As Part Of Its Lawsuit Over LGBTQ Coverage, Aetna Sued

There has been a lawsuit against Aetna Inc over allegedly discriminating against the LGBT community and transgender and genderqueer clients. In this case, the cost of fertility treatments was higher because the patients had to pay more out of pocket.

As Part Of Its Lawsuit Over LGBTQ Coverage, Aetna Sued .

Reuters reported Monday that plaintiff Emma Goidel filed a proposed class action in federal court in Manhattan alleging that she and her spouse were forced to spend nearly $45,000 on fertility treatments. Furthermore, Aetna’s policy required same-sex couples to pay for fertility treatment out of pocket before receiving coverage required them to disqualify themselves from coverage.

CVS Health Corp acquired Aetna in 2018. No comments were immediately forthcoming from a company spokesperson. Goidel is covered by her boyfriend’s Aetna tuition plan, which covers the costs of reproductive health services such as intrauterine insemination (IUI) and in vitro fertilization (IVF).

As a result, couples that can try to conceive through heterosexual intercourse can receive coverage simply by proving that they have tried for six or 12 months, depending on age. The complaint explains that couples who are unable to become pregnant through intercourse because of their sexual orientation or gender identity will be required to pay for at least six or twelve months of IUI upfront.

Aetna refused to cover four unsuccessful IUI cycles and one unsuccessful IVF cycle that Goidel and her husband paid for, and which resulted in a fifth IUI cycle that successfully produced a child. Although she failed in the past, she chose IUI partly because of the higher cost of IVF.

Under Ms. Goidel, she has suffered great emotional distress during the process of choosing a medical treatment based solely on the cost, rather than based on her medical needs and personal circumstances as determined by her doctor. According to Noel León, the attorney for Goidel, the decision ultimately prevents queer people from forming families in the ways they choose.

In addition, the suit alleges a violation of the Human Rights Laws of New York State and the City of New York that prohibits discrimination against people based on sexual orientation or gender identity in all public venues. Despite the high price tag, León says Goidel and her spouse were lucky enough to be able to purchase the house. However, there are many others who cannot afford it. As she continued, the impact is greater on those who live with low incomes, who are disproportionately people of color, those who have disabilities, or those who are marginalized in other ways.

Aetna student health plans described in Goidel’s complaint contain “identical language” regarding infertility treatment in at least 17 other New York state plans. The allegation says that altogether, these institutes accommodate over 150,000 students, comprising over 60,000 professionals as well as graduate students. At least one more plaintiff may join given the numbers, though Goidel was the only plaintiff when the lawsuit was filed on Monday.

Aetna’s policy discriminates against LGBTQ individuals, denying them the right to have children equal to those of heterosexual couples, Goidel claimed. The Aetna policy language results in these individuals incurring high costs at best. The exorbitant costs of beginning a family are prohibitive at worst – most disproportionately LGBTQ persons of color. With these costs, individuals are prevented from getting pregnant or starting a family.

New York State’s Department of Financial Services announced in February that policies like Aetna’s violate state law, according to the lawsuit. Under the Human Rights Act of New York State and New York City, Goidel is bringing claims on behalf of a class of student health plan members that are covered by Aetna.