Victory for LGBTQ+ couples in landmark fertility coverage case

A federal judge in New York approved the settlement in a landmark class action suit against health insurer Aetna brought by a lesbian couple seeking to have a child through fertility treatment

Lead plaintiff Emma Goidel, her partner, writer Illana Caplan, and other plaintiffs claimed they did not receive the same coverage for fertility services as straight couples, NBC News reports. As part of the settlement, Aetna expanded its fertility coverage regardless of the policyholder’s sexual identity or partner status earlier this year.

“LGBTQ+ folks are as deserving of becoming parents as anyone else on this planet,” Goidel said. “I hope that when people can start signing up to be compensated, queer folks who have gone on the journey to become parents and faced barriers from insurance feel that they’re not alone in that.”

Under its previous policy, Aetna provided IUI coverage to straight couples who claimed they had been unable to conceive after engaging in unprotected vaginal intercourse for the previous six or 12 months, depending upon age. LGBTQ+ individuals or couples were required to pay out of pocket for 12 cycles of IUI before they became eligible for coverage.

Goidel and Caplan were forced to pay $45,000 from their savings before Aetna would provide IUI coverage under their policy through the Student Health Plan for Columbia University. With assistance from the National Women’s Law Center (NWLC), Goidel filed suit when the couple learned straight policyholders were only required to state they had been unable to conceive a child following up to a year of unprotected sex to receive immediate coverage.

“How is it OK to say if you’re straight and your partner can’t get you pregnant, you come into the doctor and we’ll cover your treatment, but if you’re a queer and your partner can’t get you pregnant, too bad you’re going to pay?” Goidel asked in an interview with ABC News in 2023.

Without admitting liability, Aetna agreed to take steps to eliminate the disparity in fertility treatment coverage for straight and LGBTQ+ policyholders regardless of partner status. The insurer also agreed to re-process and reimburse eligible claims up to plan limits and establish a $2 million fund to compensate each class member.

“This settlement is a big win for queer families. It means so many of us who hope to become parents or have more children can now begin the journey to do that with the same access to fertility treatment coverage as heterosexual couples,” Goidel said in a press release in May announcing the settlement. “We hope other insurance companies will follow Aetna’s example and review their policies to make sure everyone has equal access to fertility care.”

Goidel and Caplan have a son, Avi.