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Cruel court decision makes it harder to prevent AIDS

Disease gets a boost from federal judge in Texas

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Just as the disease was on a glide path to extinction thanks to new drugs, HIV/AIDS got a boost from a federal court in Texas.

On Sept. 7, U.S. District Judge Reed O’Connor ruled that the government can’t require an employer-sponsored health care plan to cover a therapy that prevents the spread of a disease that has already killed more than 700,000 Americans. The decision in Braidwood Management Inc. v. Becerra is not just poorly argued; it is flat-out cruel.

Perhaps the best feature of the Affordable Care Act (ACA) of 2010, nicknamed Obamacare, was a requirement that insurance offer coverage of specified preventive care procedures and therapies, such as colon cancer screening and influenza immunizations.

In June 2019, the U.S. Preventive Services Task Force, an advisory panel of experts, issued a “Grade A” recommendation for pre-exposure prophylaxis, or PrEP, a medicine that is 99% effective in preventing HIV transmission during sex. The first PrEP drug, Truvada, had been approved seven years earlier by the Food & Drug Administration. On Jan. 1, 2021, the federal government required plans to cover PrEP with no copay, coinsurance, or deductible.

Even before the mandate, the Centers for Disease Control and Prevention (CDC) credited PrEP with helping reduce new HIV infections in the U.S. by 8% between 2015 and 2019 “after a period of general stability.” The CDC now calls PrEP “a key prevention strategy for ending the HIV epidemic in the U.S.,” a goal for 2030 set by both the Trump and Biden administrations.

The way to end AIDS once and for all is to get PrEP to those who need it most. Researchers are developing intravaginal rings, implants, antibodies, and long-lasting injectables. Although PrEP use has risen by a factor of eight in just five years, three-quarters of those most at risk are not using the therapy.

The success of the lawsuit by a group of self-described Christian business owners and employees will make access even more difficult. The plaintiffs argued that the preventive care mandate for PrEP violated their constitutional right to religious freedom. In the complaint, Dr. Steven Hotze said that he was unwilling to pay for a health plan covering PrEP “because these drugs facilitate or encourage homosexual behavior, which is contrary to [his] sincere religious beliefs.”

Hotze, whose vitamin company ran afoul of the FDA for COVID-19 claims, was indicted in April on aggravated assault charges involving a bizarre search for ballots after the 2020 election.

In the PrEP case, Hotze’s objection went beyond gay sex. He complained that providing coverage of the drugs facilitates and encourages “sexual activity outside of marriage between one man and one woman” as well as illegal drug use.

Judge O’Connor agreed. He went even further, ruling that members of the Preventive Services Task Force were “unconstitutionally appointed.”

In a previous case, O’Connor had ruled that the entire ACA was unconstitutional, but the Supreme Court reversed that decision last year. The current ruling draws on the Religious Freedom Restoration Act (RFRA) of 1993, which was enacted by Congress after the Supreme Court ruled in Employment Division v. Smith that the protection of the free exercise of religion in the First Amendment does not entitle anyone to a religion-based exception from a general law.

In recent years, writes Michael Dorf of the Cornell University Law School, “conservative Christians have increasingly relied on [RFRA] to obtain exceptions from laws involving insurance coverage for contraception and abortion.”

For example, in Burwell v. Hobby Lobby, a 2014 case, the Supreme Court held that a company owned by religious Christians could be excused from an obligation to pay for health insurance that covered “forms of contraception that the owners regarded as tantamount to abortion.”

But the ruling in the Braidwood case is far more sweeping. The Hobby Lobby plaintiffs considered abortion itself immoral. In this case, it’s not PrEP that Braidwood considers immoral; it’s certain kinds of sexual activities. By substantially lowering the risk of contracting HIV/AIDS, this twisted logic goes, PrEP is a facilitator of what Hotze considers immoral. And by offering insurance that covers PrEP, Braidwood says it becomes complicit.

There is a serious cost to this attenuated argument. By decreasing access to PrEP, people will needlessly become ill and, in some cases, die. The economy will also be burdened with the cost of treating a disease that can be prevented.

Modern science has developed therapies that are ending the spread of a dangerous, mortal virus. Easing access to these medicines is clearly a legitimate function of government — undoubtedly, a compelling interest. What can be more selfish and foolish than to erect needless obstacles for those who want to protect themselves and people around them?

James K. Glassman, a former Under Secretary of State in the George W. Bush administration, is an adviser to health care companies and non-profits.

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I respect AOC, even though I often disagree with her

She should work toward House leadership role and skip presidential run

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Rep. Alexandria Ocasio-Cortez (D-N.Y.) (Washington Blade file photo by Michael Key)

There is a column in the New York Times asking, “Is Ocasio-Cortez ready for the glass cliff?” The author thinks it’s a great idea for her to run for president. I believe it’s a bad idea for her personally, and a disastrous idea for the Democratic Party. However, that is not the only column written recently about Ocasio-Cortez, discussing her options and private life. I think it is cringeworthy what social media, and even some mainstream media, are focusing on these days. 

Politicians have become fodder for what were once just stories about Hollywood, and loud showmen like the felon in the White House. Now, like the showman, those like AOC, can’t claim they aren’t asking for it by striving for the biggest online following possible. They obviously see that as a way to validate themselves; politicians use it as a way to raise money, become influencers, and get their message out. 

But they also open themselves up to even more intrusion into their private lives. Those who do that also open the door for all politicians to have their private lives made public. Running for president, which the column suggests AOC should do, and which she herself has said she isn’t ruling out, is a great way to grab a headline, and leads to reporters digging to find every little fact about her. AOC is trying to get ahead of the curve by talking about a breakup, and then about harvesting her eggs — topics once considered private that should stay that way. There was once just the National Enquirer, but today every news outlet incorporates what the Enquirer did, as it makes for great clickbait.

I feel for her, thinking all this has to be public, when a single woman wants to run for higher office. We have seen married women, including Geraldine Ferraro, Sarah Palin, Hillary Clinton, and Kamala Harris, run and be subjected to dealing with questions about their husbands, their former boyfriends, and in some cases, more reporting about those things than what they stood for. Maybe for AOC, that would be a good thing, as the country is far from ready for a candidate who up until now, proudly represents the Democratic Socialists of America (DSA). Yes, she is trying to step away from them a little, but I don’t think that is possible, which is why I feel it is a disaster for her to run, both for herself, and the Democratic Party. She could decide to run for the Senate if Chuck Schumer (D-N.Y.) understands it is time for him to retire. Even that could be a difficult race. She might win a primary, which another progressive representative, Bella S. Abzug (D-N.Y.), tried and lost in 1976, if she gets a big enough New York City vote. Should she try, we would see how much change there has actually been.

Back when JFK had women in and out of the White House, Ronald Reagan got Nancy pregnant before they married, and George H.W. Bush allegedly had a mistress traveling with him, those were not the headlines. I think we were all better off. Gary Hart asked for it when he told the press to follow him, and they caught him with a woman not his wife. Again, he asked for that. Then we got to the Clinton era and the right wing, actually David Brock, got the information on Paula Jones, and it all exploded, eventually cascading down to harm Hillary. They tried to find anything they could on Jimmy Carter, George W. Bush, and Barack Obama, but couldn’t find the salacious bits they were looking for. But I bet they will find some things that sound salacious on AOC, even if they have to make them up. She appears to be a normal, highly intelligent, motivated, single woman. 

Recent primaries in Michigan and Wisconsin, and general election results, will clearly impact what she decides to do. DSA candidates are not an easy sell to most Democrats, let alone the general electorate. We will find out how Dr. El-Sayed does in the general election. While I didn’t support him in the primary, I do in the general election. Those results, and looking back at other women who have run, may give AOC second thoughts about giving up working toward seniority in the House. I predict she could be much more impactful than one of her idols, Bernie Sanders, has been. He has been there for 40 years and accomplished nothing. I think AOC could accomplish a lot.  


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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Will Michigan save the GOP?

We must stop fighting each other as Democrats and rid country of Trump

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(Photo by SSilver/Bigstock)

Last week in Michigan we saw how dramatically wrong, and misleading, political polling can be. Because of that, and the media hype, it might have made a difference in the Democratic primary for the United States Senate. Haley Stevens lost by about 16,000 votes, and the second Democrat closest to Stevens’s views, withdrew from the race, but her name was still on the ballot, and she received 61,000 votes. So, what would have happened if she had withdrawn in time to keep her name of the ballot? We will never know. 

The media have been hyping the few wins the DSA, and far-left Democratic candidates, have had, to the point you might think they are winning hundreds of primaries around the country. I think they have won fewer than 15. But those 15, and the hype, could actually make a difference in the general election. They could make a difference because they clearly divided the Democratic Party, and we don’t know if it will come back together in time to rid ourselves of the control of the felon, his fascist advisers, and their sycophants in Congress, now running our country. 

While strongly opposed to parts of the platform of the Democratic Socialists of America, (DSA), and those who would espouse them, I am even more opposed to the felon in the White House who has proven he has no redeeming values. The DSA platform is a mixed bag. In my view there are some frightening parts such as calling for total defunding of the police, for workers to own every business, for the abolishment of the State of Israel, telling their endorsed candidates they may not meet with any Zionist organization, and now, elimination of the United States Senate. Before you respond telling me about what is not in the platform, please just read some of it. But then I am for the parts calling for universal healthcare, a higher minimum wage, strong union support, and working toward affordable housing, and a decent life for all. 

So, what do the candidates who won with the support of the DSA do between now and Nov. 3? They must be very clear which parts of the DSA platform they believe in, and tell voters clearly, how they will govern and legislate. Make clear their priorities. That is the only way we will unite Democrats in time to win the general election.

Then those who lost to them should do what Rep. Stevens did in her concession statement in the Michigan U.S. Senate primary. It was a classy statement responding to the election results. She said: “I want to congratulate Abdul El-Sayed on winning the Democratic nomination for U.S. Senate. He is a doctor, a community health official, a Rhodes Scholar, and a dedicated Michigander. I am proud to offer my support as he takes on Mike Rogers in the general election. This was a thorough and rigorous campaign that brought out the full span of views within the Democratic Party – and that is why we have primaries. I am proud to have put up my hand to serve, and prouder to continue to work together to make sure this Senate seat remains blue, that we flip the United States Senate and continue the work for MichiganNow I hope Dr. El-Sayed will run a campaign understanding which voters he needs to appeal to in order to win, and to keep the Michigan United States Senate seat in Democratic hands. When a vote is split 50/50, which was basically the case in this race, reading the 50% who voted against you correctly, is the key to winning. Many of those voters didn’t trust Dr. El- Sayed for a multitude of reasons. But he must now convince them, even with what they didn’t like about him, he is still a better choice than the Republican candidate. This is no different than in so many races around the nation, although it might be harder for a very far-left candidate to sway more moderate voters.” 

I would say to the voters of Michigan, “While I did not support Dr. El-Sayed in the primary, I would definitely vote for him in the general election. The goal is saying to the felon in the White House that we will not let you continue to destroy our country. We Democrats may speak with a host of different voices, but they should all say to the felon: you are a loser, and we will see you, your fascist government, and your sycophants in Congress, defeated.”  

We must stop fighting each other as Democrats, at least long enough, to accomplish this goal.


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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Treat our political opponents as neighbors not enemies

I want an America where each party makes the other better

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(Image by Drawlab19/Bigstock)

For much of my adult life, people have assumed they know my politics before I open my mouth. As a transgender man writing for an LGBTQ publication, many assume I fit neatly into one political camp. The truth is more complicated. I have long felt politically centrist. I believe deeply in protecting LGBTQ Americans from discrimination and violence, and I also vehemently believe in Black Lives Matter, but I also believe in fiscal responsibility, a strong national defense, and institutions that encourage personal responsibility. I have found wisdom on both sides of the aisle, and I have found blind spots on both sides as well. I’ve also found some Republicans close to me to love me deeply, and I’ve found Democrats to do the same. 

That leaves me with an unfashionable conclusion as a sort of pioneering transgender man: America desperately needs more bipartisanship.

Not because disagreement is unhealthy. Democracy depends on disagreement. But because democracy cannot survive if we begin treating our political opponents as enemies instead of neighbors.

Sen. John McCain understood this better than most. During his concession speech after losing the 2008 presidential election, supporters booed when Barack Obama’s name was mentioned. McCain immediately stopped them. “No, my friends,” he said. “Senator Obama is a decent person and a person you do not have to be scared of as president.” At a time when it would have been politically convenient to inflame partisan passions, McCain instead reminded Americans that losing an election did not mean losing a country.

Years later, after being diagnosed with brain cancer, McCain returned to the Senate to cast one of the defining votes of his career. More memorable than his famous thumbs-down vote on repealing the Affordable Care Act was the speech he delivered beforehand, pleading for senators to return to “regular order” and legislate together rather than behind closed doors. It was not simply a procedural argument. It was a moral one: institutions work best when neither party assumes it possesses all the answers.

American history repeatedly validates that lesson. The Civil Rights Act of 1964 did not become law because one party overwhelmed the other. It passed through bipartisan coalitions that included Democrats and Republicans willing to work across ideological divides. The Voting Rights Act of 1965 followed a similar path. Even President Ronald Reagan, remembered today as a conservative icon, ultimately signed legislation establishing Martin Luther King Jr. Day as a federal holiday after bipartisan support made the case impossible to ignore.

LGBTQ equality has followed a similar trajectory.

One of the most significant LGBTQ legislative victories in recent years—the Respect for Marriage Act—was not a partisan triumph. The bill passed the Senate by a vote of 61-36 with the support of 12 Republican senators after bipartisan negotiations added religious liberty protections that broadened its coalition. It later became law with bipartisan support in the House as well. Those Republican senators deserve much attention and a decent amount of respect. 

As the son of two State Department diplomats, I also grew up overseas, living in embassies with legions of Marines that protected us kids from violence outside and potential assaults from foreign agents and spies. I learned from a young age that the American military is necessary to the survival of our nation. We need bases in foreign lands, Navy ships, and a CIA apparatus to defend us from overseas enemies. This is the reality that America faces, yet some in the LGBTQ community advocate for the demolition of the military. 

As someone who is transgender, I understand why many LGBTQ Americans are skeptical of this argument. There are lawmakers advancing legislation that threatens our dignity or our rights. Those concerns are real. But political victories that endure rarely come solely from defeating opponents. They come from persuading them—or at least persuading enough of them that they become partners rather than permanent adversaries.

Right now, America is in a hellish partisan crisis. Trump is verging on a crazed dictator and Alexandria Ocasio Cortez and Bernie Sanders are yelling platitudes condemning Republicans. This crisis needs to be resolved. We need to dull the flames of political hate. We need to come back to the center, as McCain rightfully said. 

This is called the politics of the neighbor. When you step outside your house or apartment, you will inevitably meet neighbors who carry different political views than you. They may believe in gun rights, or even vote for Trump, but if they act decently toward you, you should probably act decently toward them. 

The neighbor coaches your child’s soccer team. They teach your daughter mathematics in middle school. They are therapists in addiction centers. They are bus drivers. They are bankers. They are lawyers. They could very well be politicians, too. 

The neighbor helps shovel your driveway after a snowstorm. They give you a plant to put in your garden. When you have to go in for a biopsy, they stand by your side and help you through medical results.

The neighbor attends a different church, watches a different cable network, votes differently than you do—and still shows up when your family is in crisis. 

But the neighbor means a lot to you, and you should mean a lot to them. 

I do not want an America where Republicans disappear. I do not want an America where Democrats disappear. I want an America where each party makes the other better.

That aspiration should not sound naïve. It should sound patriotic.

The measure of a democracy is not whether it eliminates disagreement. It is whether disagreement remains compatible with mutual respect. We can argue fiercely over taxes, immigration, foreign policy, and LGBTQ rights while still recognizing that the person casting the opposite vote is not necessarily a villain.

America has always been strongest when it remembered that political opponents are still fellow citizens. Before they are Republicans or Democrats, conservatives or progressives, they are our neighbors. And neighbors, unlike enemies, have to find a way to keep living together.


Isaac Amend is a transgender man and writer based in D.C. In 2017, he starred in National Geographic’s ‘Gender Revolution’ documentary, hosted by Katie Couric. His author’s portfolio is available at isaacamend.com, and you can catch him on Instagram at @isaacamend.

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