Opinions
‘Nuclear option’ needed to overcome filibusters
Lawmakers shouldn’t fear appointments of those who share president’s views
(Washington Blade file photo by Michael Key).
The minority in the Senate, be it Republican or Democrat, have been afraid of debating presidential appointments to administration positions and judicial openings below the Supreme Court and deciding them by majority vote. After the vote last week to end filibusters in these areas there was much gnashing of teeth on all sides.
The Washington Post editorial “After filibuster vote, both parties will face nasty ‘nuclear’ fallout” said, “Majority Leader Harry M. Reid (D-Nev.) proved not enough of a leader to resist the naked power grab. American democracy is that much poorer as a result.”
The New York Times in its editorial “Democracy Returns to the Senate” said, “Today’s vote was an appropriate use of that power, and it was necessary to turn the Senate back into a functioning legislative body.”
Over the past decade partisanship has reached new levels and political fights in Congress are now more oriented toward debating philosophical differences rather than looking for compromise that will serve the people well. Many attribute this to the gerrymandering of congressional districts, which created more safe seats for members of a particular party. In the Senate, more politicians get elected with slogans without actually having to discuss what their positions and votes in the Senate will mean to their constituents. Because of the Supreme Court decision in Citizens United, huge amounts of money from both the far right and far left are being poured into campaigns and that often overwhelms any rational debate.
Sen. Ted Cruz (R-Texas) was able to lead the fight trying to repeal the Affordable Care Act gaining enough support from other Tea Party members of Congress, against the will of many of his Senate colleagues, to close down the government. He was and is still able to disregard the issue of what it means that 25 percent of Texans, his constituents, don’t have health insurance and he has no apparent plan to get them coverage.
There is enough money pouring into the right wing of the Republican Party to threaten primaries against anyone who dares speak out against them. There is a willingness to threaten filibusters over every political appointee that the president sends to the Senate regardless of their qualifications simply to make a point and stymie him.
It was with this background that the Democrats in the Senate used rules that they had only threatened to use before and took the action they did to end the pointless filibusters.
Many share my view of our democracy, which is that we elect a president with the anticipation that he or she will be able to put together an administration to try to move forward the agenda on which they were elected. They should be able to appoint qualified judges who promise to judge cases based on the law but may have a worldview more in tune with the elected president who is appointing them. That has always been the case for Supreme Court nominees but since that is the court of last resort in protecting the Constitution, those nominees will continue to get much more scrutiny and the minority party will still be able to use the filibuster to try to stop those nominations should they feel inclined to do so.
For many years the filibuster was a rarely used threat. We must remember that this was not thought of when the Senate was formed but was added by senators at a later date. It was assumed that it would be seldom used because the members of the Senate, being the more deliberative body of Congress, would also understand the art of compromise. In recent years that has clearly changed and the minority party has tried to have much more sway over the people the president wants to help him/her carry out their agenda. This has led to gridlock in many areas and openings in the executive branch and on the courts going unfilled for months or even years at a time. Just a quick look at the number of cloture votes (a vote needed to end a filibuster) shows where we are today. There were 38 in the eight years of George W. Bush and there are already 81 in less than five years of Obama’s presidency.
Neither Democrats nor Republicans should fear the appointment of people to the administration or the courts who share the views of the president. That is what elections are for. Should the people not like the direction of the country they will vote against it in off-year elections for the House and Senate and in presidential elections every four years. I would rather trust the people than a small group of radical senators to do the right thing.
Letter-to-the-Editor
D.C. electoral bumper car season is in full swing
More than a dozen candidates running for incumbent Eleanor Holmes Norton’s seat
The District of Columbia has entered into a challenging time not seen since Dr. Martin Luther King was murdered, the city burned and rioted and risked home rule being taken away. While statehood has twice passed the U.S. House of Representatives, the dream of being the 51st star on the American flag stagnates, to say the least.
Currently according to Politics 1.com, there are already 14 Democrats including two sitting members of the City Council (At-Large Robert White and Ward 2’s Brooke Pinto) and one Republican who have declared their candidacy to become the new voice in Congress. Unfortunately Congresswoman Eleanor Holmes Norton has refused to either announce her intentions to run for re-election again or gracefully acknowledge her time is over and she is ready to hand over the reins to continue the battles inflicted upon our home city. Congressional representation by press releases has simply got to stop as soon as possible!
Rank choice voting is going to be implemented in this 2026 cycle despite efforts to overturn or delay its implementation. Regardless of your thoughts on the new system, this will be one very interesting contest year to say the least. Rank choice … ready or not … here it comes!
Needless to say, the race for the Congressional seat is not the only major contest. Let us not forget the other positions up for election: the mayor, the attorney general, the chairman of the City Council, several ward and at-large races for the council. Add all these up and you will be looking at more moves on the political chess board than seen in the first Harry Potter film with the same results too. (As an aside, while the District of Columbia has no elected senators, it should be pointed out that any elected House member AND the District mayor have Senate floor privileges when in session.)
Before the June primary, it would be wise to make sure your voting registration is still current at the D.C. Board of Elections. Also, please urge friends not registered to do so as soon as possible. May we have the strength and will power to take back our city and stand up to those who want to destroy it.
Opinions
Zach Wahls stood up for us, now let’s stand with him
Young Iowa Democrat running for U.S. Senate
It was 15 years ago, on Jan. 30, 2011, that a college student, Zach Wahls, bravely stood in front of the Iowa Legislature, and spoke out, defending the marriage rights of his two moms. On Jan. 28 we will celebrate the 15th anniversary of that speech. That was the first time I, and millions of others, heard of Zach Wahls. I know Zach had no idea that speech would propel him to national prominence. It went viral, and Zach was invited to appear on the Ellen DeGeneres show, among other appearances.
At the time, he was an engineering student at the University of Iowa. As he has said, when he prepared his notes over the weekend for his Monday speech to the legislature, he had no idea where this would lead him. Today, so many of us, not just his moms, have the chance to repay him for what he did that day, when he defended all our rights in Iowa. In the past 15 years, Zach has never stopped standing up for the rights of his moms, and for all of us in the LGBTQ community.
I first met Zach at an event in Washington, D.C., when he was leading the fight to allow gay men to be leaders in the Boy Scouts of America. Having been a Boy Scout myself, and an Explorer adviser, and having promoted scouting for the handicapped (the term we used back in those days) this was an important fight for me. I was both honored to meet Zach, and have the chance to join him in that fight. Since then, I have followed his career. First as he went to Princeton for his graduate degree, and then back to Iowa, he is a sixth generation Iowan, to run for, and win, a seat in the Iowa State Senate. He was then elected to the post of minority leader. Today, Zach is running to become the United States Senator from Iowa. Zach is a member of the younger generation so many of us want to see serving in Congress.
As soon as I heard Zach was running, I endorsed him. Many of you may have read my endorsement column in the Blade. He was recently in Washington, D.C. for a fundraiser held at the Women’s National Democratic Club, where I had the pleasure of meeting his wife, and his absolutely adorable son. I kidded him he should never go campaigning without them. Now, it’s important to remember, he is running in Iowa. Not an easy race to win. He has a primary to win, which I firmly believe he will, and then his likely opponent is the ultra MAGA Republican Congresswoman Ashley Hinson (R-Iowa). A poll done just before Sen. Joni Ernst (R-Iowa) said she would not run again, had Zach leading her. That may have been part of the reason she dropped out. If you followed Zach’s career in Iowa, you understand why Iowans would vote for him. If you haven’t, take a look at his website, to get an idea of where Zach stands on the issues, and the things he has been doing to fight for all Iowans. His proposed federal legislation, Keep the Promise Act, would strengthen Social Security. Zach understands we need to defeat the fascists working with the felon in the White House, before they totally destroy our country. He understands we need to fight for affordable healthcare for all, for his constituents in rural Iowa, who are getting hit the hardest by the felon’s policies. Iowa farmers are losing their farms because of the felon’s policies. While continuing to fight for the LGBTQ community, Zach has always understood, we are part of the broader community he is now fighting for.
I hope those of you who read this column, will join with me, support Zach, and be part of the Zoom call on Wednesday, Jan. 28, to celebrate the 15th anniversary of Zach’s speech to the Iowa Legislature. To join, click on this link, and sign up. I also ask you to share this link with everyone you know. Our community owes something to Zach, but everyone will benefit, if Zach Wahls ends up in the United States Senate. He will make us all proud.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Rollback of health IT standards will harm LGBTQ patients
Trump proposal would remove most data fields in medical records
For most Americans, the ability to change healthcare providers and easily have their health records transfer feels like a given. But it was not until the 21st century Cures Act was signed in 2020 that regulations on health technology mandated that electronic health records had to be able to collect, receive, and transfer specific data fields in a uniform way (known as the U.S. Core Data for Interoperability). Before that, if your new doctor and your prior doctor subscribed to different electronic health records systems, there was a very good chance that the data fields didn’t match up and some patient information would literally be lost in translation.
Through the Office of the National Coordinator for Health IT, created through executive order by President George W. Bush, the Biden administration advanced health IT policy specifically to ensure that LGBTQI+ patients records would transfer to new providers with unique information that patients need their providers to have access to. This includes data fields for chosen names, pronouns, and sex parameters for clinical usage – or in other words, what sex should be listed for lab work, regardless of the patient’s gender identity. There were also fields added for sexual orientation and gender identity. To be clear, the requirement was for the electronic health record systems to be able to collect, transfer, and receive these data points. There was never a requirement for providers to ask all these questions or for patients to be required to answer them. But if the IT systems aren’t mandated to have these fields in a uniform way, the impact of a provider asking the questions is limited only to the care that the specific provider offers to the patient. The Trump administration has proposed removing 34 of the 60 required data fields in electronic health records, including the fields for chosen names, pronouns, sexual orientation, gender identity, and sex parameters for clinical usage.
There has been widespread support for these regulations on health IT companies. Having a lowest common denominator for health IT systems is good for patients and for healthcare providers. It also isn’t particularly controversial. Not surprisingly, the only folks cheering on deregulation are those ideologically opposed to any government regulations, and the specific companies who are subject to these health IT regulations.
The deregulators in the Trump administration would have us believe the myth that these regulations somehow hinder innovation and make it harder for tech startups to enter the health IT field. They gaslight us by calling this clear disservice to patients “prosperity.” But imagine what it would be like to go back to a time before these critical health IT regulations. When the new doctor you see doesn’t have very much if any information about the patient and the transfer of patient records was manual and cumbersome, often requiring someone to pay for their records to be printed, mailed, and then scanned into a different electronic health record system. This won’t lead to innovation, but it will lead to harm for the patient-provider relationship, and worsened health outcomes for the American people.
HHS Secretary Robert F. Kennedy Jr. has been deliberate and unrelenting in his rollbacks of health equity measures for LGBTQI+ Americans. He has proposed rules that would ban hospitals from receiving federal funds if they offer gender affirming care for youth; he has gutted the Office of Infectious Disease and HIV/AIDS; he has rolled back civil rights protections in health care for LGBTQI+ Americans; and he has eliminated most federal health agency data collection of sexual orientation and gender identity. And this is just a small slice of his crusade at HHS to erase LGBTQI+ people.
There are currently many proposed rules and administrative changes that would harm access to equitable, high quality healthcare for LGBTQI+ people. So it makes sense that LGBTQI+ Americans may not be aware of such a wonky area of policy as federal health IT regulations. But we want to stress that deregulating health IT, with a specific goal of removing the minimum requirements for electronic health record systems to collect, transfer, and receive basic data fields of importance to LGBTQI+ people’s clinical care, will worsen both access to as well as quality of even basic healthcare for LGBTQI+ Americans. And for healthcare providers it is uniquely scary. They rely on the data in patient’s electronic records. And they need the IT systems they use to be able to talk to each other. Deregulating health IT is akin to trying to charge an iPhone with an Android charger, but as if your life depended on it.
There is an opportunity for public comment until Feb. 27, and anyone can make a comment. As a person who receives healthcare and/or a person who provides healthcare, speaking up is imperative. These health IT regulations are described by some as “woke” but really it’s very simple: when you go to the doctor, any doctor, you want them to have some basic information about who you are. Without that information, a healthcare provider could easily make an assumption about the patient that is inaccurate and that leads the provider to make different recommendations than what the patient needs.
This is not radical, this is the very premise of healthcare delivery. And LGBTQI+ patients stand to be left behind, deliberately and systematically, if these deregulations of health IT are put into effect. Without accurate, timely data, providers are unable to live up to the promise of precision medicine and will fail to ensure everyone receives the care that matches their unique needs.
Adrian Shanker is senior fellow at Lehigh University College of Health. He served as deputy assistant secretary for health policy and senior adviser on LGBTQI+ health equity at the U.S. Department of Health and Human Services in the Biden-Harris administration. Dr. Carl G. Streed, Jr. is Associate Professor of Medicine at Boston University Chobanian and Avedisian School of Medicine and Research Director at the GenderCare Center at Boston Medical Center.
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