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
FreeState Justice launches 501(c)(4) group
FreeState Equality will focus on policy and advocacy
FreeState Justice, an LGBTQ organization that provides legal services, community programs, and public education in Maryland, announced the launch of FreeState Equality on Wednesday.
The new, independent organization intends to pursue advocacy and policy work beyond the legal capability of FreeState Justice, a 501(c)(3) non-profit. FreeState Equality functions as a 501(c)(4) organization, meaning it can partake in political activity.
“We are committed to transparency throughout this process and look forward to continuing our work together in service of LGBTQ+ Marylanders,” said FreeState Justice Executive Director Phillip Westry.
FreeState Equality will take on policy, advocacy, and civic engagement initiatives while FreeState Justice will pursue legal and direct-service work, according to Westry.
While both organizations adhere to similar values, they will feature separate leadership, operations and compliance.
FreeState Equality is hosting its first launch fundraiser on Dec. 10 at the Brass Tap in Baltimore. The event, held from 5-7 p.m., will feature insight from FreeState Equality staff about how Maryland policy can support the state’s LGBTQ community.
Attendees can purchase fundraiser tickets on Zeffy for $25 general admission, which includes a free first drink. The organization also welcomes additional donations.
By LEE O. SANDERLIN, PAMELA WOOD and BRENDA WINTRODE | Maryland House of Delegates Speaker Adrienne A. Jones, the first woman and first person of color to hold her position, stepped down from her leadership post Thursday, effective immediately.
Jones, 71, has been a member of the legislature since 1997 and ascended to the top role in 2019 following the death of longtime House Speaker Michael E. Busch.
Jones held a meeting with top House Democratic leaders Thursday afternoon, sources said, at which she informed them of her decision. In a statement, Jones described the changes of life’s seasons and said she was ready to focus on what lies ahead.
The rest of this article can be found on the Baltimore Banner’s website.
District of Columbia
Activists praise Mayor Bowser’s impact on city, LGBTQ community
‘She made sure LGBTQ residents knew they were seen, valued, loved’
Members of D.C.’s LGBTQ community offered their thoughts on the impact Mayor Muriel Bowser has had on them, the city, and LGBTQ people in statements and interviews with the Washington Blade in the week following Bowser’s announcement that she will not run for re-election in 2026.
Bowser’s Nov. 25 announcement came during the third year of her third four-year term in office as mayor and after she served as a member of the D.C. Council representing Ward 4 from 2007 to Jan. 2, 2015, when she took office as mayor.
The LGBTQ activists and mayoral staffers who spoke to the Blade agreed that Bowser has been an outspoken and dedicated supporter on a wide range of LGBTQ-related issues starting from her time as a Council member and throughout her years as mayor.
Among them is one of the mayor’s numerous openly LGBTQ staff members, Jim Slattery, who has served in the Cabinet-level position as the Mayor’s Correspondence Officer since Bowser first became mayor.
“As Mayor Muriel Bowser’s longest serving LGBTQIA+ staffer – dating back to her first term as the Ward 4 Council member – and a proud member of her Cabinet since day one of her administration, I have had the opportunity to witness her at work for the people she serves and leads,” Slattery said in a statement. “Noteworthy is that throughout the entirety of my 27 years in District government, I have always been able to do so as an out and proud gay man,” he stated.
Slattery added that he has witnessed first-hand Bowser’s “absolute belief” in supporting the LGBTQ community.
“She has led on HIV/AIDS prevention and treatment, on shelter for vulnerable members of our community, housing for older members of the community, and has been a reliable and constant presence at events to LGBTQIA+ residents,” Slattery said. Among those events, he said, have been World AIDS Day, the D.C. Pride Parade, the 17th Street LGBTQ High Heel Race, and WorldPride 2025, which D.C. hosted with strong support from the mayor’s office.
Ryan Bos, CEO & president of Capital Pride Alliance, the D.C. group that organizes the city’s annual LGBTQ Pride events and served as lead organizer of WorldPride 2025, praised Bowser for being a longtime supporter of that organization.
“She played a very supportive role in helping us as an organization grow and to be able to bring WorldPride to Washington, D.C.,” Bos told the Blade. “And we commend her years of service, And our hope is that she helps us to continue to advocate for the support from the D.C. government of the LGBTQ+ community, especially during these times,” Bos said.
Bos, who was referring to the Trump administration’s hostility toward LGBTQ issues and sharp cutbacks in federal funds for nonprofit organizations, including LGBTQ organizations, said Capital Pride Alliance appreciated Bowser’s efforts to provide city funding for events like WorldPride.
“She provided support through the event process of WorldPride and ultimately along with the D.C. Council provided necessary funding to ensure WorldPride was a success,” Bos said. “And we are proud that we are able to show that Capital Pride and WorldPride had such a large economic impact for D.C. and the D.C. government,” he added.
Marvin Bowser, Mayor Bowser’s gay brother who operates a local photography business and has been active in the D.C. LGBTQ community for many years, said he has also witnessed first-hand his sister’s support for the LGBTQ community and all D.C. residents since the time she became a Council member and even before that.
Among his vivid memories, he said, was his sister’s strong support for the marriage equality law legalizing same-sex marriage in D.C. that the Council approved in 2009 under then-Mayor Adrian Fenty.
“I remember the first time she was standing up and giving clear and unequivocal support to the community when that law passed,” Marvin Bowser told the Blade. “And she was front and center in speaking very strongly in support of marriage equality,” he said.
Marvin Bowser also credits his sister with expanding and strengthening the then-Mayor’s Office of GLBT Affairs, among other things, by appointing advocate Sheila Alexander Reid as the office’s director in 2015.
Reid, who for many years prior to becoming director of the GLBT Affairs office was founder and publisher of the national lesbian publication Women In The Life, had the reputation of a “rock star,” according to Marvin Bowser.
He recalls that Mayor Bowser also played a lead role in D.C.’s bid to host to the quadrennial international LGBTQ sports competition Gay Games for 2022.
D.C lost its bid for the 2022 Gay Games after the Federation of Gay Games selected Hong Kong to host the event in an action that Marvin Bowser says was unfair and based on the effort to hold the Gay Games for the first time in Asia even though D.C. had a stronger bid for carrying out the event.
“Everything she’s done for the community has been very visible and from the heart,” he said of Muriel Bowser. “And in my personal relationship with her, she has also been nothing but absolutely supportive of me and my partner over the years,” he said.
“And we were just at her house helping her put up Christmas decorations,” he added. “And so, it’s been wonderful having her as a sister.”
Veteran D.C. LGBTQ advocate Japer Bowles, who serves as the current director of the Mayor’s Office of LGBTQ Affairs, discussed the mayor’s record on LGBTQ issues in his own statement to the Blade.
“Mayor Muriel Bowser has been an unwavering champion for D.C.’s lesbian, gay, bisexual, transgender, queer, intersex, and asexual community and movement,” he said. “Her more than 20 years of leadership brought consistent and historic investments for our LGBTQIA+ youth, seniors, veterans, and residents experiencing homelessness as well as impactful violence-prevention initiatives,” he added.
“Under her leadership, the Mayor’s Office of LGBTQ Affairs grew into a national leader, delivering more than $10 million in community grants for LGBTQIA+ programs and managing 110 Housing Choice vouchers,” Bowles said in his statement.
“Because of her work, we are stronger, safer, more visible, and, proudly, ‘the gayest city in the world,’” he said in quoting Bowser’s often stated comment at LGBTQ events about D.C. being the world’s gayest city.
In a statement that might surprise some in the LGBTQ community, gay D.C. small business owner Salah Czapary, who served from 2022 to 2024 as director of the Mayor’s Office of Nightlife and Culture as a Bowser appointee, criticized some of the city’s non-LGBTQ related polices under the Bowser administration as being harmful to small businesses.
Bowser appointed Czapary, a former D.C. police officer, to the nightlife office position shortly after he lost his race as an openly gay candidate for the Ward 1 D.C. Council seat held by incumbent Brianne Nadeau.
“Mayor Bowser led D.C. through turbulent years and major growth, and we can all be proud of her leadership on many fronts,” Czapary said in a statement to the Blade. “She is also setting an example that more leaders should follow by stepping aside to allow a new generation to lead,” he said. “But as we turn the page, we must be honest about what the next mayor should deliver,” he says in his statement.
Without mentioning Bowser by name, he went on to list at least four things the next mayor should do that implied that Bowser did not do or did wrong. Among them were treating the D.C. Council as a “true governing partner,” not letting residents and small businesses “feel the weight of outdated, slow, and unresponsive systems,” and the need for leadership that “values competence over loyalty.”
He added that a “reversal” by the city of the city’s streetery program that was put in place during the COVID pandemic to allow restaurants to install outdoor seating into street parking lanes, was a “roll it back” on progress for small businesses.
He concluded by stating, “LGBTQ rights and inclusion are among the many fronts on which we can be very proud of the mayor’s leadership.”
The mayor’s office did not immediately respond to an offer by the Blade to give the office an opportunity to respond to Czapary’s statement.
A significantly different perspective was given by Sheila Alexander Reid, who said she was proud to serve as director of the Mayor’s LGBTQ Affairs Office during the first six-and-a-half years of Bowser’s tenure as mayor.
“I watched her evolve from a newly elected mayor finding her footing into a confident, seasoned leader who met every challenge head-on and time after time slayed the competition,” Alexander Reid said in a statement to the Blade.
“With each year in office, her voice grew stronger, more grounded, and more fearless,” her statement continues. “And she needed that strength, because being a Black woman mayor is not for the faint of heart, But Mayor Bowser never backed down. Instead, she showed the city what courageous, compassionate leadership truly looks like.”
Alexander Reid added that Bowser funded a new LGBTQ Community Center facility, expanded a workforce development program for the transgender community, and “made D.C. the first jurisdiction in the nation to require LGBTQ+ cultural competency training for healthcare providers.”
She also pointed to the mayor’s LGBTQ “safety nets” through low-barrier shelters and housing vouchers and her support for LGBTQ celebrations like the 17th Street High Heel Race.
“But what inspired me most was this,” Alexander Reid stated. “At a time when some elected officials across the country were retreating from LGBTQ support, Mayor Bowser was doing the opposite. She leaned in, she doubled down. She made sure LGBTQ residents knew they were seen, valued, protected, and loved by their city.”
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