Aetna LGBT+ discrimination suit expands to employer plans

by Reuters
Thursday, 4 November 2021 21:09 GMT

A logo of Aetna is displayed on a monitor above the floor of the New York Stock Exchange shortly after the opening bell in New York, U.S., December 5, 2017. REUTERS/Lucas Jackson

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American healthcare company, Aetna was sued by LGBT+ New Yorkers who say they were denied coverage for fertility treatment

(Reuters) - Aetna Inc discriminated against "thousands" of New Yorkers who are lesbian, gay, bisexual, transgender and other gender identities (LGBT+) by denying coverage for fertility treatment, women covered by employer health plans alleged in a lawsuit Thursday.

In an amended complaint filed in federal court in Manhattan, three women said they had to pay out-of-pocket for services that were covered for heterosexual beneficiaries, in violation of New York anti-discrimination law, joining a proposed class action filed in September on behalf of students covered by Aetna-backed plans.

Aetna did not immediately respond to a request for comment.

In response to the lawsuit in September, the company said it was "committed to equal access to infertility coverage and reproductive health coverage for all its members." It acknowledged that upon review, some claims had been improperly denied and said they would be "promptly covered," and it would review similar cases to ensure compliance with New York law.

All the plaintiffs say they were discriminated against by an Aetna policy requiring same-sex couples to pay for fertility treatment out of pocket before becoming eligible for coverage.

They allege that, while couples that can try to get pregnant through heterosexual intercourse can receive coverage simply by representing that they have tried for six or 12 months, depending on age, couples that cannot conceive through intercourse because of their sexual orientation or gender identity must first pay out of pocket for six or 12 months of intrauterine insemination (IUI), according to the complaint.

Emma Goidel, a Columbia University student who filed the original complaint in September, alleged that she and her spouse were forced to spend $45,000 for fertility treatments as a result of Aetna's denial of coverage.

She said that beginning in 2020 they paid for four unsuccessful IUI cycles, and one unsuccessful IVF cycle, before becoming pregnant through a fifth IUI cycle, all of which Aetna refused to cover.

Plaintiffs Ilana Lee and Madeleine Lee, a couple covered by an Aetna plan sponsored by Madeleine's employer who joined the lawsuit Thursday, say they paid nearly $5,000 for IUI, foregoing medically recommended monitoring visits because of cost, in order to become pregnant.

Plaintiff Lesley Brown, who is covered by an employer self-insured plan administered by Aetna, said she and her wife have paid more than $6,000 for IUI in their effort to become pregnant.

The plaintiffs are seeking to represent a statewide class of Aetna beneficiaries.

The case is Goidel v. Aetna Inc, U.S. District Court, Southern District of New York, No. 21-cv-07619.

For plaintiff: Zoe Salzman of Emery Celli Brinckerhoff Abady Ward & Maazel; Sunu Chandy of National Women's Law Center

For Aetna: Earl Austin and Sarah Reeves of Baker Botts

(Reporting by Brendan Pierson)

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