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.
Iran
LGBTQ groups condemn Trump’s threat to destroy Iranian civilization
Ceasefire announced less than two hours before Tuesday deadline
The Council for Global Equality is among the groups that condemned President Donald Trump on Tuesday over his latest threats against Iran.
Trump in a Truth Social post said “a whole civilization will die tonight” if Tehran did not reach an agreement with the U.S. by 8 p.m. ET. on Tuesday.
Iran is among the handful of countries in which consensual same-sex sexual relations remain punishable by death.
Israel and the U.S. on Feb. 28 launched airstrikes against Iran.
One of them killed Supreme Leader Ayatollah Ali Khamenei. Iran in response launched missiles and drones against Israel and other countries that include Kuwait, Bahrain, Qatar, the United Arab Emirates, Jordan, Saudi Arabia, Azerbaijan, and Cyprus.
Gas prices in the U.S. and around the world continue to increase because the war has essentially closed the Strait of Hormuz, a strategic waterway that connects the Persian Gulf and the Gulf of Oman through which roughly 20 percent of the world’s crude oil passes.
Trump less than 90 minutes before his deadline announced a two-week ceasefire with Iran that Pakistan helped broker.
“We the undersigned human rights, humanitarian, civil liberties, faith-based and environmental organizations, think tanks and experts are deeply alarmed by President Trump’s threat regarding Iran that ‘a whole civilization will die tonight’ if his demands are not met. Such language describes a grave atrocity if carried out,” reads the statement that the Council for Global Equality more than 200 other organizations and human rights experts signed. “A threat to wipe out ‘a whole civilization’ may amount to a threat of genocide. Genocide is a crime defined by the Genocide Convention and by the Rome Statute of the International Criminal Court as committing one or more of several acts ‘with intent to destroy in whole or in part a national, racial or religious groups as such.'”
The statement states “the law is clear that civilians must not be targeted, and they must also be protected from indiscriminate or disproportionate attacks.”
“Strikes on civilian infrastructure — such as the recent attack on a bridge and the attacks President Trump is repeatedly threatening to carry out to destroy power plants — have devastating consequences for the civilian population and environment,” it reads.
“We urge all parties to respect international law,” adds the statement. “Those responsible for atrocities, including crimes against humanity and war crimes, can and must be held accountable.”
The Alliance for Diplomacy and Justice, Amnesty International USA, Human Rights Watch, the American Civil Liberties Union, the NAACP, MADRE, and the Robert and Ethel Kennedy Human Rights Center are among the other groups that signed the letter.
National
Glisten’s 30th annual Day of Silence to take place April 10
Campaign began as student-led protests against anti-LGBTQ bullying, discrimination
Glisten’s 30th annual Day of Silence will take place on April 10.
The annual Day of Silence began as a student-led protest in response to bullying and discrimination that LGBTQ students face. It is now a national campaign for the LGBTQ community and their allies to come together for LGBTQ youth.
It takes place annually and has multiple ways for supporters to get involved in the movement.
Glisten, originally GLSEN, champions LGBTQ issues in schools, grades K-12. Glisten’s mission is to create more inclusive and accepting environments for LGBTQ students through curriculum, supportive measures, education campaigns, and engagement, such as the Day of Silence.
There are three main ways for the community to get involved in the Day of Silence.
Glisten has a Day of Silence frame, a series of pictures used as profile photos across social media that feature individuals holding signs. The signs allow for personalization, by providing a space to put the individual’s name, followed by filling in the prompt “ … and I am ENDING the silence by…”
Participants are encouraged to post the photo on social media and use it as a profile picture. The templates can be found on Google Drive through this link.
Using #DayOfSilence and #NSCS, as well as tagging Glisten’s official Page @glistencommunity, is another way to participate in the Day of Silence.
Glisten also encourages participants to tag creators, friends, family and use a call to action in their caption, to call attention to the facts and stories behind the Day of Silence.
“Today’s administration in the U.S. wants us to stay silent, submit to their biased and hurtful conformity, and stop fighting for our right to be authentically ourselves,” said Glisten CEO Melanie Willingham-Jaggers. “We urge supporters to use their social platforms and check in with local chapters to be boots on the ground to help LGBTQ+ students feel seen, heard, supported, and less alone. By participating in the ‘Day of Silence,’ you are showing solidarity with young people as they navigate identity, safety, and belonging. Our voices matter.”
Hungary
Vance speaks at Orbán rally in Hungary
Anti-LGBTQ prime minister trailing ahead of April 12 vote
Vice President JD Vance on Tuesday urged Hungarians to support Prime Minister Viktor Orbán in the country’s April 12 elections.
“We have got to get Viktor Orbán re-elected as prime minister of Hungary,” Vance told Orbán supporters who gathered at Budapest’s MTK Sportpark.
Vance and Orbán on Tuesday met before they held a press conference in Budapest. Orbán also spoke at the rally.
The U.S. vice president after he took to the stage called President Donald Trump, who told the crowd he is “a big fan of Viktor” and is “with him all the way.” Vance, as he did during Tuesday’s press conference with Orbán, criticized the European Union.
“We want you to make a decision about your future with no outside forces pressuring you or telling you what to do. I’m not telling you exactly who to vote for, but what I am telling you is that the bureaucrats in Brussels, those people should not be listened to,” said Vance. “Listen to your hearts, listen to your souls, and listen to the sovereignty of the Hungarian people.”
Vance in his speech noted “across the West, we’ve got a small band of radicals” who, among other things, “condemn children to mutilization and sterilization in the name of gender care.” Vance also criticized a “far-left ideology given quarter in university circles, in the media, and in our entertainment industry, and increasingly among bureaucrats on both sides of the Atlantic.”
Vice President JD Vance speaks at MTK Sportpark in Budapest, Hungary, on April 7, 2026
Orbán has been in office since 2010. He and his Fidesz-KDNP coalition government have faced widespread criticism over its anti-LGBTQ crackdown.
A Hungarian activist with whom the Washington Blade previously spoke said it is “impossible to change your gender legally in Hungary” because of a 2020 law that “banned legal gender recognition of transgender and intersex people.” Hungarian MPs the same year effectively prohibited same-sex couples from adopting children and defined marriage in the country’s constitution as between a man and a woman.
The European Commission in 2022 sued Hungary, which is a member of the EU, over the country’s anti-LGBTQ propaganda law.
Hungarian lawmakers in March 2025 passed a bill that banned Pride events and allowed authorities to use facial recognition technology to identify those who participate in them. MPs later amended the Hungarian constitution to ban public LGBTQ events.
Upwards of 100,000 people last June defied the ban and marched in Budapest’s annual Pride parade.
Polls indicate Orbán is trailing Péter Magyar and his center-right Tisza party ahead of the April 12 election. Vance at Tuesday’s rally told Orbán supporters that he and Trump “want you to make a decision about your future with no outside forces pressuring you or telling you what to do.”
“I’m not telling you exactly who to vote for, but what I am telling you is that the bureaucrats in Brussels, those people should not be listened to,” said Vance. “Listen to your hearts, listen to your souls, and listen to the sovereignty of the Hungarian people.”
“Unlike some of the leadership of Brussels, I’m not threatening you or telling you that we’re going to withhold funds to which you’re legally entitled,” he added. “You will make the decision about Hungary’s future.”
Magyar on Tuesday appeared to dismiss Vance’s comments.
“No foreign country may interfere in Hungarian elections. This is our country. Hungarian history is not written in Washington, Moscow, or Brussels — it is written in Hungary’s streets and squares,” said Magyar on his X account.
A spokesperson for the Háttér Society, a Hungarian LGBTQ rights group, told the Blade that neither Magyar, nor his party have reached out to the organization.
The spokesperson said the group does not “campaign directly for them or for any other political party.” The Háttér Society, however, is encouraging LGBTQ Hungarians to vote.
“Ahead of election day, we will encourage everyone on our social media channels to go out and vote, as this is the only way we can act against a system that has been working against the LGBTQI community for many years,” said the spokesperson.
LGBTQ groups condemn Trump’s threat to destroy Iranian civilization
Glisten’s 30th annual Day of Silence to take place April 10
D.C. Council member honored by LGBTQ homeless youth group
Vance speaks at Orbán rally in Hungary
White House ends protections for trans students in multiple school districts
Belarusian lawmakers approve bill to crackdown on LGBTQ rights
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