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.”
Maryland
Supreme Court ruling against conversion therapy bans could affect Md. law
Then-Gov. Larry Hogan signed statute in 2018
By PAMELA WOOD, JOHN-JOHN WILLIAMS IV, and MADELEINE O’NEILL | The U.S. Supreme Court on Tuesday ruled against a law banning “conversion therapy” for LGBTQ kids in Colorado, a ruling that also could apply to Maryland’s ban on the discredited practice.
An 8-1 high court majority sided with a Christian counselor who argues the law banning talk therapy violates the First Amendment. The justices agreed that the law raises free speech concerns and sent it back to a lower court to decide whether it meets a legal standard that few laws pass.
Justice Neil Gorsuch, writing for the court’s majority, said the law “censors speech based on viewpoint.” The First Amendment, he wrote, “stands as a shield against any effort to enforce orthodoxy in thought or speech in this country.”
The rest of this article can be read on the Baltimore Banner’s website.
District of Columbia
As mayor’s race takes shape, candidates endorse LGBTQ equality
Like nearly all recent D.C. elections, LGBTQ voters will be choosing a candidate for mayor in 2026 from a list of mostly strong LGBTQ rights supporters in the city’s June 16 primary.
As of March 30, the D.C. Board of Elections’ list of candidates who submitted the required number of petition signatures for the June 16 primary ballot included 10 mayoral candidates: nine Democrats and one Statehood Green Party candidate.
Among those candidates, six, all Democrats, have issued statements expressing strong support for LGBTQ rights, including the two leading Democratic contenders, former D.C. Council member Kenyan McDuffie and current Council member Janeese Lewis George, who represents Ward 4.
One of the lesser-known Democratic candidates who released an LGBTQ supportive statement, Rini Sampath, a cyber security consultant, told the Washington Blade she identifies as queer, becoming one of the first known LGBTQ D.C. mayoral candidates to gain access to a major party primary ballot.
“We’re living in an extremely diverse community, an extremely unique community,” she told the Blade. “And being able to self-label, self-identify as queer is something that I just want to take pride in.”
Similar to McDuffie and Lewis George, Sampath released statements to the Blade and the Capital Stonewall Democrats, the city’s largest LGBTQ local political group, expressing support for LGBTQ rights and outlining plans for LGBTQ supportive policies if elected mayor.
Although many D.C. LGBTQ activists have said they have yet to decide whom to support for mayor, those who have decided appear to be divided between McDuffie and Lewis George. Most D.C. political observers consider McDuffie and Lewis George to be the two leading candidates in the mayoral race.
The other Democratic mayoral contenders who have released statements expressing support on LGBTQ issues include Gary Goodweather, a local real estate manager and developer who has been actively campaigning at LGBTQ events; Vincent Orange, a former At-Large and Ward 5 D.C. Council member; and Kathy Henderson, a longtime Ward 5 community activist and elected Advisory Neighborhood Commissioner.
The remaining two Democratic mayoral candidates, Hope Solomon, a former U.S. Department of Homeland Security contractor and Dupont Circle civic activist; and Ernest Johnson, a real estate broker and Ward 1 community activist, did not respond to inquiries from the Blade and Capital Stonewall Democrats seeking information about their position on LGBTQ related issues.
Robert Gross, the Statehood Green Party candidate who is running unopposed in the June 16 primary, also didn’t respond to inquires from the Blade about his position on LGBTQ issues.
D.C. Board of Elections records show that at least five Republican candidates filed papers to run for mayor in the June 16 GOP primary, but none of them remained as candidates as of March 30, when the election board issued its updated candidate list.
Just one of the five Republican candidates replied to an email message from the Washington Blade sent to all mayoral candidates in early March seeking their position on LGBTQ issues. That candidate, Esa Muhammad, whose website identifies him as an engineer, consultant, and local business owner, sent a reply expressing opposition to LGBTQ rights.
“Unfortunately, I do not support LGBTQ because The God only created 2 genders (Adam/Eve),” he wrote. “Anyway, I will be fair to you all despite your sick way of looking at life,” he stated.
Capital Stonewall Democrats President Stevie McCarty said his group sent questionnaires to all the Democratic mayoral candidates as well as to Democrats running for other offices such as D.C. Council. Information posted on the group’s website shows only four of the mayoral candidates returned a complete questionnaire: McDuffie, Lewis George, Goodweather, and Sampath.
Each of them provides detailed information of their plans for supporting LGBTQ policies if elected and their record of support on LGBTQ issues. McCarty said the questionnaire responses for all candidates that submitted them can be accessed at outvotedc.org.
He said Capital Stonewall Democrats will hold virtual LGBTQ forums in April, including a mayoral forum on April 8. He said the group’s members will vote on the candidate endorsements online from April 20 through May 11, and the group expects to announce its endorsements May 14.
GLAA DC, formerly known as the Gay and Lesbian Activists Alliance of Washington, has issued candidate ratings for most D.C. elections since the 1970s, and the nonpartisan LGBTQ group was expected to issue ratings for mayoral candidates this year. But like in recent years, the group is expected to base its ratings on mostly non-LGBTQ issues, with a progressive, left-leaning perspective, according to a nine-page “Back to Basics GLAA Policy Brief 2026” that the group released in March.
The LGBTQ activists who are backing McDuffie or Lewis George appear to be gravitating to the two based on their political leanings separate from LGBTQ issues, just like voters in general. Lewis George, who identifies as a democratic socialist, is popular among LGBTQ and non-LGBTQ “progressives.”
McDuffie, who is seen as a more moderate candidate along the lines of current D.C. Mayor Muriel Bowser, is being supported by LGBTQ activists who hold those views, some of whom currently work in the Bowser administration.
Among Lewis George’s LGBTQ supporters are longtime Ward 8 community leader Philip Pannell and former Capital Stonewall Democrats president Howard Garrett. Among the LGBTQ McDuffie backers are longtime D.C. Democratic activists John Fanning and David Meadows.
Longtime D.C. LGBTQ Democratic Party activist Peter Rosenstein, who is supporting McDuffie, has raised concerns about Lewis George’s backing by the national group Democratic Socialists of America. In Facebook postings, Rosenstein points to the Democratic Socialists of America’s opposition to Israel as a country and said it is viewed by many in the Jewish community as promoting antisemitism. He has criticized Lewis George for not speaking out against that and for accepting the DSA’s endorsement.
In an interview with the Blade, Lewis George strongly disputed that assessment, saying she has been a strong ally and supporter of the Jewish community.
“I’m a member of the Metro DSA here in D.C. that I work with to fight for labor and for tenant rights,” she said. “I’m also a member of the Democratic Party,” she added, saying, “There are things that the Democratic Party does that I don’t agree with. There are things that the national DSA does that I don’t agree with. That’s a group that I work with.”
“But I want to be clear that I am running for mayor to represent all of our community, and that includes our amazing and historical Jewish community here in D.C.,” she said. “I have had the amazing opportunity to spend time at synagogues and talking to Jewish leaders and groups and institutions. And so, there should be no worry here.”
Following are short excerpts from the detailed statements five of the nine Democratic mayoral candidates submitted to the Capital Stonewall Democrats or the Washington Blade.
Kenyan McDuffie: “As mayor, every piece of legislation I sign, craft, or endorse should also encompass the interest and input of the LGBTQ community members and advocates…From housing to health care and everything in between… We have a dire crisis regarding the rise in homelessness especially among the youth in our LGBTQ communities. In my administration that simply cannot be the status quo and will not be…I have been a consistent champion for our LGBTQ community and will remain so as Mayor of D.C.’
Janeese Lewis George: “As mayor, I will protect our LGBTQ+ neighbors against federal attacks on their identity, including their health care…On the Council I have been a strong supporter of pro-LGBTQ+ bills, including making D.C. a sanctuary for people seeking gender-affirming health care as well as addressing discrimination and harassment in nightlife and hospitality…And as mayor, I am prepared to move up and win those fights – a fight for D.C. statehood, a fight for our true economy, and a real opportunity to uplift our Black queer and trans youth.”
Gary Goodweather: “A Goodweather administration will defend every D.C. law protecting LGBTQ residents. I will establish a Defend DC office to coordinate the District’s legal and public response to federal overreach, with LGBTQ+ protections explicitly within its mandate…My affordable D.C. plan will produce 50,000 new homes with 36,000 affordable units, and I will ensure LGBTQ+ youth housing programs are funded as a budget priority.”
Rini Sampath: “I am an immigrant, proud queer woman, and a 10-year resident of Washington, D.C…For me, LGBTQ+ voters including transgender and nonbinary residents, are not a separate or symbolic constituency; they are a core part of a broader, multiracial, cross-ward coalition rooted in in equity and opportunity.”
Vincent Orange: “I have a long and consistent record of supporting LGBTQ+ equality and inclusion in the District of Columbia, grounded in both policy and personal commitment. As the District’s Democratic Committeeman from 2006 to 2015, I publicly supported marriage equality and voted accordingly … During my time on the D.C. Council, I worked to advance protections for LGBTQ+ residents, including authoring and passing legislation to prohibit discrimination against transgender individuals in the workplace.”
Kathy Henderson: Kathy Henderson has maintained a consistent record of treating all members of the community with dignity, compassion, and respect, regardless of gender, race, ethnicity, sexual orientation, identity, political party, national origin, or ideology. Kathy Henderson embraced the late Wanda Alston as a colleague and good friend…Alston was the first director of the Mayor’s Office of LGBTQ Affairs and Henderson helped to organize and facilitate the first LGBTQ citizens summit.”
Local
D.C.’s affirming congregations to mark Holy Week, Easter
Dignity Washington among groups holding events
LGBTQ-friendly congregations in the D.C. area this week are marking Easter and Holy Week.
The Metropolitan Community Church of Washington, D.C., located in Mount Vernon Square, holds both online and in-person services.
An online-only Good Friday service will take place on April 3 at 7 p.m. In person or online Resurrection Sunday services will take place on April 5 at 10:30 a.m.
Dignity Washington, an LGBTQ Catholic group, is also holding Holy Week and Easter events.
The group on March 29 held a Palm Sunday prayer event. Dignity Washington on April 5 will hold a Mass at St. Margaret’s Episcopal Church at 6 p.m. It will be livestreamed on Facebook.
Foundry United Methodist Church holds two Easter Sunday services at 9 and 11:15 a.m.
Riverside Baptist Church, located in Southwest Washington, is an “Inclusive, Multicultural, Christ-Centered” congregation that also offers Holy Week and Easter activities.
The church on Good Friday at 3 p.m. is holding an outreach period in which they will clean up the neighborhood. Easter Sunday services will be held at 9:45 a.m., starting with a musical prelude, followed by services.
The church offers weekly “Wednesday Witness,” a youth and safety zone drop-in, serving as a safe space for the students of Jefferson Middle School and the community. It takes place from 3-5 p.m.
The DC LGBTQ+ Community Center offers a comprehensive list of inclusive faith communities on its website. The Association of Welcoming and Affirming Baptists offers a list of churches partnered with their organization that are inclusive and mainly Baptist, but the group does feature churches of other denominations.
The 18th National Rainbow Seder took place at the Human Rights Campaign on March 29. The sold out event is the country’s largest Passover Seder for the Jewish LGBTQ community.
Organizations behind the event included Bet Mishpachah, a local D.C. LGBTQ synagogue that Rabbi Jake Singer-Beilin leads, and GLOE, an Edlavitch DC Jewish Community Center program that sponsors events for the queer Jewish community. The theme for this year’s Seder was “Liberation for All Who Journey: Remembering, Resisting, Rebuilding.” Rabbis Atara Cohen, Koach Frazier, and Avigayil Halpern led it.
The Seder honored the late GLOE co-chair Michael Singer. Singer also served on the Edlavitch DC Jewish Community Center’s board.
“This Seder is both a celebration of how far we have come and a call to continue building a more just and inclusive world.” Bet Mishpachah Executive Director Joshua Maxey told the Washington Blade.
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