Aetna has agreed to a settlement in which it will cover fertility treatments such as artificial insemination or in vitro fertilization for same-sex couples in the same way it does for heterosexual couples. U.S. District Court Judge Haywood Gilliam Jr. of the Northern District of California last week approved a preliminary agreement for the class-action lawsuit.
Under the settlement, Aetna also will pay at least $2 million in damages to California-based members who qualify.
“I truly hope that this is the first of many insurers to change their policy,” Alison Tanner, senior litigation counsel for reproductive rights and health at the National Women’s Law Center, told CalMatters. “We were looking at that as an issue of inequality -- that folks who were in same-sex relationships were being treated differently.”
Mara Berton and June Higginbotham, a same-sex couple, said they had to pay $45,000 out-of-pocket to conceive while heterosexual colleagues with the same insurance plan had many of those costs covered. Berton, who was the lead plaintiff in the case, said she was blindsided by the policy. She had consulted with a fertility clinic and decided to move forward with donor sperm and artificial insemination when a representative from Aetna said she did not meet the definition of infertility.
“We knew it wasn’t right,” Berton said. “What we’re fighting for is about family building and having kids. It was really important to both of us that other couples not have to do this.”
Aetna previously required policyholders to engage in six to 12 months of “unprotected heterosexual sexual intercourse” without conceiving to qualify for fertility benefits, according to the lawsuit. Women “without a male partner” could access benefits only after undergoing six to 12 unsuccessful cycles of artificial insemination, depending on their age. This policy fundamentally treated LGBTQ members differently and effectively denied them access to the benefit, lawyers for the plaintiffs argued.
“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,” company spokesperson Phillip Blando said.
Higginbotham hopes the settlement will help other couples in the same situation that she and Berton faced.
“I know people that don’t have children, that wanted children, because the stuff isn’t covered,” she said. “I know people that their timeline was delayed and maybe they have fewer kids than they wanted. The settlement is such a huge step forward that is really righting a huge wrong.”
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