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
Lewis George holds strong lead over McDuffie in D.C. mayor’s race
Gay Council member Parker wins in Ward 5; bi candidate leads in Ward 1
D.C. Council member Janeese Lewis George (D-Ward 4) was leading former D.C. Council member Kenyan McDuffie (D-At-Large) in the D.C. primary race for mayor late Tuesday night by a margin of 52.79 percent of the vote compared to 36.57 percent for McDuffie with 64 percent of the votes counted, according to information released by the D.C. Board of Elections at 11:55 p.m.
A Board of Elections spokesperson informed the media by email that the board had stopped its vote counting shortly before midnight and would resume its counting Wednesday morning, June 17.
The late-night returns showed Lewis George and McDuffie were far ahead of the other five candidates competing in the Democratic primary for mayor, with candidate Rini Sampath, who self-identifies as queer, receiving 2.93 percent of the vote.
Of the remaining Democratic mayoral candidates, former Council member Vincent Orange received 3.73 percent; businessman Gary Goodweather received 3.0 percent; and civic activists Hope Solomon, 1.09 percent; and Ernest Johnson 0.53 percent.
Election board spokesperson Sarah Graham noted in her email to the media that the initial vote percentages released Tuesday night were counted under the city’s newly implemented ranked choice voting system, which was in place for mayor, D.C. Council, D.C. congressional delegate, and D.C. attorney general. She said the follow-up “round-by-round tabulation results” when voters’ second, third, fourth and possibly fifth choices are counted under the ranked choice system, they are estimated to be released between Sunday, June 21 and Wednesday, June 24.
“The final round-by-round tabulation results will be released on or after June 26, 2026,” she stated. The ranked-choice system does not go into effect if a candidate receives at least 50 percent of the vote.
Lewis George and McDuffie have strong records of support on LGBTQ issues, and Goodweather expressed strong support for LGBTQ issues during the campaign. The Capital Stonewall Democrats, the city’s largest LGBTQ political group, endorsed Lewis George for mayor.
Although the election board had yet to declare a winner in the mayor’s race, with 36 percent of the votes cast not yet counted, Lewis George delivered a rousing speech at her election-night event at the Howard Theatre that many of her supporters considered a victory speech. Among those attending the event and expressing the belief that Lewis George was the expected winner was Capital Stonewall Democrats President Stevie McCarty.
“There’s still a lot of votes to count, but I feel very confident and it looks really good,” he said in referring to Lewis George and the LGBTQ community members who supported her campaign.
Like the other races for D.C. Council, the D.C. congressional delegate seat, and D.C. attorney general, most if not all of the candidates had either expressed support for LGBTQ rights or had strong records of support, like McDuffie and Lewis George. LGBTQ activists have said that meant LGBTQ voters would be choosing a candidate based on issues other than LGBTQ rights issues.
In other races, D.C. Council member Zachary Parker (D-Ward 5), the Council’s only gay member, was far ahead of two Democratic challengers, with 76.37 percent of the vote. Challengers Bernita Carmichael and Bridgete French received 15.28 percent and 7.57 percent respectively.
Political observers believe Parker is the strong favorite to win re-election in November against a Republican and a Statehood Green Party candidate.
In the Ward 1 D.C. Council race, where five LGBTQ supportive candidates were competing for the seat being vacated by Democratic incumbent Brianne Nadeau, who is not running for re-election, community activist Aparna Raj, who identifies as bisexual, was leading gay candidate and LGBTQ rights activist Miguel Trindade Deramo by a margin of 46.7 percent to 20.27 percent in a five-candidate race.
The other candidates were Rashida Brown, 17,18 percent; Jackie Reyes Yanes, 9.98 percent; and Terry Lynch, 5.75 percent.
In the race for the D.C. delegate seat to the U.S. House of Representatives, which is being vacated by retiring Del. Eleanor Holmes Norton (D), D.C. Council member Robert White (D-At-Large) was leading in a five-candidate race with 63.16 percent of the vote. His leading opponent, D.C. Council member Brooke Pinto (D-Ward 2) had 21.45 percent of the vote.
The vote count for the other candidates was 7.66 percent for Kinney Zalene; 4.55 percent of Trent Holbrook; and 2.8 percent for Greg Jaczko.
In other D.C. Council races Council Chair Phil Mendelson (D-At-Large) and Council member Matthew Frumin (D-Ward 3) were unopposed in the Democratic primary and are considered strong favorites to win re-election in November.
Nine Democrats competed for the At-Large D.C. Council seat being vacated by Council member Anita Bonds (D), who is not seeking re-election. Community activist and local pharmacist Oye Owolewa, who was endorsed by Capital Stonewall Democrats, was leading in the Democratic primary with 33.77 percent of the vote.
The vote count percentage for the other candidates were: Lisa Raymond, 15.22; Kevin Chavous, 13.84; Greg Jackson, 10.95; Candis Nelson, 7.67; Dwight Davis, 6.02; Dyana Forester, 3.72; and Leniqua Jenkins, 3.0.
In the Ward 6 D.C. Council race, Democratic incumbent Charles Allen, a longtime LGBTQ rights supporter who received the Capital Stonewall Democrats endorsement, was far ahead of his two Democratic challengers with 74.43 percent of the vote. Gloria Ann Nauden had 18.68 percent, and Michael Murph had 6.51 percent.
D.C. Attorney General Brian Schwalb, an outspoken supporter of LGBTQ rights who also received the Capital Stonewall Democrats endorsement, had 90.34 percent of the vote in the Democratic primary, with his sole opponent J.P. Szymkowicz receiving 9.15 percent.
In the special election to fill the At-Large Council seat that must go to a non-Democrat under the city’s Home Rule Charter, and which was vacated by McDuffie when he decided to run for mayor as a Democrat, former Council member Elissa Silverman was leading with 54.75 percent of the vote. Incumbent Council member Doni Crawford, who was temporarily appointed to the seat, was in second place with 34.81 percent of the vote. A third candidate, Jaque Patterson, had 19.27 percent. All three candidates ran as independents.
In the separate D.C. Republican and D.C. Statehood Green Party primaries held on June 16, all the offices for which a candidate from those two parties were on the ballot ran unopposed. No Republican candidate ran for D.C. mayor in the primary. With a large majority of D.C. voters being registered as Democrats, no Republican or Statehood Green Party candidate has won election to public office in D.C. for at least the past 10 years or longer. No known LGBTQ Republican or Statehood Green Party candidate was on the ballot in the June 16 primary.
Delaware
57 towns in 57 hours: Rep. McBride kicks off re-election campaign
Touts record of championing bipartisan legislation
Rep. Sarah McBride (D-Del.) officially kicked off her re-election campaign this week with a grueling tour of her state that saw her visit 57 municipalities in just 57 hours.
The tour culminated Monday evening in Rehoboth Beach with a packed crowd at the Convention Center. At least 400 attendees stood patiently in a line that wrapped around the block and snaked down Rehoboth Avenue. Once inside, a DJ entertained the ebullient crowd that kept busy batting beach balls around the venue.
The crowd featured a large LGBTQ presence that cheered speakers including state Rep. Claire Snyder-Hall, state Sen. Russ Huxtable, and Delaware Democratic Party Chair Evelyn Brady, who introduced McBride.
McBride took the stage to Chumbawamba’s “Tubthumping” and the lyrics “I get knocked down, but I get up again.” In her remarks, she touched on a record of introducing more bipartisan legislation than any other freshman lawmaker and touted an award her office won for providing superior constituent service.
“People want leaders who are focused on lowering costs, solving problems, and delivering results,” she said. “That’s exactly what I’ve worked to do in Congress, and that’s why I’m running for re-election – to continue delivering for and defending Delaware.”
McBride is the first transgender member of Congress and is Delaware’s sole representative in the U.S. House. She will face the winner of the Republican primary in November. Rev. Earl Cooper — a former Democrat McBride defeated two years ago — is running for the GOP nomination. The state primary election is Sept. 15 and the general election is Nov. 3.
District of Columbia
D.C. nude dance club Archibald’s to feature male strippers beginning Pride weekend
Popular downtown venue to debut new lower floor gay ‘underworld’
Archibald’s Gentlemen’s Club, which has offered adult entertainment in the nation’s capital involving nude female dancers since it first opened in 1969 at 1520 K St., N.W., will offer nude male dancers beginning Saturday night, June 20, according to co-owner Thom Naylor.
The female dancers will continue as usual on the upper two floors of Archibald’s three-story building, according to Naylor, who released a flier promoting the opening of the male dancer venue as an event “for Gay Pride.”
He told the Washington Blade he expects a dozen male dancers to perform beginning at 9 p.m. Saturday when D.C.’s LGBTQ Pride Parade will take place earlier in the day.
Following its opening night for the male dancers, Naylor said he plans to continue offering male nude dancers on Thursday, Friday, and Saturday evenings. The club is closed on Sundays and Mondays.
“I want to have an official Champagne grand opening probably in July,” he said referring to the male dance venue. “This is like a soft opening just to get going and to get everybody acclimated.”
The decision by Archibald’s to offer nude male dance entertainment for an LGBTQ clientele will mark the first time such entertainment will take place in D.C. since March 2020, when the LGBTQ nightclub Ziegfeld’s-Secrets, which featured nude male dancers, was forced to close at the start of the coronavirus pandemic.
The owner of the building at 1824 Half St., S.W., discontinued the Ziegfeld’s-Secrets lease a short time later to demolish the building and construct a high-rise residential condominium.
Naylor, who identifies as gay, said he has long believed nude male entertainment should be available in D.C. for a gay clientele as well as anyone else interested in that type of entertainment.
“So, we decided to go with three days in the summer and then come September go into a full swing when we’re open five days a week,” he said, referring to the male dancers.
Netherlands to ban conversion therapy
Lewis George holds strong lead over McDuffie in D.C. mayor’s race
War, geopolitical tensions with U.S. overshadow Pride month events
Confronting homophobia at school
