Congress
Congress passes ‘Big, Beautiful Bill’ with massive cuts to health insurance coverage
Roughly 1.8 million LGBTQ Americans rely on Medicaid
The “Big, Beautiful Bill” heads to President Donald Trump’s desk following the vote by the Republican majority in the U.S. House of Representatives Thursday, which saw two nays from GOP members and unified opposition from the entire Democratic caucus.
To partially offset the cost of tax breaks that disproportionately favor the wealthy, the bill contains massive cuts to Medicaid and social safety net programs like food assistance for the poor while adding a projected $3.3 billion to the deficit.
Policy wise, the signature legislation of Trump’s second term rolls back clean energy tax credits passed under the Biden-Harris administration while beefing up funding for defense and border security.
Roughly 13 percent of LGBTQ adults in the U.S., about 1.8 million people, rely on Medicaid as their primary health insurer, compared to seven percent of non-LGBTQ adults, according to the UCLA School of Law’s Williams Institute think tank on sexual orientation and gender identities.
In total, the Congressional Budget Office estimates the cuts will cause more than 10 million Americans to lose their coverage under Medicaid and anywhere from three to five million to lose their care under Affordable Care Act marketplace plans.
A number of Republicans in the House and Senate opposed the bill reasoning that they might face political consequences for taking away access to healthcare for, particularly, low-income Americans who rely on Medicaid. Poorer voters flocked to Trump in last year’s presidential election, exit polls show.
A provision that would have blocked the use of federal funds to reimburse medical care for transgender youth was blocked by the Senate Parliamentarian and ultimately struck from the legislation — reportedly after the first trans member of Congress, U.S. Rep. Sarah McBride (D-Del.) and the first lesbian U.S. senator, Tammy Baldwin (D-Wis.), shored up unified opposition to the proposal among Congressional Democrats.
Congress
Five HIV/AIDS activists arrested outside Susan Collins’s D.C. office
Protesters demanded full PEPFAR funding
U.S. Capitol Police on Tuesday arrested five HIV/AIDS activists who protested outside U.S. Sen. Susan Collins (R-Maine)’s office in the Dirksen Senate Office Building.
A press release that Housing Works, Health GAP, and Disability Voters of Maine issued notes 30 HIV/AIDS activists “carried out an act of civil disobedience” at Collins’s D.C. office and “delivered mock ‘bodybags'” to her office in Portland, Maine.
“Activists were reacting to deadly harms caused by Collins’s unwillingness to hold Office of Management and Budget (OMB) Director Russell Vought accountable for illegally obstructing the release of already appropriated funding for lifesaving HIV treatment and prevention,” reads the press release.
Elizabeth Koke, senior director of brand strategy for Housing Works, told the Washington Blade that Housing Works CEO Charles King is among those who were arrested in D.C. The press release notes 30 HIV/AIDS activists participated in the protest.

Activists since the Trump-Vance administration took office in January have demanded full PEPFAR funding.
Secretary of State Marco Rubio Jan. 28 issued a waiver that allowed PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during the freeze on nearly all U.S. foreign aid spending. HIV/AIDS service providers around the world with whom the Blade has spoken say PEPFAR cuts and the loss of funding from the U.S. Agency for International Development, which officially closed on July 1, has severely impacted their work. (The State Department last month announced PEPFAR will distribute lenacapavir, a breakthrough HIV prevention drug, in countries with high prevalence rates.)
The New York Times in August reported Vought “apportioned” only $2.9 billion of $6 billion that Congress set aside for PEPFAR for fiscal year 2025. (PEPFAR in the coming fiscal year will use funds allocated in fiscal year 2024.)
Bipartisan opposition in the U.S. Senate prompted the Trump-Vance administration in July withdraw a proposal to cut $400 million from PEPFAR’s budget. Vought on Aug. 29 said he would use a “pocket rescission” to cancel $4.9 billion in foreign aid that Congress had already approved.
The federal government has been shut down since Oct. 1.
“In July, we applauded Collins’s willingness to fight for people with HIV which resulted in a temporary reprieve from further unlawful cuts,” said Health GAP Executive Director Asia Russell. “In response, Vought has gone behind Collins’s back. Why isn’t she fighting back? We cannot allow Collins to refuse to take action now — just because Vought is violating the law doesn’t mean she can break her promise to people with HIV.”
Collins chairs the Senate Appropriations Committee.
“Collins has said that PEPFAR funds are not reaching people in need, yet she refuses to use the full power of her position to end the political obstruction and lawlessness while people continue to die,” said Marie Follayttar of Disability Voters of Maine. “The consequences of her inaction, and of her votes, will be measured in body bags around the world.”
The protesters’ press release notes two specific demands for Collins:
• Fully restore PEPFAR programming by directing Vought to release withheld PEPFAR funding consistent with Congressional appropriations
• Include the release of withheld PEPFAR funding as part of her 6-point plan to re-open government
“Senator Collins has been the Senate champion for PEPFAR and was responsible for saving the program from $400 million in cuts just three months ago,” Blake Kernen, Collins’s press secretary, told the Blade on Wednesday. “It was difficult to understand what the protesters wanted or their message.”
“Many entered the office, sat on the ground, and used a loud noisemaker, which made it impossible to hear,” said Kernen. “A member of Sen. Collins’s staff offered to speak with the group, but they continued to shout over her and refused the offer.”
Congress
Mike Waltz confirmed as next UN ambassador
Trump nominated former national security advisor in May
The U.S. Senate on Sept. 19 confirmed former U.S. Rep. Mike Waltz (R-Fla.) as the next U.S. ambassador to the U.N.
The Florida Republican had been the national security advisor until President Donald Trump in May tapped him after U.S. Rep. Elise Stefanik (R-N.Y.) withdrew her nomination in order to ensure Republicans maintained their narrow majority in the U.S. House of Representatives.
Senators approved Waltz’s nomination by a 47-43 vote margin.
“Thank you President Trump and the U.S. Senate for your trust and confidence to Make the UN Great Again,” said Waltz on X.
The U.N. General Assembly is taking place this week in New York. Trump is scheduled to speak on Tuesday.
Congress
State Department urged to restore LGBTQ-specific information in human rights reports
Congressional Equality Caucus sent Secretary of State Marco Rubio a letter on Sept. 9
The Congressional Equality Caucus has called upon the State Department to once again include LGBTQ and intersex people in their annual human rights report.
U.S. Reps. Robert Garcia (D-Calif.), Julie Johnson (D-Texas), and Sarah McBride (D-Del.), who co-chair the caucus’s International LGBTQI+ Rights Task Force, spearheaded a letter sent to Secretary of State Marco Rubio on Sept. 9.
The 2024 human rights report the State Department released last month did not include LGBTQ-specific references. Jessica Stern, the former special U.S. envoy for the promotion of LGBTQ and intersex rights under the Biden-Harris administration who co-founded the Alliance for Diplomacy and Justice, described the removal of LGBTQ and intersex people and other groups from the report as “deliberate erasure.”
“We strongly oppose your decision to remove the subsection on Acts of Violence Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics (SOGIESC Subsection) from the State Department’s Annual Country Reports on Human Rights Practices (Human Rights Reports),” reads the letter. “We urge you to restore this information, or else ensure it is integrated throughout each human rights report.”
Congress requires the State Department to release a human rights report each year.
The Congressional Equality Caucus’s letter points out the human rights reports “have been a critical source of information on human rights violations and abuses against LGBTQI+ persons around the world.” It specifically notes consensual same-sex sexual relations remain criminalized in more than 60 countries, and the 2017 human rights report included “details on the state-sponsored and societal violence against LGBTQI+ persons in Chechnya, including extrajudicial killings.”
Immigration Equality in response to the 2024 human rights report said the reports “serve as key evidence for asylum seekers, attorneys, judges, and advocates who rely on them to assess human rights conditions and protection claims worldwide.”
“The information in these reports is critical — not just for human rights advocates — but also for Americans traveling abroad,” reads the Congressional Equality Caucus’s letter. “LGBTQI+ Americans and their families must continue to have access to comprehensive, reliable information about a country’s human rights record so they can plan travel and take appropriate precautions.”
The caucus’s full letter can be read here.
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