By Michael D. Shear
Washington Post Staff Writer
Friday, April 16, 2010; A01
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."