary school, Jaber moved to Jordan, where his parents relocated. He decided to leave his corporate job and open a bakery. According to Jaber, his father initially refuted the idea until he tried the desserts Jaber perfected in culinary school.
“He was part of the Palestinian diaspora. So, you know, given all the instability in his life having been forced out of their homes in 1948, it was really a very scary thought to add more instability by going out on your own and starting your own business,” Jaber said.
Jaber then opened Sugar Daddy’s, his first bakery, in Amman, Jordan, in 2007.
According to Jaber, the bakery was the first cupcake shop in the Middle East. He soon launched additional locations in Beirut, Lebanon, and Dubai, United Arab Emirates.
After six years, Jaber decided to return to the U.S. Jaber noted that he had “always longed” to live there, but he struggled to make his cakes a novel concept to an American audience.
“I’m kind of bringing pasta to the Italians, in a sense, where my cupcakes were very unique in Jordan, they wouldn’t be as unique in D.C.,” Faber said. “But my mom had confidence. She didn’t even bat an eye, and she was like, ‘I think you should do it.’”
Years prior, Jaber began visiting Washington while attending the College of William & Mary. Upon the move, he settled on Washington as a less competitive market than New York, citing his appreciation for the city’s international feel, architecture and nature.
After recruiting investors, Jaber opened Sugar Daddy’s in Adams Morgan in December 2013. However, upon being struck with a cease and desist letter from a bakery in Ohio with a similar name, Jaber experimented with 20 different names for the business.
Finally, he settled on the Cakeroom in the summer of 2014.
“I actually got some calls from D.C. government employees thanking me for the name change, because they said Sugar Daddy’s didn’t look good when they would Google it on their work laptops,” Jaber said, jokingly.
As for Jaber’s identity as a gay man, he notes that he hopes customers visit the Cakeroom because “they like our product” rather than due to his sexual identity. Still, he notes that operating the bakery in an LGBTQ-friendly city increases business opportunities to bake for LGBTQ weddings.
“A lot of people know me as the owner, I’m the face behind the brand. People in D.C. know that I’m gay, so I think we do get some business that way, but I would hate for people to just support my business because of my sexual orientation,” Jaber said.
Jaber manages the Cakeroom remotely, focusing on online orders, deliveries, scheduling, ordering, cash management, and more. He notes that while most days are routine, “at least two, three times a week there’s some firefighting that needs to happen.”
While Jaber does not intend on opening another location of the Cakeroom, he hopes to continue managing the business for another decade.
“I’ve been in this industry for 18 years,” Jaber said. “So if I can just keep it afloat, that would be my hope. It gives me purpose on a daily basis.”
Jaber’s top recommendations from the Cakeroom’s array of sweets include Nutella cookies, the date cake, and the carrot cake.
The carrot cake is based on the dessert that first inspired Jaber to pursue a career in baking.
“I think I altered it just a tiny bit, but for the most part, it is based off of the original recipe that I got from my friend’s wife,” Jaber said.
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