Washington -- President Barack Obama mandated Thursday that hospitals extend visitation rights to the partners of gay men and lesbians and allow same-sex couples to share medical power of attorney, 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 quietly have been 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.
It is currently common policy in many hospitals that only those related by blood or marriage be allowed to visit patients.
"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 praising the decision.
Obama's actions are 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 seeking equal rights for gays, 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 for doing what it can, 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 their 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.
Obama's memo to HHS Secretary Kathleen Sebelius, made public late Thursday night, orders new rules that would ensure that hospitals "respect the rights of patients to designate visitors."
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," Obama wrote in the memo.
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."
The new rules do not apply only to gays. They also affect widows and widowers who have found themselves unable to receive visits from a friend or companion. And it 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 is aimed squarely at gays. A number of areas remain in which federal law requires proof of marriage, including receiving Social Security benefits and in taxes.