These instances spelled out in the letter may seem highly technical and not significant in the grand scheme of themes, but for people affected by these situations, they are quite important. The Medicaid letter is another in a long and growing list of instances in which the Obama Administration has undertaken to reinterpret existing law and regulations in a way that recognizes the existence of same-sex partners. Because of the continuing applicability of Section 3 of DOMA (which the Administration has conceded is unconstitutional and which the Justice Department will no longer defend against court challenges), there are limits to what the Administration can do administratively -- and some gay rights opponents may argue that the Administration's actions are pushing the limits, perhaps over the line -- but it appears that the Administration is trying to do whatever it can. It is worth noting that in many cases this is a matter of administrative grace that could be rescinded where an anti-gay Republican administration elected in 2012. (One need only call to mind the pull-back on administratively-enacted protection against discrimination for gay federal employees after the Bush Administration took over from the Clinton Administration.)