Colman Domingo
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Lawsuit: Aetna Fertility Coverage Is an 'Illegal Tax on LGBTQ+ People'

Pregnant couple

A new lawsuit accuses Aetna of discrimination against LGBTQ+ people by forcing them to pay more out of pocket for fertility treatments.

Emma Goidel filed the suit, which seeks class action status, Monday in U.S. District Court for the Southern District of New York. She and her same-sex spouse are enrolled in Aetna’s student health plan for Columbia University, which provides broad coverage for assisted reproductive procedures, such as intrauterine insemination and in vitro fertilization, according to the suit.

The policy provides immediate coverage, without any out-of-pocket cost, to people who attest that they have had unprotected heterosexual intercourse for 12 months without a pregnancy resulting. But it “requires individuals who cannot conceive through intercourse due to their sexual orientation or gender identity to pay out of pocket for 12 cycles of IUI before Aetna will provide them with coverage for fertility treatments,” the suit says. Goidel and her spouse spent about $45,000 out of pocket because of this.

“Aetna’s discriminatory Policy is an illegal tax on LGBTQ individuals that denies the equal rights of LGBTQ individuals to have children,” the suit continues. “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.”

Aetna’s action violates section 1557 of the Patient Protection and Affordable Care Act as well as New York City and state antidiscrimination laws, the suit claims. The state’s Department of Financial Services released a report in February saying that policies like this do not conform to state law.

The suit seeks to change Aetna’s policy and also seeks punitive and compensatory damages for Goidel and others who’ve been affected similarly. It asks for a jury trial.

Goidel is now eight weeks pregnant after her sixth cycle of intrauterine insemination. “She is overjoyed to be pregnant yet outraged at having to spend nearly $45,000 for a successful pregnancy,” says a press release from the National Women’s Law Center, which is representing her along with the firm of Emery Celli Brinckerhoff Abady Ward & Maazel LLP.

A spokesperson for Aetna told Reuters, “We ... 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.”

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