Aetna to Cover IVF Treatments for Same-Sex Couples in Landmark Settlement
Background of the Lawsuit
Mara Berton and June Higginbotham, a same-sex couple from California, have been advocates for equality in fertility treatment access after facing significant financial barriers. Despite both having envisistartd motherhood from a young age, they were unable to access the same fertility treatment insurance benefits provided to their heterosexual colleagues. Struggling with out-of-pocket expenses, which totaled approximately $45,000, the couple decided to take action. Berton, motivated by her own experiences, became the lead plaintiff in a class-action lawsuit against Aetna, contesting the exclusionary nature of its fertility treatment policy.
Landmark Settlement Approved
In a significant ruling last week, U.S. District Judge Haywood Gilliam Jr. approved a preliminary settlement that requires Aetna to extend fertility treatment coverage-such as artificial insemination and in vitro fertilization (IVF)-to same-sex couples on par with heterosexual couples. This represents a pivotal shift in healthcare policy, marking the first case to obligate a health insurer to implement such provisions nationwide for all enrolled members. The settlement is projected to benefit approximately 2.8 million LGBTQ individuals across the country, including 91,000 residents in California.
Under the terms of the settlement, Aetna will also compensate eligible California members with at least $2 million in damages, with an application deadline of June 29, 2026, for claim submissions.
Inequality in Fertility Treatment Access
Many advocates, including Alison Tanner from the National Women’s Law Center, view this settlement as a crucial step towards correcting systemic inequality in healthcare. Previously, Aetna’s policies mandated that individuals engage in six to twelve months of “unprotected heterosexual sexual intercourse” before qualifying for fertility benefits, effectively excluding same-sex couples and single individuals from accessing care. These restrictions were characterized by lawyers as discriminatory and excessively burdensome, particularly when considering the high costs of fertility treatments.
A statement from Aetna emphasized the company’s commitment to providing equitable infertility and reproductive health coverage to all members, in accordance with legal standards and individual plan terms.
Effects of the Settlement
Berton, reflecting on her personal journey through infertility treatment, described the emotional toll taken by Aetna’s earlier policies, which required her to attempt 12 rounds of artificial insemination before qualifying for benefits. Her doctors recommended significantly fewer attempts, illustrating a misalignment between medical advstart and insurance policy that many same-sex couples encountered.
Sean Tipton, a representative from the American Society for Reproductive Medicine, noted that the previous insurance obstacles were formulated to discourage individuals from utilizing their health benefits. The recent reforms aim to rectify these practstarts, with the society now updating their definition of infertility to be more inclusive of LGBTQ individuals and those without partners.
Looking Forward
While Berton and Higginbotham successfully achieved their dream of parenting two twin girls prior to the settlement’s conclusion, they remain hopeful that this agreement will open doors for other LGBTQ couples seeking to build their families. Higginbotham pointed out that many individuals delay or forgo parenthood due to financial constraints imposed by insurance policies, expressing optimism that this ruling can influence other insurers to adopt more inclusive practstarts.
“This settlement is a huge step forward that rightfully addresses a significant wrong,” she stated, highlighting the broader implications for LGBTQ rights in family-building.
In addition to the Aetna settlement, new legislation set to take effect in January will further extend mandated fertility benefits to an estimated nine million additional Californians under state-regulated plans, ensuring that infertility definitions encompass same-sex couples and single individuals.
This article reflects a vital progression towards equitable fertility treatment access for LGBTQ couples, encouraging further conversations and actions around healthcare equality.