Local
Will health reform make AIDS groups obsolete?
HIV clinics face new competition as clients obtain insurance by 2014
‘Health care reform has been a real motivator around us improving the quality of what we do because we know we’re going to have to get better,’ said Don Blanchon, executive director of Whitman-Walker Clinic. (Washington Blade photo by Michael Key)
When the AIDS epidemic burst on the scene in the 1980s, a cadre of volunteers –many from the LGBT community — emerged to provide compassionate and dedicated care for the sick and dying, services that government agencies and existing charitable groups were not providing.
Since that time, the mostly volunteer-driven, community-based AIDS clinics and advocacy groups created back then have evolved into professionally run facilities receiving millions of dollars in state and federal funds. Like the Whitman-Walker Clinic in D.C., many of the clinics and advocacy groups provide a vast array of services for people with HIV and AIDS, most of whom can’t afford private health insurance.
But in March, Congress approved and President Obama signed into law a sweeping health care reform measure called the Patient Protection and Affordable Care Act. Obama administration officials say it will result in more than 94 percent of all Americans being covered by some form of private or public health insurance by 2014.
Although most AIDS activists and officials with local and national AIDS organizations have hailed the health care reform measure as an unprecedented benefit to people with HIV and AIDS, some believe the law could prompt large numbers of patients to leave the community-based clinics and seek medical care elsewhere.
With a possible loss of clients, community AIDS clinics would be in jeopardy of losing government funding, which is based on the number of clients served. It would be ironic, some have said, if the benefits of healthcare reform result in the closing of community institutions that have served people with AIDS during a time of need.
“The LGBT community and people living with HIV are going to have options that they may not have now,” said Don Blanchon, executive director of the Whitman-Walker Clinic, which has served people with HIV and AIDS since the epidemic began.
“And so for us, health care reform has been a real motivator around us improving the quality of what we do because we know we’re going to have to get better,” Blanchon said. “We know at some point in time almost every District resident is going to have some type of public or private insurance, which means they, in theory, are going to be able to go to a lot of different places for their care.”
Blanchon noted that a financial crisis that Whitman-Walker faced four years ago forced it to take steps that have placed it in an excellent position to flourish under the health care reform law. The Clinic’s board hired Blanchon, a managed care expert, to help the Clinic survive at a time when private donations and fundraising efforts were faltering.
With the board’s full approval and over the objections of some of the Clinic’s longtime supporters and volunteers, Blanchon transformed the Clinic from a volunteer model operation into a managed care type facility with the status known as a “federally qualified health center look alike.”
According to Blanchon and other Clinic officials, the new status enables the Clinic to accept a greater number of Medicaid patients as well as patients with a wide range of private health insurance. Patients covered by these programs allow the Clinic to obtain reimbursement for its services by doctors, its own pharmacy, and other service providers, eliminating the need to rely more on private donors.
Unlike other community-based AIDS clinics, Whitman-Walker will be in an excellent position to take on new patients or retain its existing ones as the new health care reform measure enables the majority of patients to obtain private insurance or Medicaid.
Under the Patient Protection and Affordable Care Act, all lower income individuals, including people with HIV, will be eligible for Medicaid coverage if they fall below 133 percent of the federal poverty level, where an individual has an income of about $15,000 a year or lower.
Under current federal law, low-income people with full-blown AIDS are already eligible for Medicaid coverage. For years, Congress has declined to pass legislation proposed by AIDS advocacy groups calling for Medicaid coverage for low-income people with HIV, with the intent of providing medical services to prevent them from advancing to AIDS.
The new law makes that legislation unnecessary after 2014, when the Medicaid provision takes effect.
Jeffrey Crowley, director of the White House Office of National AIDS Policy, calls the Patient Protection and Affordable Care Act one of the nation’s most significant advances for the care and treatment for people with HIV/AIDS.
“It will fundamentally expand access to insurance coverage for people living with HIV,” he said. “Much of that will be through the mandatory expansion of the Medicaid program.”
He said that similar to all Americans, people with HIV will also be eligible for private insurance coverage through a variety of options based on their income. Among the options will be the purchase of insurance coverage through competitive insurance exchanges. He noted that by 2014, no insurance company can deny coverage based on pre-existing conditions such as HIV or other illnesses.
Keith Maley, a spokesperson for the U.S. Department of Health and Human Services, which will administer most of the provisions of the new health care law, said people with HIV and other illnesses could be immediately eligible for private insurance coverage through high-risk pools.
Those eligible for the immediate coverage must show that they have had no health insurance coverage for six consecutive months, have a chronic health condition, and are not eligible for employer provided insurance or Medicaid.
Crowley noted that the new law has other immediate benefits for people with HIV and other chronic health conditions. As of July 1, private health insurers can no longer use a rescission, a practice that cancels a policy when someone gets sick and needs expensive treatment.
He said the law also immediately prohibits insurers from imposing a lifetime “cap” on insurance benefits. Annual limits on coverage or benefits will end in 2014, he said.
Crowley, a gay man who previously worked for the National Association of People with AIDS before joining the White House staff, said he expects most community-based AIDS clinics and local and national AIDS advocacy organizations to continue to exist after the health care law is fully implemented in 2014. However, he said most will have to change the way they do business.
“I think we know from our experience with HIV that we’ve built up a great HIV workforce,” he said. “We have a lot of expertise. I want to make sure as we build and expand an insurance system through the Affordable Care Act that these HIV medical providers are making sure that they’re part of this new system.”
“Some of them might only receive funding through the Ryan White programs, and I would say they need to look at their future and say that they need to be part of the new insurance system,” he said. “But there’s no question that we’re going to need their expertise and commitment at providing medical care going forward.”
Crowley’s reference to the Ryan White CARE Act, the largest existing federal program created to provide care for low-income people with HIV/AIDS, is expected to change significantly following the full implementation of the Patient Protection and Affordable Care Act, according to officials with a number of national AIDS groups.
Nearly everyone, including Crowley, agrees that the Ryan White program should remain, but most likely in a scaled back form. Congress passed the act in the 1990s as a means of helping cities and states that were grappling with the enormous burden of providing care for people with HIV/AIDS who lacked health insurance coverage and were overwhelming local and state hospitals and health care facilities.
Carl Schmid, director of federal affairs for the AIDS Institute, a national advocacy organization; Michael Weinstein, executive director of the AIDS Healthcare Foundation, the nation’s largest AIDS-related medical care provider; and Jose Zuniga, executive director of the International Association of Physicians in AIDS Care, each said they believe the Ryan White program will be needed for at least some services the new law does not provide.
“It will not solve all of our access issues,” said Schmid of the new health care measure.
Weinstein said that state programs to expand health insurance have been slow to enroll as many people as expected for a variety of reasons, some bureaucratic in nature.
“So I wouldn’t expect an overnight change in 2014,” he said, pointing to a need to keep the Ryan White program operating for some time after 2014.
Weinstein said that in some states, including California, Medicaid reimbursement for medical services is far lower than that provided by private insurance companies. He predicted that people with HIV or AIDS who obtain coverage under the new law through Medicaid might be turned away by private doctors who declined to take all Medicaid patients.
“The reimbursement that we receive from Medicaid or from private insurance is far below our cost and far below what we get from Ryan White,” he said of the AIDS Healthcare Foundation. “So we will suffer a hit in that regard as well as most providers.”
Weinstein said his organization has a wide variety of income streams and the lower reimbursements under the new law “won’t be a fatal blow to us.”
Blanchon of Whitman-Walker said the benefits of the new law greatly outweigh its possible shortfalls.
“Health care reform is going to be a real help to our patients and clearly to the Clinic because more of our patients are going to be insured under more comprehensive benefit programs,” he said.
“And what that means at the end of the day is the Clinic is not going to have to shell out as much free care. So we’re going to be in a position to be able to offer more services to more patients and keep them healthy, and ultimately that’s what we’re here for.”
District of Columbia
D.C. Council approves increased funding for Mayor’s Office of LGBTQ Affairs
Increase attached to 2027 budget bill
The D.C. Council on July 14 gave final approval for the city’s fiscal year 2027 budget that includes an amendment calling for increasing the number and size of funding grants that the Mayor’s Office of LGBTQ Affairs provides for local organizations providing services for the LGBTQ community.
The amendment, called the “LGBTQ Community Grant Amendment Act of 2026,” was introduced earlier this year by D.C. Council member Zachary Parker (D-Ward 5), the Council’s only gay member.
The D.C. LGBTQ Budget Coalition called the Parker amendment “a historic measure that establishes the District’s most sustainable model for a vehicle for investing in LGBTQ communities.”
The Council approved the version of the FY 2027 budget bill with the attached Parker amendment in its first of two required votes on June 9. Shortly after voting unanimously to give final approval of an earlier version of the two-part budget measure on July 7 that includes the Parker amendment, the Council sent the bill to Mayor Muriel Bowser for her signature.
Bowser has expressed strong opposition to several provisions in the $22 billion budget measure passed by the Council that are unrelated to the Parker amendment regarding the Office of LGBTQ Affairs. The mayor has yet to say whether she will sign, veto, or choose not to sign the bill.
The latter option would allow the bill to become law if Congress does not choose to overturn it during its required 30-day legislative review period for all D.C. bills. Political observers believe the Council will vote to override a veto if Bowser chooses to veto the bill.
When contacted by the Washington Blade on July 22 to determine where the mayor stands on the budget bill, mayoral spokesperson Daniel Gleick said only, there was “no update on the budget just yet.”
Among other things, the Parker amendment calls for the Mayor’s Office of LGBTQ Affairs to issue a $980,000 grant in FY 2027 to a private, nonprofit organization in partnership with the office “for the purpose of supporting programs that promote the welfare of the lesbian, gay, bisexual, transgender, and questioning community.”
It says the organization selected would also initiate its own fundraising effort to expand the amount of funds beyond the amount the office would provide, enabling it to provide larger grants to a greater number of local LGBTQ organizations.
“The legislation arrives at a critical moment, as LGBTQ-serving organizations face unprecedented uncertainty,” the D.C. Budget Coalition said in its comment on the Parker amendment. “Growing demand for services is colliding with shrinking resources, federal attacks on LGBTQ programs, and ongoing threats to local funding streams,” the coalition’s statement says.
In what some observers have called a highly controversial action; the budget bill approved by the Council reverses and restores millions of dollars in budget cuts proposed by Bowser in the budget she submitted to the Council earlier this year.
Among other things, the Council’s budget preserves the current level of funding for housing vouchers, childcare, paid family leave, and other programs slated to be cut in the mayor’s proposed budget, according to a report by the Washington Post.
Bowser points out that the Council approved budget bill calls for using $150 million from the city’s reserve fund, which she and others have said could put the city in jeopardy in future years. The mayor has said the cuts were needed to prevent a major funding shortfall brought about by the action by Republicans in Congress to cut the city’s budget by over a billion dollars.
Rehoboth Beach
Craig Thier says experience, civility are key to Rehoboth’s future
Mayoral candidate cites finance background as key strength
(Editor’s note: This is the third installment in a three-part series profiling the candidates for mayor of Rehoboth Beach, Del.: Commissioners Suzanne Goode, Susan Stewart, and Craig Thier; a fourth candidate, William Raak, filed to join the race but has not responded to multiple Blade inquiries. Visit washingtonblade.com for previous installments.)
Rehoboth Beach City Commissioner Craig Thier says his experience in public service and finance has prepared him to lead the city as residents elect a new mayor on Aug. 8.
Thier, who has owned property in Rehoboth Beach since 2002 and has lived there full time for a little more than five years, said he first sought public office after becoming concerned about the city’s financial planning.
“A couple of years ago, when I decided to run, the city raised taxes and fees across the board unnecessarily. They had a broken budgeting process,” said Thier.
Elected as a city commissioner in August 2024, Thier draws on a background in corporate finance and consulting, He said he could improve the city’s budgeting practices.
“I felt that I could bring that experience in and help the city improve that broken budgeting process,” he said.
Thier said one of his accomplishments as commissioner has been helping transition the city from annual budgeting to long-term financial planning.
“Within the first year, I worked with the city administration to transition us from an annual budgeting process that was really broken to a multi-year planning process,” he said.
If elected mayor, Thier said his first priority would be improving relationships among members of the Board of Commissioners.
“First would be just civility. There is a lot of infighting among some of the commissioners,” said Thier.
He says that he wants to focus on “getting people to work together so that we can get back to the business of the city.”
Thier said disagreements are inevitable but believes they should be handled more respectfully.
“We have to return to civility. People need to respect each other, people need to respect the right of other individuals to express their thoughts and opinions,” he said.
“That lack of civility absolutely has impacted our ability to get the business of the city done.”
He also said meetings should remain focused on the agenda even when commissioners disagree.
“Everyone’s got to tone things down a little bit,” Thier said. “Just because we may not agree with someone’s position doesn’t mean that that position isn’t valid.”
He added that after discussions conclude, commissioners should be willing to accept the outcome.
“People need to be prepared to move on if they don’t have the support,” he said.
Thier pointed to his previous elected experience as another qualification for the mayor’s office.
“I spent 12 years on a school board, five years as president, and I’m finishing up my second year here [as commissioner]. I believe that I have far more experience than anyone else.”
“I’ve been able to accomplish things because of my experience, and I’ve been doing this a long time,” he added.
Thier also said maintaining Rehoboth Beach’s perfect score on the Human Rights Campaign’s Municipal Equality Index would remain a priority if he is elected.
“It is absolutely a priority for the city,” he said.
“I think it’s one of the great things about the city of Rehoboth Beach is the diversity that’s there, and that we’ve been a very welcoming community.”
Thier credited city staff for helping achieve the city’s perfect score and said he would continue working with LGBTQ+ organizations, including CAMP Rehoboth.
“I have relationships with these organizations. I would continue to foster these relationships,” he said. “It’s critical that we’re doing the things to maintain this perfect score.”
Thier also expressed support for the city’s partnership with Clear Space Theatre Company as it works toward constructing a permanent performing arts venue downtown.
“Clear Space has been part of the community for more than 20 years. I think they’re an important part of the community.”
He said the theater contributes to Rehoboth’s identity as a tourist destination.
“The tourists come to Rehoboth for the whole package: the beach, the boardwalk, our restaurants, our retailers, Clear Space. They’re an important part of that whole package.”
The election will take place on Aug. 8 from 10 a.m.-6 p.m. at the Rehoboth Beach Convention Center.
District of Columbia
Is the Metro safe for riders?
WMATA says crime dropped 37 percent on system in 2025
I was inside Benning Road train station in April waiting for my train with two friends on the way to school. It usually took me 25-30 minutes to get from Benning Road Station to school at Congress Heights. As I waited for the train, I kept noticing that every train that got to five minutes away would disappear from the Metro screen before it got to my stop.
I found out from one of my friends that a Metro work vehicle had crashed into a train at Metro Center and that all trains were now delayed. While my friends were able to call their family to pick them up, I had no such luxury. The train was my only option. It took me more than an hour to get to school. I missed my first period because of it and had to make up my work later in the day. I was marked absent because when a student misses one class, they’re marked absent for the day and an email is sent to their parents. I felt irritated knowing that I had to deal with all of these problems that weren’t even my fault due to an incident that happened on a different side of town.
The incident at Metro Center isn’t the only incident that I have experienced on the subway. I have experienced kids fighting and almost pushing me on the tracks, massive delays because a woman was passed out on the train and Metro police pulling out their assault rifles and arresting someone in the station, which caused people to panic and start running.
I later learned the crash that led to me being late to school caused 11 injuries to people who were on the train, according to media reports. And the Metro has experienced other dangerous incidents this year. A man was beaten so badly on Cinco de Mayo that he needed staples in his head and another man was beaten to death by a stranger at the Addison Road station.
However, I’ve never experienced any incident that has led to me getting hurt, nor actually seen anyone get hurt.
So, is the Metro safe?
Metro experienced the lowest crime rate in its history in 2025, the Washington Metropolitan Area Transit Authority said. The crime rate decreased by 37 percent in 2025 compared to 2024.
Last year, the Metro Transit Police Department increased enforcement efforts department-wide by more than 25 percent, Metro said. WMATA said it is in the process of installing upgraded video systems on our 6000 and 7000-series rail cars, which make up most of the cars in the system. This new camera system allows for live video access to rail cars from Metro’s Integrated Command and Communications Center.
Asked if he felt unsafe using the Metro, Dr. Aruna Rajam, a teacher at Bard High School Early College DC and George Washington University, recalled being on the train with a man who was smoking weed and yelling.
“It didn’t turn physically violent, but it was alarming and made me feel like the situation could go sideways quickly,” said Rajam, who takes the train to both of his jobs, traveling day and night.
Incidents like these are what make Rajam feel unsafe occasionally when he is riding the subway at night: “Late at night — like my 8:45 ride from Foggy Bottom to Springfield — it’s a different atmosphere.”
Jayden Payne, a rising sophomore at Bard, worries even more.
“There was a man who seemed intoxicated, moving around his phone, pretending it was a gun-all up in ladies’ faces,” he said in an interview.
When asked if he would recommend the subway to others, he gave a firm “no” due to all of the incidents that he has heard about that have happened on the Metro.
Erin Bray, who graduated from Bard in June, recalled an incident when a man brought a gun on the train when she was on it. Asked if she felt safe on the subway, Bray said: “No, because there’s not enough security and people keep bringing [weapons] on there.”
Metro said it launched a Safety Risk Reduction Plan to improve riders’ safety and employs several other safety tactics, including Safe Passage patrols to help students in D.C. get to and from school safely.
While all of the people interviewed said that they saw or experienced an uncomfortable incident, Metro said it is increasing its security and safety protocols.
WMATA data coincides with what one of my interviewees said about his experience on Metro.
“I feel safer now than I felt riding the Metro today than I did 10 years ago,” Dr. Samuel Slattery, a social science teacher at Bard High School Early College, said.
He spoke of his experience with the Southeastern Pennsylvania Transportation Authority subway in Philadelphia in comparison: “… That’s what an unsafe train system feels like,” Slattery said.
The week before he was interviewed in May, Slattery said he was on SEPTA and there was a woman “eating beans off the floor of the train,” a homeless man “passed out in the middle of the train,” and a mentally ill woman yelling in his and other passengers’ faces that, “‘Jesus was watching her’ and the rest of us were in contact with demons.” This incident agitated Slattery so much that he said, “Screw this” to his friend and decided to pay extra for an Uber.
Metro riders who want to report an incident or safety concern can call Metro Transit Police (MTPD) at 202-961-2121 or text MYMTPD (696783). Metro also posts a daily Crime Blotter on its website where the public can see the calls MTPD responded to on a given day. The Crime Blotter can be found here: https://www.wmata.com/about/transit-police/crime-stats.cfm
Christian Jennings, a 2026 graduate of Bard High School Early College DC, is a rising freshman at North Carolina State University, where he plans to major in nuclear engineering. He worked with journalist-instructors at Youthcast Media Group on this article.
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