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.”
Maryland
Expanded PrEP access among FreeState Justice’s 2026 legislative priorities
Maryland General Assembly opened on Jan. 14
FreeState Justice this week spoke with the Washington Blade about their priorities during this year’s legislative session in Annapolis that began on Jan. 14.
Ronnie L. Taylor, the group’s community director, on Wednesday said the organization continues to fight against discrimination against people with HIV/AIDS. FreeState Justice is specifically championing a bill in the General Assembly that would expand access to PrEP in Maryland.
Taylor said FreeState Justice is working with state Del. Ashanti Martinez (D-Prince George’s County) and state Sen. Clarence Lam (D-Arundel and Howard Counties) on a bill that would expand the “scope of practice for pharmacists in Maryland to distribute PrEP.” The measure does not have a title or a number, but FreeState Justice expects it will have both in the coming weeks.
FreeState Justice has long been involved in the fight to end the criminalization of HIV in the state.
Governor Wes Moore last year signed House Bill 39, which decriminalized HIV in Maryland.
The bill — the Carlton R. Smith Jr. HIV Modernization Act — is named after Carlton Smith, a long-time LGBTQ activist known as the “mayor” of Baltimore’s Mount Vernon neighborhood who died in 2024. FreeState Justice said Marylanders prosecuted under Maryland Health-General Code § 18-601.1 have already seen their convictions expunged.
Taylor said FreeState Justice will continue to “oppose anti anti-LGBTQ legislation” in the General Assembly. Their website later this week will publish a bill tracker.
The General Assembly’s legislative session is expected to end on April 13.
Virginia
From the Pentagon to politics, Bree Fram fighting for LGBTQ rights
Transgender veteran running for Congress in Va.
After being ousted from military service, Col. Bree Fram — once the highest-ranking openly transgender officer in the Pentagon — is now running for Congress.
Fram, who lives in Reston, Va., brings more than two decades of public service to her campaign. From the battlefield to the halls of the Pentagon, she spent more than 20 years working inside the federal government, often advocating for LGBTQ people and other marginalized communities from within the system.
Fram spoke with the Washington Blade about her decision to run amid sustained attacks against her — and against the LGBTQ community more broadly — from the Trump-Vance administration and far-right officials.
She said her commitment to public service began more than 22 years ago, shaped in large part by watching the Sept. 11, 2001, terrorist attacks.
“I had grown up expecting that there was this beautiful American peace stretching into the world for the foreseeable future, and that kind of image was shattered,” Fram told the Blade. “I realized that there was a continuous price to be paid to protect our democracy, to protect our freedoms. To be able to play a small part in defending those freedoms was incredibly important to me — to be part of something larger than myself.”
Commissioned through the U.S. Air Force Officer Training School in 2003, Fram served as an astronautical engineer and rose to the rank of colonel in the U.S. Air Force before later serving in the U.S. Space Force. She remained on active duty until 2025, when she was forced out following the Trump-Vance administration’s reinstated ban on trans military service.
Fram has been married for 20 years to her spouse, Peg Fram, and they have two children.
Beyond her military service, Fram has long been involved in advocacy and leadership. She has been a member of SPARTA, a trans military advocacy organization, since 2014, served on its board of directors beginning in 2018, and was president of the organization from 2021-2023.
Most recently, Fram served as chief of the Requirements Integration Division at Headquarters, Space Force, and as co-lead of the Joint Space Requirements Integration Cell in collaboration with the Joint Staff. Previously, she was chief of the Acquisition Policies and Processes Division for the assistant secretary of the Air Force for space acquisition and integration.
Earlier in her career, Fram served as a materiel leader at the Air Force Research Laboratory, overseeing the development of counter-small unmanned aerial systems and offensive cyberspace technologies in support of Pentagon and intelligence community priorities, managing an annual budget exceeding $100 million.
Her previous assignments also included oversight of Air Force security cooperation in four strategically significant Middle Eastern countries and 258 foreign military sales cases valued at $15.79 billion; serving as executive officer to the Air Force director of strategic plans, where she helped integrate the 30-year, $3.6 trillion Air Force Plan; a legislative fellowship on Capitol Hill with then-U.S. Del. Madeleine Bordallo (D-Guam), handling military, veterans, and foreign affairs issues; and a program management role at the National Reconnaissance Office, where she led a $700 million multi-agency engineering and IT contract overseeing more than 500 personnel and supporting $40 billion in assets.
Fram also directed 24/7 worldwide operations and maintenance of mission data processing for space-based and airborne national intelligence assets and co-led the Department of the Air Force’s LGBTQ+ Initiatives Team and Barrier Analysis Working Group from 2023-2025.
She holds a master’s degree from the Air Force Institute of Technology and is a distinguished graduate of the Naval War College. Fram deployed in support of Operation Iraqi Freedom, where she worked on airborne counter-improvised explosive device technologies.
In January, Fram, alongside four other trans military officers, was given a special retirement ceremony by the Human Rights Campaign — a direct result of President Donald Trump’s 2025 Executive Order 14183, titled “Prioritizing Military Excellence and Readiness.” The policy directed the Pentagon to adopt measures prohibiting trans, nonbinary, and gender-nonconforming people from serving in the military.
Under Virginia’s current congressional maps, Fram would challenge Congressman James Walkinshaw in a Democratic primary in the 11th Congressional District, which includes the city of Fairfax and most of Fairfax County. However, the district’s boundaries could change pending ongoing redistricting discussions in the state.
Fram emphasized that her decades working within the executive branch shaped her understanding of what it means to take — and uphold — an oath to the Constitution, even when those in power later forced her out of service solely because of her identity, not her performance.
“Through 23 years of service, I learned what it meant to fulfill that oath to the Constitution, and I wanted to continue serving,” she said. “But when this administration came in and labeled me and others like me ‘dishonorable’ and ‘disciplined liars who lack the humility required for military service,’ it hit hard. When the Supreme Court then agreed to let the administration fire all of us, I had to figure out what would allow me to continue my service in a way that was meaningful and lived up to that oath.”
After being told she would have to retire from a career she describes as her life’s calling, Fram said she began searching for another way to serve — a path that ultimately led her to run for Congress.
“I had done the work over the past couple of decades to understand the America that I believe in, that America I believe we all can be,” Fram said. “That’s where this decision came from. I believe I can fight back and fight forward for Virginians — with the knowledge I have and with a vision of the America we can be.”
That vision, she said, is one that has yet to be fully realized — despite decades of promises from Democratic leaders across all branches of government.
“This is about protecting our fundamental rights — freedom of speech, freedom to assemble, bodily autonomy, a woman’s right to choose, and the ability for queer people to live our best lives,” Fram said. “Right now, our government is throwing barriers up in front of many people. They’re strengthening them, building walls higher, and actively damaging lives.”
Fram said her leadership philosophy was shaped by watching strong, effective leaders during her time in the Air Force and Space Force — leaders who reinforced her belief that true leadership means expanding opportunity, not restricting it.
“Leadership is about tearing barriers down — not climbing over them and forcing others to suffer through the same things,” she said. “It’s about making sure the people coming up behind us have even more opportunity to go further, faster. How do we be better tomorrow than we are today? How do we fulfill our founding promise of life, liberty, and the pursuit of happiness?”
One way Fram said Congress could help dismantle those barriers is by passing the Equal Rights Amendment, enshrining constitutional protections for all people — particularly LGBTQ Americans.
“Getting the Equal Rights Amendment into the Constitution is absolutely critical to the future of queer rights,” she said. “Voting rights must also be clearly protected.”
Protecting democracy itself is also among her top priorities, Fram said.
“We need to take control of the House so we can put real checks on this administration,” she said. “That allows the American people to see how this administration is actively making their lives worse and less affordable — and it’s how we ultimately throw them out and get back to making life better.”
Fram said her experience working under four presidents — including during Trump’s first term — reinforced her belief that opposition to efforts curtailing civil liberties is essential.
“The primary thing we can do to protect democracy is to get rid of this administration,” she said. “Taking control of the House gives us true investigative power. Under every rock, there is likely an impeachable offense because they are failing to faithfully execute the laws of the United States.”
For her, the message Trump is sending is clear — he and others close-minded to the LGBTQ community are threatened by the possibility of what someone truly dedicated to service can become.
“One of the reasons this administration had to throw us out and silence us was because we were an example of what was possible. We shined so brightly by meeting or exceeding every standard that they couldn’t hide us away by any other means except kicking us out.”
Fram acknowledged that her identity has been a political target since 2016, but said those attacks have never been grounded in her ability to lead or accomplish complex missions over more than two decades of service.
“If others want to attack me on my identity, I welcome it,” she said. “I’m focused on whether people can afford groceries or feel safe in their communities.”
“I’m happy to be a lightning rod for those kinds of attacks,” she added. “If it allows Democrats to advance an agenda that makes life better for Americans, they can come after me all day long. They attacked me while I was in the military, before I was ever running for office.”
On policy, Fram said affordability, health care, and safety are at the center of her agenda.
“No one should be afraid to go to the doctor or fear surprise medical bills that put them into debt,” she said. “Every American deserves access to affordable, high-quality health care.”
She also emphasized a willingness to work across party lines — even with those who previously politicized her identity — if it means delivering results for constituents.
“If someone wants to work together to make people’s lives better, I’ll work with them,” she said. “If they want to come after me based on who I am, they can waste their energy on that.”
Asked how she defines hope in the current political moment, Fram rejected the idea of passive optimism.
“Hope isn’t naive optimism,” she said. “Hope is doing the work — engaging people and bending the moral arc of the universe toward justice.”
She added that representation itself can be transformative.
“Just being in Congress changes the narrative,” Fram said. “It lets a kid say, ‘Oh my God — I could do that too.’”
District of Columbia
Eleanor Holmes Norton ends 2026 reelection campaign
Longtime LGBTQ rights supporter introduced, backed LGBTQ-supportive legislation
The reelection campaign for D.C. Congressional Delegate Eleanor Holmes Norton, who has been an outspoken supporter of LGBTQ rights since first taking office in 1991, filed a termination report on Jan. 25 with the Federal Elections Commission, indicating she will not run for a 19th term in the U.S. House of Representatives.
Norton’s decision not to run again, which was first reported by the online news publication NOTUS, comes at a time when many of her longtime supporters questioned her ability to continue in office at the age of 88.
NOTUS cited local political observers who pointed out that Norton has in the past year or two curtailed public appearances and, according to critics, has not taken sufficient action to oppose efforts by the Trump-Vance administration and Republican members of Congress to curtail D.C.’s limited home rule government.
Those same critics, however, have praised Norton for her 35-year tenure as the city’s non-voting delegate in the House and as a champion for a wide range of issues of interest to D.C. LGBTQ rights advocates have also praised her longstanding support for LGBTQ rights issues both locally and nationally.
D.C. gay Democratic Party activist Cartwright Moore, who has worked on Norton’s congressional staff from the time she first took office in 1991 until his retirement in 2021, points out that Norton’s role as a staunch LGBTQ ally dates back to the 1970s when she served as head of the New York City Commission on Human Rights.
“The congresswoman is a great person,” Moore told the Washington Blade in recounting his 30 years working on her staff, most recently as senior case worker dealing with local constituent issues.
Norton has been among the lead co-sponsors and outspoken supporters of LGBTQ rights legislation introduced in Congress since first taking office, including the currently pending Equality Act, which would ban employment discrimination based on sexual orientation and gender identity.
She has introduced multiple LGBTQ supportive bills, including her most recent bill introduced in June 2025, the District of Columbia Local Juror Non-Discrimination Act, which would ban D.C. residents from being disqualified from jury service in D.C. Superior Court based on their sexual orientation or gender identity.
For many years, Norton has marched in the city’s annual Pride parade.
Her decision not to run for another term in office also comes at a time when, for the first time in many years, several prominent candidates emerged to run against her in the June 2026 D.C. Democratic primary. Among them are D.C. Council members Robert White (D-At-Large) and Brooke Pinto (D-Ward 2).
Others who have announced their candidacy for Norton’s seat include Jacque Patterson, president of the D.C. State Board of Education; Kinney Zalesne, a local Democratic party activist; and Trent Holbrook, who until recently served as Norton’s senior legislative counsel.
“For more than three decades, Congresswoman Norton has been Washington, D.C.’s steadfast warrior on Capitol Hill, a relentless advocate for our city’s right to self-determination, full democracy, and statehood,” said Oye Owolewa, the city’s elected U.S. shadow representative in a statement. “At every pivotal moment, she has stood firm on behalf of D.C. residents, never wavering in her pursuit of justice, equity, and meaningful representation for a city too often denied its rightful voice,” he said.
A spokesperson for Norton’s soon-to-close re-election campaign couldn’t immediately be reached for a comment by Norton on her decision not to seek another term in office.
Van Sant returns with gripping ‘Dead Man’s Wire’
Expanded PrEP access among FreeState Justice’s 2026 legislative priorities
Dignidad para vidas LGBTQ en Centroamérica
Defunding LGBTQ groups is a warning sign for democracy
Blade welcomes spring intern
Trump-appointed EEOC leadership rescinds LGBTQ worker guidance
LGBTQ Ugandans targeted ahead of country’s elections
A ‘Battle’ we can’t avoid
Queer liberation is your liberation
