Same-Sex Couple Sues Aetna Over the Insurer’s Discriminatory Fertility Treatment Policy

Aetna won’t cover fertility treatments for same-sex couples, claiming that they don’t meet the insurer’s definition of “infertility.” Now one lesbian couple is challenging that policy in court. Read on for the full story.

Same-Sex Couple Sues Aetna Over the Insurer’s Discriminatory Fertility Treatment Policy

In September 2020, NYC writer Emma Goidel and her partner decided to start their family and try for a baby. Goidel began intrauterine insemination (IUI) treatments, the most common method of conception for lesbian couples. However, when she applied to have her treatments covered by her Aetna Student Health Plan, she was denied because she didn’t fit the insurer’s definition of infertility.

As TIME magazine reported,  Aetna’s policy defined infertility as “not becoming pregnant after 12 months of regular, unprotected heterosexual sex—or 12 months of therapeutic donor insemination.  The plan only kicks in to cover IUI or IVF treatments once those conditions have been met.

However, since no amount of unprotected sex can lead to pregnancy in same-sex couples, fertility treatments are their only real option. According to Goidel, she and her partner would need to pay for the first 12 months of IUI on their own before they could access the benefits of her plan, which is exactly what they ended up doing. After being repeatedly denied, the couple paid roughly $45,000 total on six rounds of IUI and, ultimately, one round of IVF, which resulted in pregnancy.

Ectopic Pregnancy and Abortion Bans
Ectopic Pregnancy and Abortion Bans

Goidel, along with other same-sex couples in the same position, are now part of a class-action lawsuit that alleging that Aetna’s policy violates the Affordable Care Act’s anti-discrimination provisions. She told reporters,

“Aetna’s discriminatory policy is an illegal tax on LGBTQ individuals that denies the equal rights of LGBTQ individuals to have children. At best, these individuals incur great costs due to Aetna’s policy language. At worst, these exorbitant costs are prohibitive and entirely prevent people who are unable to shoulder them — disproportionately LGBTQ people of color — from becoming pregnant and starting a family.”

Civil rights lawyers Emery Celli Brinckerhoff Abady Ward & Maazel, joined by the National Women’s Law Center, filed the suit in the Southern District of New York on Monday. Noel León, Goidel’s own attorney, stated that the policy undermines the rights of LGBTQ people to “form families in the way that they choose.” Leon added that while Goidel is among the fortunate who can actually afford the high price tag of fertility treatments, many other families cannot.

Additionally, the suit alleges that Aetna’s policy violates both the New York State Human Rights Law and the New York City Human Rights Law—both of which prohibit discrimination on the basis of sexual orientation or gender identity by any place of public accommodation. It also alleges that the policy violates New York State and New York City Human Rights Laws.

Aetna told TIME,

We learned of this suit only this morning and are still actively investigating the facts. Aetna is committed to equal access to infertility coverage and reproductive health coverage for all its members, and we will continue to strive toward improving access to services for our entire membership.”

You can read the full complaint filed in the case of Goidel v. Aetna Inc, U.S. District Court, Southern District of New York, No. 21-cv-07619.

What are your thoughts on this? Should insurers be able to deny fertility treatments to same-sex couples or is it discriminatory? Share below. 

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