Same-Sex Couple Sues Aetna Over Fertility Treatment's 'LGBTQ+ Tax'

Friday September 17, 2021

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Aetna is being sued by a lesbian couple who allege discrimination because the company requires higher out-of-pocket expenditures before covering fertility treatment for non-heterosexuals.

NBC News reports that Emma Goidel and her spouse brought a "proposed class action" against the insurance company on Sept. 13, characterizing the company's policies regarding coverage for fertility treatment as a "tax" that singles out couples who are not heterosexual and cisgender.

"Goidel is covered through her spouse by Aetna's health insurance plan for Columbia University students, which provides broad coverage for intrauterine insemination (IUI) or in vitro fertilization (IVF) treatments, according to the complaint," NBC News detailed.

TIME Magazine reports that the Aetna policy "defines infertility as not becoming pregnant after 12 months of regular, unprotected heterosexual sex — or 12 months of therapeutic donor insemination. (The window shortens to 6 months if the person seeking to get pregnant is 35 or older.)

"Only then does Aetna's plan cover IUI and in vitro fertilization (IVF) treatments."

Since Goidel and her spouse are a same-sex couple, "regular heterosexual sex" is not an option for them; they must rely on fertilization treatments like IUI or IVF.

"Goidel estimates that she and her partner spent around $45,000 for one successful pregnancy, after six rounds of IUI and one round of IVF," TIME summarized. But Goidel's attempts to have the procedures covered were rejected by Aetna.

"It really feels like a queer tax," Goidel told TIME.

The suit echoes that language, claiming that "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," the suit goes on to say. "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."

The suit also claims that "Ms. Goidel has endured great emotional distress with each failed attempt to get pregnant" and adds that "The knowledge that she was being subjected to unequal, discriminatory treatment by having to pay for these attempts at pregnancy compounded this emotional distress."

The company responded to the press with a statement that it is "still actively investigating the facts" and added, "Aetna is committed to equal access to infertility coverage and reproductive health coverage for all its members."

The suit claims a legal basis in "the Affordable Care Act's anti-discrimination provisions and New York state and city human rights laws," Reuters notes.

The text of the lawsuit says that it "challenges Aetna's discriminatory health insurance policy that, on its face, engages in sex discrimination by denying LGBTQ (lesbian, gay, bisexual, transgender, queer, intersex, or non-binary) individuals equal access to fertility treatment."

The suit further alleges that "Aetna's discrimination is deliberate. It has continued to enforce this discriminatory Policy against Ms. Goidel and other LGBTQ individuals despite the passage of
Section 1557, despite the clear definition of sex discrimination under federal and state law to include LGBTQ individuals, and despite being specifically informed by the New York State agency that regulates Aetna and other health insurance issuers that such health insurance policies constitute illegal discrimination on the basis of gender identity and sexual orientation."

The suit seeks a "trial by jury" and damages "in an amount to be determined at trial."

Goidel framed the suit as a matter of reproductive rights, telling TIME that such freedoms "have to be more than just the right to end a pregnancy.

"They have to include the right to begin a pregnancy."