WASHINGTON (AP)– In a move hailed as a step toward fairness for same-sex couples, President Barack Obama is ordering that nearly all hospitals allow patients to say who has visitation rights and who can help make medical decisions, including gay and lesbian partners.

The White House on Thursday released a statement by Obama instructing his Health and Human Services secretary to draft rules requiring hospitals that receive Medicare and Medicaid payments to grant all patients the right to designate people who can visit and consult with them at crucial moments.

The designated visitors should have the same rights that immediate family members now enjoy, Obama's instructions said. It said Medicare-Medicaid hospitals, which include most of the nation's facilities, may not deny visitation and consultation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity or disability.
The move was called a major step toward fairness for lesbian, gay, bisexual and transgender Americans.

"This is a critical step in ending discrimination against LGBT families and ensuring that, in the event of a hospital stay, all Americans have the right to see their loved ones," said House Speaker Nancy Pelosi, D-Calif.

The new rules, Obama said, should "guarantee that all patients' advance directives, such as durable powers of attorney and health care proxies, are respected," and that patients' designees be able to "make informed decisions regarding patients' care."