National
What’s next for health care reform?
After court ruling, focus turns to state plans for Medicaid
Now that the Supreme Court has upheld the constitutionality of President Obama’s health care reform law, advocates are pushing for additional efforts to extend coverage of the law to LGBT people and people with HIV/AIDS to the fullest extent possible.
For the most part, the next step in the process involves looking to the states to determine whether they will adopt health policies afforded to them under the law — foremost among them is the Medicaid expansion to cover all people with incomes up to 133 percent of the federal poverty level.
Although the Supreme Court ruled the majority of the health care law is constitutional, it prevented the federal government from withholding all Medicaid funds from states if they decline to take part in the Medicaid expansion. As a result, states can decide whether or not to enter the expansion without fear of losing money.
Patrick Paschall, a policy advocate at the National Gay & Lesbian Task Force, said the Medicaid expansion is particularly important for LGBT people because they disproportionately live below the poverty level.
“The Medicaid expansions are going to end up being hugely important for LGBT people because it expands coverage to low-income people, and LGBT people are disproportionately low-income,” Paschall said. “We know this because of rampant employment discrimination and housing discrimination.”
A report on transgender people published earlier this year by the Task Force and the National Center for Transgender Equality, titled “Injustice at Every Turn: A Report of the National Transgender Discrimination Survey,” found that transgender people experience unemployment at rates twice that of the national population, and black transgender people experience it at a rate of four times as much.
Carl Schmid, deputy executive director of the AIDS Institute, said the Medicaid expansion is particularly important for people with HIV/AIDS because of 50 percent of those in care rely on that program for support and those numbers will “grow substantially” if states decide to participate.
“Those who are really poor, they’re going to be covered under Medicaid,” Schmid said. “The question is what are we expecting from the states.”
But a number of states may not take part. According to a report in The Hill newspaper, at least 15 governors have signaled they won’t participate in the Medicaid expansion now that the Supreme Court has enabled them to wiggle out of participation.
Florida Gov. Rick Scott, a Republican elected to office during the Tea Party wave in 2010, was among those saying his state wouldn’t take part in the Medicaid expansion — or other parts of the health care law that are optional to the states.
“We’re not going to implement Obamacare in Florida,” Scott said last week on Fox News. “We’re not going to expand Medicaid because we’re going to do the right thing. We’re not going to do the exchange.”
Under the health care reform law, the federal government will pay for the Medicaid expansion for the first few years. Expenses for states come up in 2017, when the federal government will pay 95 percent; That’s reduced to 94 percent in 2018 and in 2019 it goes down to 93 percent. Starting in 2010 and then on out, the federal government will pay 90 percent of the total amount.
Schmid said the bargain that was set up for states under the health care law makes the governors’ decision not to participate in the law questionable.
“Here their taxpayers are going to be paying their taxes to pay for this; this is federal funds,” Schmid said. “Their state is not going to take responsibility for covering. The hospitals? Don’t they want people to be covered? They’re going to have unconstituted care if they don’t.”
For the states that don’t participate in the Medicaid expansion, Schmid said people living there with HIV/AIDS will have to continue relying on the Ryan White Care Program, which provides funds for AIDS medications for low-income people with HIV. The program will be up for reauthorization in 2013.
As advocates push for states to adopt the Medicaid expansion, the law has several key components that already offer protections and benefits for LGBT people and people with HIV/AIDS. State and federal health insurance will be set up in the law starting in 2014.
For the first time, the law extends federal non-discrimination protection in the health care system on the basis of gender.
Paschall noted that provision is key as courts and agencies have determined that discrimination against transgender people amounts to gender discrimination.
“We know that federal agencies like the Equal Employment Opportunity Commission, the Department of Housing & Urban Development as well as federal courts have interpreted sex-based discrimination to include protections on the basis of gender identity and sex stereotypes,” Paschall said. “What this means is that in the context of health care, LGBT people, especially transgender people have now for the first time protections in that setting, which is hugely important.”
Earlier this year, the Department of Health & Human Services issued rules saying that no program activity in an exchange, nor a health plan, can discriminate on the basis of sexual orientation and gender identity. The rule takes effect when exchanges open in 2014.
The administration has taken additional efforts to help the LGBT community when it comes to accessing health care. Same-sex couples can now search for health plans that cover domestic partners through the health care finder tool at healthfinder.gov. HHS has also undertaken data collection efforts to include questions about sexual orientation and gender identity in surveys like the National Health Interview Survey.
Still, advocates are looking for additional efforts from the administration — in addition to the adoption of the Medicaid expansion by the states — to ensure LGBT people are included in health care reform to the greatest extent possible.
Paschall said the Task Force wants to see data collection efforts expanded beyond the federal surveys already designated by the administration.
“Generally speaking, we would like to see sexual orientation and gender identity questions added to all federal surveys where demographic data is collected,” he said. “Our priorities include a number of federal surveys, maybe most notably the American Community Survey, which is an annual survey that collects demographic data and is considered one of the largest annual data sources on the American population.”
For people living with HIV/AIDS, Schmid said he is awaiting from the administration regulatory guidance in the next couple months on essential health benefits to cover people in the Medicaid program and federal exchanges.
“We’ll see if the coverage will be strong enough for medications and for all different other services,” Schmid said.
Federal Government
Gay Venezuelan man ‘forcibly disappeared’ to El Salvador files claim against White House
Andry Hernández Romero had asked for asylum in US
A gay Venezuelan asylum seeker who the U.S. “forcibly disappeared” to El Salvador has filed a claim against the federal government.
Immigrant Defenders Law Center, who represents Andry Hernández Romero, on Friday announced their client and five other Venezuelans who the Trump-Vance administration “forcibly removed” to El Salvador under the Alien Enemies Act of 1798, filed “administrative claims” under the Federal Tort Claims Act.
The White House on Feb. 20, 2025, designated Tren de Aragua, a Venezuelan gang, as an “international terrorist organization.”
President Donald Trump less than a month later invoked the Alien Enemies Act of 1798, which the Associated Press notes allows the U.S. to deport “noncitizens without any legal recourse.” The White House then “forcibly removed” Hernández, who had been pursuing his asylum case in the U.S., and more than 250 other Venezuelans to El Salvador.
Immigrant Defenders Law Center disputed claims that Hernández is a Tren de Aragua member.
Hernández was held at El Salvador’s Terrorism Confinement Center, a maximum-security prison known by the Spanish acronym CECOT, until his release on July 18, 2025. Hernández, who is back in Venezuela, claims he suffered physical and sexual abuse while at CECOT.
“As a Venezuelan citizen with no criminal record anywhere in the world, I would like to tell not only the government of the United States but governments everywhere that no human being is illegal,” said Hernández in the Immigrant Defenders Law Center press release. “The practice of judging whole communities for the wrongdoing of a single individual must end. Governments should use their power to help every person in the nation become more aware and informed, to strengthen our cultures and build a stronger generation with principles and values — one that multiplies the positive instead of destroying unfulfilled dreams and opportunities.”
Immigrant Defenders Law Center filed claims on behalf of Hernández and the five other Venezuelans less than three months after American forces seized then-Venezuelan President Nicolás Maduro and his wife, Cilia Flores, at their home in Caracas, the Venezuelan capital.
Maduro and Flores have pleaded not guilty to federal drug charges. Delcy Rodríguez, who was Maduro’s vice president, is Venezuela’s acting president.
‘Due process and accountability cannot be optional’
Immigrant Defenders Law Center on Friday also made the following demands:
- The Trump administration must officially release the names of all people the United States sent to CECOT to ensure that everyone has been or will be released.
- The federal government must clear the names of the 252 men wrongfully labeled as criminal gang members of Tren de Aragua.
- DHS (Department of Homeland Security) must end the practice of outsourcing torture through third‑country removals, restore humanitarian parole, and rebuild a functioning, humane asylum system.
- DHS must reinstate Temporary Protected Status for all individuals who cannot safely return to their home countries, halt mass deportations and unlawful raids and arrests, and guarantee due process for everyone navigating the immigration system.
- Congress must pass the Neighbors Not Enemies Act, which would repeal the Alien Enemies Act.
“In all my years as an immigration attorney, I have never seen a client simply vanish in the middle of their case with no explanation,” said Immigration Defenders Legal Fund Legal Services Director Melissa Shepard. “In court, the government couldn’t even explain where he was — he had been disappeared.”
“When the government detains and transfers people in secrecy, without transparency or access to the courts, it tears at the basic protections a democracy is supposed to guarantee,” added Shepard. “What this experience makes painfully clear is that due process and accountability cannot be optional. They are the only safeguards standing between people and the kind of lawlessness our clients suffered. We must end third country transfers, restore the asylum system, and humanitarian parole, and reinstate temporary protective status so this nightmare never happens again.”
The White House
Trump proclamation targets trans rights as State Dept. shifts visa policy
Recent policy actions from the White House limit transgender rights in sports, immigration visas, and overarching federal policy.
In a proclamation issued by the Trump White House Thursday night, the president said he would, among other things, “restore public safety” and continue “upholding the rule of law,” while promoting policies that restrict the rights of transgender people.
“We are keeping men out of women’s sports, enforcing Title IX as it was originally written, and ensuring colleges preserve — and, where possible, expand — scholarships and roster opportunities for female athletes,” the proclamation reads. “At the same time, we are restoring public safety and upholding the rule of law in every city so women, children, and families can feel safe and secure.”
The statement comes amid a broader series of actions by the Trump administration targeting transgender people across multiple federal policy areas, including education, health care, and immigration. A nearly complete list of policies the current administration has put forward can be found on KFF.org.
One day before the proclamation was issued, the U.S. State Department announced changes to visa regulations that could impact transgender and gender-nonconforming people seeking entry into the United States.
The policy, published March 11 and scheduled to take effect April 10, introduces changes to the Diversity Immigrant Visa Program, commonly known as the “DV Program.” The rule is framed by the department as an effort to strengthen oversight and prevent fraud within the visa lottery system, which allocates a limited number of immigrant visas annually to applicants from countries with historically low rates of immigration to the United States.
However, the updated language also standardizes the use of the term “sex” in federal regulations in place of “gender,” a change that LGBTQ advocates say could create additional barriers for transgender and gender-diverse applicants.
The policy states: “The Department of State (‘Department’) is amending regulations governing the Diversity Immigrant Visa Program (‘DV Program’) to improve the integrity of, and combat fraud in, the program. These amendments require a petitioner to the DV Program to provide valid, unexpired passport information and to upload a scan of the biographic and signature page in the electronic entry form or otherwise indicate that he or she is exempt from this requirement. Additionally, the Department is standardizing and amending its regulations to add the word ‘shall’ to simplify guidance for consular officers; ensure the use of the term ‘sex’ in lieu of ‘gender’; and replace the term ‘age’ in the DV Program regulations with the phrase ‘date of birth’ to accurately reflect the information collected and maintained by the Department during the immigrant visa process.”
Advocates say the shift toward using “sex” rather than “gender” in federal immigration rules reflects a broader push by the administration to roll back recognition of transgender identities in federal policy.
According to the National Center for Transgender Equality, an estimated 15,000 to 50,000 undocumented transgender immigrants currently live in the United States, with many entering the country to seek refuge from persecution and hostile governments in their home countries.
Florida
Fla. House passes ‘Anti-Diversity’ bill
Measure could open door to overturning local LGBTQ rights protections
The Florida House of Representatives on March 10 voted 77-37 to approve an “Anti-Diversity in Local Government” bill that opponents have called an extreme and sweeping measure that, among other things, could overturn local LGBTQ rights protections.
The House vote came six days after the Florida Senate voted 25-11 to pass the same bill, opening the way to send it to Republican Gov. Ron DeSantis, who supports the bill and has said he would sign it into law.
Equality Florida, a statewide LGBTQ advocacy organization that opposed the legislation, issued a statement saying the bill “would ban, repeal, and defund any local government programming, policy, or activity that provides ‘preferential treatment or special benefits’ or is designed or implemented with respect to race, color, sex, ethnicity, sexual orientation, or gender identity.”
The statement added that the bill would also threaten city and county officials with removal from office “for activities vaguely labeled as DEI,” with only limited exceptions.
“Written in broad and ambiguous language, the bill is the most extreme of its kind in the country, creating confusion and fear for local governments that recognize LGBTQ residents and other communities that contribute to strength and vibrancy of Florida cities,” the group said in a separate statement released on March 10.
The Miami Herald reports that state Sen. Clay Yarborough (R-Jacksonville), the lead sponsor of the bill in the Senate, said he added language to the bill that would allow the city of Orlando to continue to support the Pulse nightclub memorial, a site honoring 49 mostly LGBTQ people killed in the 2016 mass shooting at the LGBTQ nightclub.
But the Equality Florida statement expresses concern that the bill can be used to target LGBTQ programs and protections.
“Debate over the bill made expressly clear that LGBTQ people were a central target of the legislation,” the group’s statement says. “The public record, the bill sponsors’ own statements, and hours of legislative debate revealed the animus driving the effort to pressure local governments into pulling back from recognizing or resourcing programs targeting LGBTQ residents and other historically marginalized communities,” the statement says.
But the statement also notes that following outspoken requests by local officials, sponsors of the bill agreed to several amendments “ensuring local governments can continue to permit Pride festivals, even while navigating new restrictions on supporting or promoting them.”
The statement adds, “Florida’s LGBTQ community knows all too well how to fight back against unjust laws. Just as we did, following the passage of Florida’s notorious ‘Don’t Say Gay or Trans’ law, we will fight every step of the way to limit the impact of this legislation, including in the courts.”
Gay Venezuelan man ‘forcibly disappeared’ to El Salvador files claim against White House
Trump proclamation targets trans rights as State Dept. shifts visa policy
Adolescentes trans en Ecuador podrán cambiar datos en su cédula, pero con condicionamientos
Gay Cameroonian immigrant will be freed from ICE detention — for now
Laverne Cox, Liza Minnelli among authors with new books
Claudia López wins primary in Colombian presidential race
Trump will refuse to sign voting bill without anti-trans provisions
Man stuck in Lebanon as Iran war escalates
CAMP Rehoboth hires new executive director
