This story is a repost from WashingtonPost.com

President Obama mandated Thursday that nearly all hospitals extend visitation rights to the partners of gay men and lesbians and respect patients’ choices about who may make critical health-care decisions for them, perhaps the most significant step so far in his efforts to expand the rights of gay Americans.

The president directed the Department of Health and Human Services to prohibit discrimination in hospital visitation in a memo that was e-mailed to reporters Thursday night while he was at a fundraiser in Miami.

Administration officials and gay activists, who have been quietly working together on the issue, said the new rule will affect any hospital that receives Medicare or Medicaid funding, a move that covers the vast majority of the nation’s health-care institutions. Obama’s order will start a rule-making process at HHS that could take several months, officials said.

Hospitals often bar visitors who are not related to an incapacitated patient by blood or marriage, and gay rights activists say many do not respect same-sex couples’ efforts to designate a partner to make medical decisions for them if they are seriously ill or injured.

“Discrimination touches every facet of the lives of lesbian, gay, bisexual and transgender people, including at times of crisis and illness, when we need our loved ones with us more than ever,” Joe Solmonese, president of the Human Rights Campaign, said in a statement praising the president’s decision.

Obama’s mandate is the latest attempt by his administration to advance the agenda of a constituency that strongly supported his presidential campaign.

In his first 15 months in office, he has hailed the passage of hate crime legislation and held the first Gay Pride Day celebration at the White House. Last month, Obama’s top military and defense officials testified before Congress in favor of repealing of the “don’t ask, don’t tell” policy for gays in the armed forces.

But the moves have been too slow for some gay rights activists, who have urged the president to be more vocal and active in championing their causes. John Aravosis, a prominent gay blogger, wrote last October that Obama’s “track record on keeping his gay promises has been fairly abominable.”

Other gay rights activists have defended the administration, while at the same time pushing Congress to act on broader issues such as passage of an employment non-discrimination act and an end to the ban on gays serving openly in the military.

“We see this as part of our ongoing effort to encourage the administration to take action where it has the authority to act,” said David Smith, a Human Rights Campaign spokesman. “We’ve been working and pressing the administration on our legislative agenda. That work continues.”

Gay activists have argued for years that recognizing same-sex marriage would ease the stress associated with not being able to visit hospitalized partners.

But opponents of same-sex marriage have called the visitation issue a red herring, arguing that advocates want to provide special rights for gays that other Americans do not have. A spokesman for one group said the president’s move was part of a broader effort to appease gays and to undermine the institution of marriage.

“In its current political context, President Obama’s memorandum clearly constitutes pandering to a radical special interest group,” said Peter S. Sprigg, a senior fellow for policy studies at the Family Research Council. He said that his organization does not object to gays giving their partners power of attorney but that it questions Obama’s motives.

“The memorandum undermines the definition of marriage,” he said.

Obama’s memo to HHS Secretary Kathleen Sebelius orders the development of new rules to ensure that hospitals “respect the rights of patients to designate visitors” and to choose the people who will make medical decisions on their behalf.

The action has the potential to increase conflicts between family members, same-sex partners and hospital staff over end-of-life decisions.

A spokesman for the American Hospital Association did not return calls and e-mails. Efforts to reach a spokesman for the Catholic Health Association of the United States were unsuccessful.

In the memo, Obama said hospitals should not be able to deny visitation privileges on the basis of sexual orientation or gender identity.

“Every day, all across America, patients are denied the kindnesses and caring of a loved one at their sides whether in a sudden medical emergency or a prolonged hospital stay,” he wrote.

Affected, he said, are “gay and lesbian Americans who are often barred from the bedsides of the partners with whom they may have spent decades of their lives — unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.”

Officials said Obama had been moved by the story of a lesbian couple in Florida, Janice Langbehn and Lisa Pond, who were kept apart when Pond collapsed of a cerebral aneurysm in February 2007, dying hours later at a hospital without her partner and children by her side.

Obama called Langbehn on Thursday evening from Air Force One as he flew to Miami, White House officials said. In an interview, Langbehn praised the president for his actions.

“I kept saying it’s not a gay right to hold someone’s hand when they die, its a human right,” she said, noting that she and Pond had been partners for almost 18 years. “Now to have the president call up and say he agrees with me, it’s pretty amazing, and very humbling.”

The new rules will not apply only to gays. They also will affect widows and widowers who have been unable to receive visits from a friend or companion. And they would allow members of some religious orders to designate someone other than a family member to make medical decisions.

But it is clear that the document focuses on gays. A number of areas remain in which federal law requires proof of marriage, including receiving Social Security benefits and in taxes.

“The General Accounting Office has identified 1,138 instances in federal law where marriage is important,” said one gay rights activist, who spoke on the condition of anonymity before the White House formally announced the directive. “We’ve knocked off one of them.”

This story is a repost from theweek.com

Bipartisanship died at the Health Care Summit. The president can continue to reach out—that’s good politics at a time when Gallup reports that 54 percent of Americans don’t expect the GOP to make a “sincere” effort to achieve compromise on health reform. But as he reaches out, the president also has to draw clear dividing lines. He did that at the summit. After listening to the other side obfuscate, deceive, and spurn common ground, he said, “I don’t know if we can bridge” the differences. He knew that it was crystal clear where the fault lies.

Speaking of lies, Obama called them out in that unflappable way that carried him through storm and smear to the presidency in the first place.

No, it wasn’t true that Republicans had been excluded from the process; a whole range of their proposals—at least the ones that aren’t cockamamie or counterproductive—are included in the Senate and House bills and in Obama’s plan. Competition among insurance companies across state lines, small business pools to negotiate lower rates—there are literally pages of amendments that the Party of No was for before it was against the bill.

Unctuous Tennessee Sen. Lamar Alexander threw out the canard, concocted to frighten seniors, that the president’s plan would “cut” Medicare by $500 billion. (This from a party whose sole effort at serious reform—by Rep. Paul Ryan, ranking member on the House Budget Committee—calls for replacing Medicare with vouchers.) Alexander was wrong, and plainly, intentionally so. The bill, as the president and Speaker Nancy Pelosi responded, would not cut Medicare benefits for seniors but reform wasteful and sometimes fraudulent payments to providers.

The president deftly stuffed Alexander on another deception as well —that the reform would raise premiums for families. The Tennessee senator had read his talking points, but not the Congressional Budget Office report. According to CBO, premiums would be lower for 92 percent of Americans, in some cases by as much as 20 percent.

On and on it went. The Republicans trotted out their tired hobbyhorses—Health Savings Accounts for the wealthy and healthy and, of course, tort reform, which CBO says would address one-fifth of 1 percent of total health spending. CBO adds that the Republican version of tort reform is so ingeniously crafted that it would also reduce the pressure to avoid medical errors, resulting in 4,800 additional deaths annually. All told, the GOP’s token and total contribution to the debate is a plan to cover all of 3 million uninsured Americans while leaving the insurance companies to gouge their policyholders until the system collapses in a “death spiral” to the bottom.

To paraphrase Justice Brandeis, the television lights were the best disinfectant for Republican claims. With these televised, face-to-face exchanges, Obama has invented a new form of presidential leadership; he exercises it masterfully. The GOP knew what was happening—you only had to look at their sour faces.

Because they had so little to say that was positive or truthful, the summit was a debate the Republicans were bound to lose. But the decisive moment wasn’t the summit, it’s what happens now. Having won the debate, Democrats must now win the battle—not by conciliation but in a straight-out partisan confrontation. They hold the cards if only they will play them. House Democrats can put aside their injured sense of prerogative and pass the Senate bill—and then both chambers can improve it in the filibuster-free process of reconciliation. (Democrats should pay no attention to the crocodile tears of a GOP that used reconciliation to enact the entire Reagan economic plan and the massive Bush tax cut of 2001.)

Republicans will stop at nothing to stop health reform because they know it would reduce the Obama presidency to an authority-depleted, time-serving interval of insignificant change. Obama would be Carter rather than Reagan-in-Reverse. The president plainly understands this—which is why he has rejected counsels of caution and retreat from some of his own advisors.

Victory in the health fight—and now more than ever, it’s a fight, not a courtship—has to be a beginning, not an end. The president has to be more ambitious, not less. Early in the summit, Nancy Pelosi quoted from the letter a dying Ted Kennedy left behind for Barack Obama. The outcome on health care, Kennedy wrote, was fundamentally a test of “the character of our country.”

That outcome will also define the character of the Obama presidency—and that in turn will determine not merely his and his party’s political prospects, but the possibility, perhaps for generations to come, of a progressive America.

We saw the alternative, too, at the summit, where the character of today’s Republicans was on display. If they won’t join in, then they have to be beaten—beginning with health reform. As someone in the White House told me, when the crunch comes—and it has—“I wouldn’t bet against Obama.”.