Aetna has agreed to settle a lawsuit that accused the health insurer of discriminating against LGBTQ+ customers in need of fertility treatment. The settlement requires Aetna to make coverage of artificial insemination standard for all customers nationally and work to ensure equal access to more expensive in-vitro fertilization procedures. The National Women’s Law Center, representing the plaintiffs in the case, announced the deal. Aetna, the health insurance arm of CVS Health Corp., covers nearly 19 million people with commercial coverage, including employer-sponsored health insurance. As part of the settlement, the insurer will set aside a $2 million fund to reimburse people who were denied reimbursement for artificial insemination under certain commercial insurance plans in New York.
The lawsuit that led to this settlement was filed in a federal court in New York in 2021. The plaintiffs, Emma Goidel and her spouse Ilana Caplan, had spent over $50,000 on fertility treatments after being denied coverage by Aetna. The couple had insurance through a Columbia University student health plan, which required them to pay thousands of dollars for cycles of artificial insemination before the insurer would start covering fertility treatments. Heterosexual couples, on the other hand, only had to attest that no pregnancy had occurred after several months of unprotected sex to receive coverage. Goidel expressed surprise at the unexpected costs of fertility treatments and noted the disparities in coverage for different couples.
After six cycles of artificial insemination and an unsuccessful $20,000 attempt at in vitro fertilization, Goidel became pregnant with their second child. She expressed her happiness that Aetna changed its policy as part of the settlement and expects to be reimbursed for the expenses incurred during their fertility treatments. In recent years, fertility treatment coverage has become more common among employers as a way to attract and retain talented workers. Benefits consultant Mercer reported that 45% of employers with 500 or more workers offered IVF coverage in 2021, up from 36% in the previous year. Many employers place limits on the number of treatment cycles or set a lifetime maximum for the benefit. Additionally, many insurers now cover artificial insemination as a standard benefit for all policyholders.
The changes brought about by this settlement are a significant victory for LGBTQ+ individuals seeking fertility treatment, ensuring they have equal access to necessary procedures. A CVS Health spokesman stated that the company is committed to providing quality care to all individuals regardless of their sexual orientation or gender identity. While the settlement still needs approval from a federal judge, it represents a step towards more inclusive and equitable healthcare coverage for all individuals. The increased coverage for fertility treatments is a positive development in the healthcare industry, reflecting a growing recognition of the importance of reproductive health and family planning.
The story of Emma Goidel and her spouse highlights the challenges faced by LGBTQ+ couples in accessing fertility treatments and the financial burdens associated with these procedures. By standing up against discrimination in healthcare coverage, they have paved the way for more inclusive policies that benefit all individuals, regardless of their sexual orientation or gender identity. As awareness grows around the disparities in healthcare coverage, more efforts are being made to ensure that everyone has access to the care they need. The settlement with Aetna serves as an example of how advocacy and legal action can bring about positive change in the healthcare system, benefiting individuals and families in need of fertility treatments.
