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Study finds LGBT health care improving

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(Public domain image)

WASHINGTON — A new report finds that things are improving for LGBT people because of better access to health care,, a Summit Professional Network publication, reports.

Citing a new study called “Health and Access to Care and Coverage for LGBT Individuals in the U.S.” from the Kaiser Family Foundation, the site reports findings that say that while LGBT people still tend to have more physical and mental health challenges than their straight counterparts, their needs are being increasingly recognized and met.

Researchers evaluated data from the U.S. Census Bureau, various state agencies, the Institute of Medicine, the National Center for Transgender Equality, the Centers for Disease Control and more to issue the report. Recent factors such as the Affordable Care Act’s implementation and the Supreme Court’s DOMA ruling were also considered, the article said.

The report credits the Affordable Care Act and the rejection of DOMA with “reshaping the health care and coverage landscape for (LGBT) individuals and their families.”


N.C. insurer drops gay, lesbian couples

CHARLOTTE, N.C. — Blue Cross and Blue Shield, the state’s biggest health insurer, has canceled family insurance policies it sold last month to gay and lesbian couples in North Carolina under the Affordable Care Act, the Charlotte News Observer reports.

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Blue Cross and Blue Shield canceled family insurance policies it sold last month to gay and lesbian couples in North Carolina.

The insurer canceled policies of 20 couples — some who were legally married in states that recognize gay marriage — and encouraged them to reapply for separate insurance policies as unmarried individuals. The couples received calls from Blue Cross in mid-January, several weeks after they purchased their family health insurance, and were told their family coverage was invalid, the article said.

Blue Cross’ strategy has stung same-sex couples and gay-rights advocates because the nonprofit insurer offers domestic partner benefits to its own employees. Blue Cross insurance plans offered by large companies in North Carolina also include health benefits for employees and their same-sex partner, the News Observer said.

The problem is traced to terminology in Blue Cross policies that define “spouse” as “opposite sex.” North Carolina insurance law does not prohibit selling coverage to gay couples, but Blue Cross was legally bound by the restrictive contract language in its individual plans, said Kerry Hall, spokeswoman for the N.C. Department of Insurance.

Blue Cross has vowed to update the language in 2015.


Md. clarifies non-bias rules for trans patients

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The Maryland Insurance Administration issued a bulletin on Jan. 27 indicating that insurance carriers cannot discriminate against transgender individuals in the state based on gender identity.  The purpose of the bulletin was to clarify the scope of the exclusion in the benchmark plan selected to define essential health benefits in Maryland as required by the Affordable Care Act for “treatment leading to or in connection with transsexualism, or sex changes or modifications, including but not limited to surgery.”

In other words, insurers cannot discriminate against transgender individuals under a health benefit plan on the basis of the insured’s actual or perceived gender identity for ordinary medical care but “the exclusion should be narrowly applied to items and services that are directly related to the gender reassignment process.”

The announcement was questioned by some members of the LGBT community on social media. “So this says that it is OK to discriminate against a transgender person if their medical need is transitioning,” wrote one woman who identified as trans on Facebook. “That doesn’t mean just surgery, which is relatively costly, but also allows discrimination regarding hormone therapy, which is the cost of scribbling a script and the cost of hormones, which in some cases is as little as five dollars at Walmart or CVS. All this really says is that they can’t discriminate against a transperson who has, say, high blood pressure or diabetes.”

Equality Maryland responded, “The bulletin is a first step in clarifying that transgender people in Maryland must have access to coverage and the medically necessary care they need. Further steps must be taken to ensure that Maryland law extends full and equal access for transgender people to coverage and care, including coverage for transition-related procedures and any other services that are covered for non-transgender people.”


Time for a new employee manual

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A review of existing employment manuals is especially important when there are significant changes in the laws governing the employer/employee relationship.


The beginning of the New Year is always a good time for companies and employers to review their existing employee manuals or employment policies to insure they are compliant with current law and with their own practices.  An old adage states that the only thing worse than not having an employment manual or written policies is to have them but not follow them. This adage reflects the need to insure that your policies comport with your company’s actual practices and that such practices are consistent with applicable law.

A review of existing employment manuals is especially important when there are significant changes in the laws governing the employer/employee relationship, as we have seen in 2013. These include the Windsor decision issued by the Supreme Court that struck down the Defense of Marriage Act, the implementation of some portions of the Affordable Care Act (“ACA”), the push for mandatory sick leave by some jurisdictions, the IRS’s continued focus on properly classifying employees v. independent contractors, and the EEOC’s stated strategic goal of focusing on workplace discrimination. Any one of these issues would require a revision to most employer’s policies and manuals, but together they call for a complete revamping and review of the way policies are formed and enforced by most employers.

D.C. employers have been used to protecting gay employees from discrimination given the D.C. Human Rights Act; however, employers in Maryland and Virginia have not had a state law with the same level of protections, although Maryland has moved in that direction. Given the Windsor decision and subsequent IRS guidance, gay couples that are lawfully married in a state or jurisdiction recognizing such unions may avail themselves of the same rights as heterosexual couples when filing their tax returns. The effect on employers in the region (where two of the three major jurisdictions recognize gay marriage) is that they cannot deny certain benefits to gay employees who are legally married. Employers should be sure that these protections are clearly set forth in their employment manuals.

Much has and will continue to be written about the ACA as its provisions are implemented but employers – especially smaller employers/companies need to be prepared. The most important lesson at this juncture is that employers with fewer than 100 employees need to begin to prepare their workers for the changes that have now been delayed until 2015. This will include mandatory participation in the local health care exchanges, as well as mandatory minimum benefits that must be provided by almost all employers.

The Equal Employment Opportunity Commission (EEOC) has issued public statements that are clear — elimination of workplace discrimination will be one of the major focuses of the commission. Accordingly, employers need to be well trained on the EEOC standards so that business owners and managers can insure adherence to EEOC rules and regulations. These standards should also be well described in the company’s employment manual and procedures so that the company has guidance, employees know their rights and if a complaint is made both parties will know the process to follow.

Another important feature that should be clearly set forth in employment manuals or procedure policies given the EEOC’s stated goals, are the rights afforded to those seeking maternity, paternity and other family leave benefits. Depending on which local jurisdiction a company is situated in and how many employees are employed, the laws will differ. It is important for the employer to know these rules, to clearly state the company policy in the manual and most importantly to consistently apply them to all employees.

These are just a few highlights of provisions that employers should make sure are part of their employment manuals or policies and are some of the most important given recent EEOC statements. Other provisions that also should be clearly defined are policies related to full time/part time distinctions, Internet use and privacy, confidentiality, termination procedures and severance benefits.

In sum, the lessons are simple — employers should be educated by a professional on the myriad laws governing the employer/employee relationship and should seek out qualified advisers to assist them in drafting consistent policy manuals to avoid the risk of employment claims.


John J. Matteo is president and chair, Business & Employment Practice Groups, Jackson & Campbell, P.C.

This is part of a series of articles by Jackson & Campbell on legal issues of interest to the LBGT and greater business community.  Jackson & Campbell is a full service law firm based in Washington with offices in Maryland and Virginia. If you have any questions regarding this article, contact John J. Matteo at 202-457-1678 or If you have any questions regarding our firm, please contact Don Uttrich, who chairs our Diversity Committee, at 202-457-4266 or


HHS backs gay couples, HIV/AIDS patients

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Married gay couples will be eligible for a family health policy under President Obama’s health care reform law. (Washington Blade file photo by Lee Whitman)

WASHINGTON — Married gay couples will be eligible for a family health policy under President Obama’s health care reform law, beginning in 2015, the U.S. government said on March 14, Reuters and other media outlets reported. Insurers were encouraged to begin offering coverage this year, the article said.

HHS exercised federal authority to prevent discriminatory insurance market practices on an issue that has been caught up in state marriage laws.

The move follows a February lawsuit filed by an Ohio gay couple that was unable to obtain family coverage under Obamacare, they said, because their state does not recognize same-sex marriage, Reuters said.

“If an insurance company offers coverage to opposite-sex spouses, it cannot choose to deny that coverage to same-sex spouses,” Dr. Matthew Heinz, who heads HHS outreach to LGBT communities, said in a posting to a government website.

The HHS also said insurers cannot turn down HIV/AIDS patients whose premiums are being paid through the federal Ryan White program, the AP reports.


Only 8% of Republicans say contraceptive use is “morally unacceptable”

PEW found Republicans and Democrats both oppose adultery, while GOP opposed being gay by only a slight majority.


GOP egos more important than serving U.S. citizens

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On Oct. 1, congressional Republicans allowed the federal government to shut down for the first time in 17 years. (Washington Blade photo by Michael Key)

On Oct. 1, congressional Republicans allowed the federal government to shut down for the first time in 17 years. It might have been understandable if this occurred due to a disagreement about federal budget issues that were on the table, but that is not the case.  Instead, the shutdown has occurred because the far right wing of the Republican Party decided to use the federal spending bill as a vehicle to delay the implementation of Obamacare, a law President Obama signed in 2010.

Even when it became apparent that Democratic senators were not going to be bullied into undermining a healthcare reform law that, as President Obama noted, passed Congress; was signed by the president; upheld by the U.S. Supreme Court; and allowed to stand by American voters; House Republicans decided that their egos were more important than continuing to provide vital services to American citizens.

These actions should make the LGBT community feel uneasy. In this instance, congressional Republicans are using the spending bill to attempt to delay and defund Obamacare, but if they are successful, it may embolden them to use similar mechanisms to reverse or oppose LGBT-rights laws. In the past, Congress has blocked D.C. laws that the LGBT community has supported, such as needle exchange, so what’s to stop them from attempting to undermine marriage equality or continuing to prevent the Employment Non-Discrimination Act from passing.

Many marginalized groups have sought employment with the federal government to escape discrimination in the private sector. According to NPR, the government (local, state, and federal) is the largest employer of African Americans and numerous studies have shown that the majority of the black middle-class work in public sector jobs. The number of Latinos in government has increased by 10.6 percent, despite losses of government jobs by other groups, NPR noted. While federal law does not prevent employment discrimination based on sexual orientation or gender identity, many in the LGBT community have also sought out federal employment as a refuge from worse discrimination in the private sector.

The poison provisions that House Republicans added to the spending bill that would delay Obamacare and deny contraception to women should also concern the LGBT community because Congress is meddling in people’s personal affairs, which never turns out well for our community. As D.C. residents, we are keenly aware of Congress’ ability to impose its will on American citizens with no regard to those citizens’ rights and views on the matter. Unfortunately, the rest of the country is now getting to see this firsthand, although local residents will still pay a disproportionate price, due to the large number of federal employees in the area and the number of local businesses that depend on tourism, which will take a hit if the federal government remains closed for a prolonged period of time.

Thankfully, local D.C. politicians understand that the decision to keep the government open is not about them, it’s about the residents that they serve. Remaining open also helps the District’s cause for budget autonomy. After all, there is nothing like the city acting independently to illustrate that it can do so. Council member David Grosso should be applauded for pushing for the D.C. government to remain open and for D.C. government employees to be paid as normal with city funds; Mayor Gray should be applauded for acting on the suggestion and classifying all city workers as essential; and Chairman Mendelson should be applauded for circulating legislation among his colleagues to use reserve funds to pay for city operations. The federal government can learn a thing or two from District government leaders in how to put residents first.

President Obama has been shown more disrespect than any president in American history. Congressional Republicans would rather shut down the government than implement an Obamacare plan that most Americans support. Apparently, they will go to great lengths to see the president fail.

What they fail to understand is it is not the president who suffers in the government shutdown. It’s the hardworking government worker who will now be without a paycheck.  It’s the family that has planned a vacation to D.C. for a year and now all of the Smithsonian museums and national parks are closed. It’s the senior citizen that depends on nutrition grants and will now need to find another source of food. Average Americans are the ones who suffer and I am fairly confident that average Americans will not forget the actions of House Republicans anytime soon.

Lateefah Williams’ biweekly column, ‘Life in the Intersection,’ focuses on the intersection of race, gender and sexual orientation. She is the immediate past president of the Gertrude Stein Democratic Club. Reach her at or follow her at twitter @lateefahwms.


Gay Republicans criticize Obamacare video

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A scene from the Out2Enroll video that encourages gay men to enroll in the Affordable Care Act. (Image courtesy of YouTube)

WASHINGTON—Log Cabin Republicans on Dec. 22 criticized an online video that encourages gay men to enroll in the Affordable Care Act.

Gregory T. Angelo, the group’s executive director, described the Out2Enroll video that features muscular men wearing underwear, stuffed reindeer antlers and Santa hats as an “example of the left promoting harmful stereotypes that gay men are nothing more than sex-crazed lechers.”

“As a self-proclaimed ‘fierce advocate’ of gay equality, President Obama would do well to distance himself from this nonsense and denounce it immediately,” said Angelo.

Angelo also referenced the controversy surrounding A&E’s decision to suspend “Duck Dynasty” patriarch Phil Robertson after making homophobic and racist comments during an interview with GQ magazine.

“At a time when left-wing propagandists are decrying ‘Duck Dynasty’s’ Phil Robertson for equating homosexuality with promiscuity and deviance, Out2Enroll and others should take a look in the mirror and ask if the truth is that they are the ones responsible for promoting such harmful stereotypes,” he said.


Local LGBT groups assist with Obamacare

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Local businessman David Franco was among several D.C.-area advocates who spoke at a news conference at the National Press Club on Tuesday to draw attention to what they consider the strong advantages of the Obamacare program. (Washington Blade file photo by Michael Key)

At least seven D.C.-based LGBT or LGBT-friendly organizations sprang into action on Tuesday to help members of the LGBT community and people with HIV choose a health insurance plan under the controversial U.S. Affordable Care Act that’s better known as “Obamacare.”

Similar to reports surfacing from across the country, officials from the local groups said some of their clients encountered computer glitches on the website for D.C. Health Link, the city’s online health insurance marketplace or “exchange” on its first day of operations on Tuesday.

But all of the officials contacted by the Blade said they were optimistic that the exchange program in D.C. and those in neighboring Maryland and Virginia would soon be operating smoothly and would be an important resource for LGBT people looking for health insurance.

“I’m excited about it,” said Ron Simmons, executive director of the D.C.-based Us Helping Us, an HIV services organization that reaches out to black gay men.

“We have so many clients who don’t have health insurance,” Simmons said. “If you are HIV positive you need a certain type of insurance, and we are ready to help people choose the best policy suited for their needs.”

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Ron Simmons, president/CEO of Us Helping Us (Washington Blade photo by Michael Key)

Us Helping Us is one of five D.C.-based organizations that received a grant from the D.C. Health Benefit Exchange Authority to recruit members of the LGBT community to sign up for insurance under the Obamacare program. The grant calls on the five groups — as well as another 30 organizations that received grants to work with other constituencies — to help their clients navigate the complicated process of choosing the best possible insurance plan.

The other organizations that received grants to work with the LGBT community on the Obamacare program are Whitman-Walker Health, D.C. Care Consortium, Damien Ministries and Health HIV.

Health HIV, a new national AIDS advocacy organization located in the Dupont Circle area, applied for its grant in partnership with the D.C. Center for the LGBT Community and Westminster Presbyterian Church’s START program. The START program provides HIV/AIDS-related services with a special outreach to people with substance abuse problems.

“This is an important opportunity to engage our communities in a conversation about healthcare and for us all to better understand the changes that are taking place in the healthcare system,” said David Mariner, executive director of the D.C. Center.

“Our goal is to help 300 individuals enroll in a healthcare plan and to make the process as simple as possible for them,” Mariner said.

Simmons of Us Helping Us said his group has a goal of helping to enroll 1,000 people on a health insurance plan through the D.C. Health Link system during the nine-month-long grant period.

“We will have town hall meetings,” said Simmons. “We will go to the clubs. Our purpose is to help people enroll in the plan best for them.”

Under the Affordable Care Act’s various provisions, Tuesday, Oct. 1, became the first day that the health insurance exchanges opened for business, enabling people to review dozens of options for insurance plans. Consumers may sign up for a plan between now and next March during the program’s first annual open enrollment period. Insurance policies won’t go into effect until Jan. 1.

In order to receive a policy that begins Jan. 1, people must sign up and pay their first monthly premium by Dec. 15, government officials in charge of the program said. People may still sign up between Dec. 15 and March 31, with their policy taking effect at the first day of the following month. After the March 31 deadline, enrollment in the program will be closed until October 2014.

Experts monitoring the system have said the cost of premiums and additional payments such as deductibles and co-payments for doctor visits and prescription drugs vary widely with the different options available. But those familiar with the program say the costs so far appear to be significantly lower than health insurance available in the past in the private market.

Carl Schmid, deputy director of the AIDS Institute, a national AIDS advocacy organization, noted that low-income people may now enroll in Medicaid in the states that have agreed to expand their Medicaid programs under a non-mandatory provision of the Affordable Care Act. D.C. and Maryland opted to become part of the expanded Medicaid program while Virginia declined to do so.

Schmid points out that prior to the Affordable Care Act’s Medicaid provision, which took effect last year, low-income people with HIV who didn’t have private health insurance were not eligible for Medicaid unless they were medically disabled with an AIDS diagnosis.

“So now people with HIV who don’t have full-blown AIDS qualify for Medicaid,” Schmid said. “Our goal, of course, is to keep these people healthy.”

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AIDS Institute Deputy Executive Director Carl Schmid (Washington Blade file photo by Michael Key)

Schmid and others familiar with the Obamacare program note that in Virginia and other states that chose not to participate in the expanded Medicaid program, people with incomes below a certain federally defined level are eligible for federal subsidies to help pay for their insurance premiums and co-pays.

Erin Loubier, director of public benefits and senior managing attorney for Whitman-Walker Health, said people with HIV and LGBT people whose income levels may not make them eligible for the subsidies will benefit from another provision of the healthcare law already in effect.

“Anyone living with HIV or another chronic health condition will be able to get insurance,” she said, noting that prior to the Obamacare law insurance companies routinely rejected people with a pre-existing condition.

She said the generally lower prices for premiums through the exchanges will also benefit those who aren’t eligible for subsidies.

Under its grant from the D.C. Health Benefit Exchange Authority, Whitman-Walker will provide its clients as well as non-clients the services of trained “navigators” or “assisters” to help people choose the best insurance policy through D.C. Health Link. According to Loubier, Whitman-Walker will also provide training for people to become navigators and, similar to Us Helping Us, will reach out into the community to recruit people to sign up for insurance under the Obamacare program.

“The role of these assisters is critical,” she said. “Even computer savvy people may not be able to navigate the system by themselves.”

Guy Westin, executive director of D.C. Care Consortium, which provides services to people with HIV, said his group is providing navigator services to individuals as well as non-profit community organizations about the enrollment process for Obamacare.

D.C. gay businessman David Franco, owner of the clothing store chain Universal Gear and the real estate development company Level Two, said he was pleased to discover that prices announced so far by insurance companies offering employer health plans for small businesses are lower than previously available plans.

“I was able to see in a matter of 15 minutes with a couple of clicks on my keyboard what my rate would be and compare that to an equivalent plan and see the savings that are offered by different insurance companies,” Franco said.

“So the fact that you’ve got this open, free market has really created this price competition, and it’s going to drop the overall cost for the plan for all of my employees,” he said.

Franco was among several D.C.-area advocates who spoke at a news conference at the National Press Club on Tuesday called by D.C. Health Link and the healthcare consumers’ group Families USA to draw attention to what they consider the strong advantages of the Obamacare program.

Similar to Americans across the country, local LGBT advocates working on the Obamacare program say some LGBT people will likely be surprised and put off when they realize they will be subjected to a $95 tax penalty from the IRS in 2014 if they don’t have insurance and fail to buy a policy under the new program.  The penalty for not having insurance in 2015 goes up to $700.

Federal officials in charge of Obamacare point out that people who already have insurance either through their employer or on the private market and people already on Medicaid or Medicare will not be required to do anything under the new program. Their insurance status will remain as it is, officials said.

Following is a list of the seven D.C.- based organizations known to be providing services to the help the LGBT community and people with HIV access the Obamacare program, including the process of singing up for an insurance plan. Officials with the groups say it’s preferable to call first for an appointment but walk-ins are accommodated when possible.


Whitman-Walker Health

1701 14th St., N.W.



Us Helping Us

3636 Georgia Ave., N.W.



D.C. Care Consortium

7059 Blaire Road, N.W., Suite



Health HIV

2000 S St., N.W.



Damien Ministries

2200 Rhode Island Ave., N.E.



D.C. Center for the LGBT Community

1318 U St., N.W.



START Program at Westminster Presbyterian Church

400 I St., S.W.



To health, happiness and more Democrats

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2012 Democratic National Convention in Charlotte, N.C. (Washington Blade file photo by Michael Key)

I hope everyone had a great holiday season and “I wish you and your family a very happy and healthy 2014.” Such is the greeting from most holiday cards.

When I hear those words from friends they mean something. But take a moment to think about what you mean when you wish someone “health and happiness” and whether you can help make those things a reality.

We know what it means to be healthy but what it takes to make someone happy is different for each of us. When I wish someone good health to me it includes supporting the Affordable Care Act since that will give everyone an opportunity to stay healthy. We should all have access to quality healthcare. Thankfully most of my friends are lucky enough to have good jobs and insurance and think nothing of asking for a flu shot when they get their annual physical. Their doctor orders tests to check cholesterol, blood sugar, maybe a PSA or Pap smear, and a myriad of other blood counts to assure their health is good and being monitored to find out early if there are indications of an illness.

We know that not everyone today has that chance. Before the Affordable Care Act, I had friends whose kids had no insurance because they lost it after graduating college. They had no job and couldn’t afford insurance. Now they can go back on their parents’ policy until they are 26. Detecting cancer at an early stage makes the chances for a positive prognosis so much greater. But a friend diagnosed with breast cancer lost her insurance and before the Affordable Care Act couldn’t find a new policy and certainly not one she could afford. So when I wish friends good health it’s a wish for everyone and by supporting the Affordable Care Act I feel I am actually doing something to make that a reality.

Happiness is another thing. What makes me happy is likely very different from what makes you happy. For some it may be getting a new puppy (not me as I am allergic). It could be a trip to Europe or a new car. For many of my friends it’s a new home or some other purchase, or even welcoming a new baby into their lives. In 17 states and D.C. it can be getting married as a same-sex couple. But it’s important that we remember that for some, happiness may be having enough money to pay the rent each month; or pay for their prescription drugs. Happiness for some could be keeping their job, finding a new job, or Congress extending unemployment insurance benefits.

For 12 million people in our country it’s not being threatened, or having your mother, father or child threatened, with deportation. It could be having confidence that your grandmother will receive an increase in her Social Security check allowing her to pay for food and rent. Happiness for some families is knowing that your partner, husband, wife or child will come home from Afghanistan this year, safe and sound, and won’t be deployed into harm’s way again. For a veteran it might be not having to wait months to get an appointment with your VA councilor or getting benefits to continue their education.

Many of the things that enable us to continue to stay healthy and achieve our own happiness do depend on government policy. I realize that many think we shouldn’t need to depend on government and that everything should be provided by the private sector or our religious institutions. Unfortunately that just isn’t the case today. So when I say let 2014 bring health, happiness and more Democrats it is because the philosophy of the Democratic Party is more in line with having government provide people with what they need when they just can’t make it on their own. It is passing decent immigration policy; a safety net for those in need including extended unemployment insurance for those out of work. It is food stamps needed even if you have a job but one that pays so little that you can’t afford to feed your kids. It is raising the minimum wage. It is government ensuring that everyone can have health insurance and that when you are older you will have a guarantee of the minimum assistance needed allowing you to stay in your home and buy food and medicine.

Until the Republican Party is once again led by more moderate and rational individuals I will continue to add to my New Year’s wishes for friends and the country that we elect more Democrats.