National
EXCLUSIVE: Obama extends protections to gay couples under Medicaid
Protects against liens, period of ineligibility and estate recovery

The Obama administration is set on Friday to issue policy guidance to states expanding their ability to offer same-sex couples the same protections afforded to straight couples when they receive long-term care under Medicaid, the Washington Blade has learned exclusively.
Under the new guidance, dated June 10, states have the option to allow healthy partners in a same-sex relationship to keep their homes while their partners are receiving support for long-term care under Medicaid, such as care in a nursing home.
Medicaid kicks in for a beneficiary to receive care after an individual depletes virtually all of their money. To pay for the beneficiary’s expenses under Medicaid, a state could impose a lein, or take possession, of a beneficiary’s home to pay for Medicaid expenses.
However, federal law prohibits imposing this lein if beneficiaries are married to someone of the opposite-sex who’s still living in their home. The new guidance, signed by Deputy Administrator of the Centers for Medicare & Medicaid Services Cindy Mann, clarifies that states can offer this protection to the healthy partner of a Medicaid recipient in a same-sex relationship.
“A State can have a policy or rule not to pursue liens when the same-sex spouse or domestic partner of the Medicaid beneficiary continues to lawfully reside in the home,” the guidance states.
The Obama administration previously hadn’t articulated whether gay couples could receive these protections under the Defense of Marriage Act, which prohibits federal recognition of same-sex marriage. The guidance doesn’t mandate that same-sex couples receive this protection, but allows states to “incorporate their criteria for determining when to impose a lien in the Medicaid State plan.”
The Department of Health & Human Services had been examining ways to offer more protections to same-sex couples under Medicaid as part of the work it has undertaken for LGBT people, but until now hadn’t issued the policy guidance to states.
Secretary of Health & Human Services Kathleen Sebelius said in a statement the new guidance represents a path for low-income same-sex couples to receive care under Medicaid.
“Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need,” she said. “That is now changing. Today’s guidance represents another important step toward ensuring the rights and dignity of every American are respected by their government.”
Michael Cole-Schwartz, a Human Rights Campaign spokesperson, praised the Obama administration for issuing the guidance, but maintained same-sex couples won’t have equal protection under the law until DOMA is repealed.
“No one should have to choose between keeping their home and getting the medical care they need and deserve,” Cole-Schwartz said. “This is an important step to give some couples the security and dignity they deserve when they need it most. However all same-sex couples will remain vulnerable until we end discrimination in marriage and repeal the Defense of Marriage Act.”
In addition to allowing states not to impose liens on the homes of same-sex couples, the guidance also allows individuals in same-sex relationships to sell their home below market value to their partner and still receive Medicaid support.
An individual seeking Medicaid coverage may want to make this transfer to deplete his or her assets more quickly to be eligible for care. Under other circumstances, the state could impose a period of ineligibility on the beneficiary because of this sale, but the guidance says states can ignore this transfer if they believe such ineligibility would institute “undue hardship.”
“Because of the flexibility afforded to States in determining undue hardship, we believe that States may adopt criteria, or even presumptions, that recognize that imposing transfer of assets penalties on the basis of the transfer of ownership interests in a shared home to a same-sex spouse or domestic partner would constitute undue hardship,” the guidance states.
Furthermore, the guidance says states can opt not to seize the home of Medicaid beneficiaries upon their death if their same-sex partner is still living in the home.
States may seize the property of Medicaid beneficiaries upon their death — if a lien has been imposed on the home or the recipient is age 55 or over and has received nursing services — but not if the recipient’s child or spouse is living in the home. The guidance clarifies that states may also decide not to do so if a same-sex partner is living in the home.
“States have flexibility to design reasonable criteria for determining what constitutes an undue hardship and who may be afforded protection from estate recovery in such instances,” the guidance states. “At the State’s discretion, this may include establishing reasonable protections applicable to the same-sex spouse or domestic partner of a deceased Medicaid recipient.”
State Department
Rubio mum on Hungary’s Pride ban
Lawmakers on April 30 urged secretary of state to condemn anti-LGBTQ bill, constitutional amendment

More than 20 members of Congress have urged Secretary of State Marco Rubio to publicly condemn a Hungarian law that bans Pride events.
California Congressman Mark Takano, a Democrat who co-chairs the Congressional Equality Caucus, and U.S. Rep. Bill Keating (D-Mass.), who is the ranking member on the House Foreign Affairs Committee’s Europe Subcommittee, spearheaded the letter that lawmakers sent to Rubio on April 30.
Hungarian lawmakers in March passed a bill that bans Pride events and allow authorities to use facial recognition technology to identify those who participate in them. MPs last month amended the Hungarian constitution to ban public LGBTQ events.
“As a NATO ally which hosts U.S. service members, we expect the Hungarian government to abide by certain values which underpin the historic U.S.-Hungary bilateral relationship,” reads the letter. “Unfortunately, this new legislation and constitutional amendment disproportionately and arbitrarily target sexual and gender minorities.”
Prime Minister Viktor Orbán’s government over the last decade has moved to curtail LGBTQ and intersex rights in Hungary.
A law that bans legal recognition of transgender and intersex people took effect in 2020. Hungarian MPs that year also effectively banned same-sex couples from adopting children and defined marriage in the constitution as between a man and a woman.
An anti-LGBTQ propaganda law took effect in 2021. The European Commission sued Hungary, which is a member of the European Union, over it.
MPs in 2023 approved the “snitch on your gay neighbor” bill that would have allowed Hungarians to anonymously report same-sex couples who are raising children. The Budapest Metropolitan Government Office in 2023 fined Lira Konyv, the country’s second-largest bookstore chain, 12 million forints ($33,733.67), for selling copies of British author Alice Oseman’s “Heartstopper.”
Former U.S. Ambassador to Hungary David Pressman, who is gay, participated in the Budapest Pride march in 2024 and 2023. Pressman was also a vocal critic of Hungary’s anti-LGBTQ crackdown.
“Along with years of democratic backsliding in Hungary, it flies in the face of those values and the passage of this legislation deserves quick and decisive criticism and action in response by the Department of State,” reads the letter, referring to the Pride ban and constitutional amendment against public LGBTQ events. “Therefore, we strongly urge you to publicly condemn this legislation and constitutional change which targets the LGBTQ community and undermines the rights of Hungarians to freedom of expression and peaceful assembly.”
U.S. Reps. Pramila Jayapal (D-Wash.), Sarah McBride (D-Del.), Jim Costa (D-Calif.), James McGovern (D-Mass.), Gerry Connolly (D-Va.), Summer Lee (D-Pa.), Joaquin Castro (D-Texas), Julie Johnson (D-Texas), Ami Bera (D-Calif.), Mark Pocan (D-Wis.), Lloyd Doggett (D-Texas), Becca Balint (D-Vt.), Gabe Amo (D-R.I.), Ted Lieu (D-Calif.), Robert Garcia (D-Calif.), Dina Titus (D-Nev.), Raja Krishnamoorthi (D-Ill.), Jan Schakowsky (D-Ill.) and Mike Quigley (D-Ill.) and Del. Eleanor Holmes Norton (D-D.C.) signed the letter alongside Takano and Keating.
A State Department spokesperson on Wednesday declined to comment.
Federal Government
HRC memo details threats to LGBTQ community in Trump budget
‘It’s a direct attack on LGBTQ+ lives’

A memo issued Monday by the Human Rights Campaign details threats to LGBTQ people from the “skinny” budget proposal issued by President Donald Trump on May 2.
HRC estimates the total cost of “funding cuts, program eliminations, and policy changes” impacting the community will exceed approximately $2.6 billion.
Matthew Rose, the organization’s senior public policy advocate, said in a statement that “This budget is more than cuts on a page—it’s a direct attack on LGBTQ+ lives.”
“Trump is taking away life-saving healthcare, support for LGBTQ-owned businesses, protections against hate crimes, and even housing help for people living with HIV,” he said. “Stripping away more than $2 billion in support sends one clear message: we don’t matter. But we’ve fought back before, and we’ll do it again—we’re not going anywhere.”
Proposed rollbacks or changes at the U.S. Department of Health and Human Services will target the Ryan White HIV/AIDS Program, other programs related to STI prevention, viral hepatitis, and HIV, initiatives housed under the Substance Abuse and Mental Health Services Administration, and research by the National Institutes of Health and Agency for Healthcare Research and Quality.
Other agencies whose work on behalf of LGBTQ populations would be jeopardized or eliminated under Trump’s budget include the U.S. Department of Housing and Urban Development, the U.S. Department of Justice, the U.S. Small Business Administration, and the U.S. Department of Education.
U.S. Supreme Court
Supreme Court allows Trump admin to enforce trans military ban
Litigation challenging the policy continues in the 9th Circuit

The U.S. Supreme Court on Tuesday allowed the Trump-Vance administration to enforce a ban on transgender personnel serving in the U.S. Armed Forces pending the outcome of litigation challenging the policy.
The brief order staying a March 27 preliminary injunction issued by the U.S. District Court for the Western District of Washington notes the dissents from liberal Justices Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson.
On the first day of his second term, President Donald Trump issued an executive order requiring Secretary of Defense Pete Hegseth to effectuate a ban against transgender individuals, going further than efforts under his first administration — which did not target those currently serving.
The DoD’s Feb. 26 ban argued that “the medical, surgical, and mental health constraints on individuals who have a current diagnosis or history of, or exhibit symptoms with, gender dysphoria are incompatible with the high mental and physical standards necessary for military service.”
The case challenging the Pentagon’s policy is currently on appeal before the U.S. Court of Appeals for the Ninth Circuit. The lead plaintiff is U.S. Navy Commander Emily Shilling, who is joined in the litigation by other current transgender members of the armed forces, one transgender person who would like to join, and a nonprofit whose members either are transgender troops or would like to be.
Lambda Legal and the Human Rights Campaign Foundation, both representing the plaintiffs, issued a statement Tuesday in response to the Supreme Court’s decision:
“Today’s Supreme Court ruling is a devastating blow to transgender servicemembers who have demonstrated their capabilities and commitment to our nation’s defense.
“By allowing this discriminatory ban to take effect while our challenge continues, the Court has temporarily sanctioned a policy that has nothing to do with military readiness and everything to do with prejudice.
“Transgender individuals meet the same standards and demonstrate the same values as all who serve. We remain steadfast in our belief that this ban violates constitutional guarantees of equal protection and will ultimately be struck down.”
U.S. Solicitor General D. John Sauer noted that courts must show “substantial deference” to DoD decision making on military issues.
“The Supreme Court’s decision to allow the military ban to go into effect is devastating for the thousands of qualified transgender servicemembers who have met the standards and are serving honorably, putting their lives on the line for their country every single day,” said GLAD Law Senior Director of Transgender and Queer Rights Jennifer Levi. “Today’s decision only adds to the chaos and destruction caused by this administration. It’s not the end of the case, but the havoc it will wreak is devastating and irreparable. History will confirm the weight of the injustice done today.”
“The Court has upended the lives of thousands of servicemembers without even the decency of explaining why,” said NCLR Legal Director Shannon Minter. “As a result of this decision, reached without benefit of full briefing or argument, brave troops who have dedicated their lives to the service of our country will be targeted and forced into harsh administrative separation process usually reserved for misconduct. They have proven themselves time and time again and met the same standards as every other soldier, deploying in critical positions around the globe. This is a deeply sad day for our country.”
Levi and Minter are the lead attorneys in the first two transgender military ban cases to be heard in federal court, Talbott v. Trump and Ireland v. Hegseth.
U.S. Rep. Mark Takano (D-Calif.) issued a statement on behalf of the Congressional Equality Caucus, where he serves as chair.
“By lifting the lower court’s preliminary injunction and allowing Trump to enforce his trans troop ban as litigation continues, the Supreme Court is causing real harm to brave Americans who simply want to serve their nation in uniform.
“The difference between Donald Trump, a draft dodger, and the countless brave Americans serving their country who just happen to be trans couldn’t be starker. Let me be clear: Trump’s ban isn’t going to make our country safer—it will needlessly create gaps in critical chains of military command and actively undermine our national security.
“The Supreme Court was absolutely wrong to allow this ban to take effect. I hope that lower courts move swiftly so this ban can ultimately be struck down.”
SPARTA Pride also issued a statement:
“The Roberts Court’s decision staying the preliminary injunction will allow the Trump purge of transgender service members from the military to proceed.
“Transgender Americans have served openly, honorably, and effectively in the U.S. Armed Forces for nearly a decade. Thousands of transgender troops are currently serving, and are fully qualified for the positions in which they serve.
“Every court up to now has found that this order is unconstitutional. Nevertheless, the Roberts Court – without hearing any evidence or argument – decided to allow it to go forward. So while the case continues to be argued, thousands of trans troops will be purged from the Armed Forces.
“They will lose their jobs. They will lose their commands, their promotions, their training, pay and benefits, and time. Their units will lose key players; the mission will be disrupted. This is the very definition of irreparable harm.”
Imara Jones, CEO of TransLash Media, issued the following statement:
“The Supreme Court’s decision to uphold Trump’s ban on transgender soldiers in the military, even as the judicial process works its way through the overall question of service, signals that open discrimination against trans people is fair game across American society.
“It will allow the Trump Administration to further advance its larger goal of pushing trans people from mainstream society by discharging transgender military members who are currently serving their country, even at a time when the military has struggled recently to meet its recruiting goals.
“But even more than this, all of my reporting tells me that this is a further slide down the mountain towards authoritarianism. The hard truth is that governments with authoritarian ambitions have to separate citizens between who is worthy of protection and who’s not. Trans people are clearly in the later category. And this separation justifies the authoritarian quest for more and more power. This appears to be what we are witnessing here and targeting trans people in the military is just a means to an end.”
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