Thursday, December 8

Ohio LGBTQ+ couple denied fertility coverage files lawsuit alleging discrimination

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Natalie and Caroline always knew they wanted children.

In northeast Ohio, on a quiet, residential street in Summit County, they bought a home within walking distance of an elementary school they hoped their own kids would attend someday.

When the pair married in 2020, they talked about a rough timeline for their family.

Already enrolled in a healthcare plan through her employer, the Summit County Board of Developmental Disabilities, Natalie discovered that fertility services were fully covered under her plan — including surgeries, laboratory and x-ray services, therapeutic drug and hormone injections and the entire embryo transplant process

She underwent medical testing, hoping to carry their child. The couple even settled on an LGBTQ+ friendly fertility clinic.

Then Natalie noticed an exclusion in her healthcare plan that changed everything: the embryo transplant process would not be covered if the couple must receive a donation from a “non-spouse sperm donor or non-genetic mother” in order to conceive.

Now the couple have filed a lawsuit, alleging the policy violates the couple’s right to equal protection under the Affordable Care Act, as well as the 14th Amendment of the U.S. Constitution.

If they win the case, their case could help create an important legal precedent for other LGBTQ+ families in Ohio and beyond.

What’s in the lawsuit?

After learning about the exclusion, Natalie and Caroline approached the LGBT Community Center of Greater Cleveland for direction. They were referred to Equality Ohio, who pointed them toward attorney Mark Herron.

He agreed to take their case.

Herron says the exclusion specifically discriminates against LGBTQ+ people, who often cannot conceive without sperm or egg donations from individuals outside of their marriages or partnerships.

“There was no hesitation on my part to take the case,” he adds. “It’s just wrong. It unfairly burdens the LGBTQ+ community.”

The Summit County Board of Developmental Disabilities is a member of the Stark County Schools Council of Governments (COG), a massive consortium of more than 150 agencies including “public school districts, public libraries, county boards of developmental disabilities, and other governmental agencies,” according to language from the suit.

COG contracts with Medical Mutual of Ohio and AultCare Insurance Company to administer healthcare plans to thousands of employees across the state. Both Medical Mutual and AultCare are also named as defendants in the suit.

“The thing that makes this case unique is that these are governmental entities,” Herron says. “There [are]constitutional implications for equal protections.”

Defining ‘infertility’

Natalie and Caroline aren’t the first LGBTQ+ couple to fight back against health insurance exclusions that disproportionately  affect LGBTQ+ people.

In 2022, a gay male couple in New York filed a complaint against the city — where one partner was employed — for denying them coverage to fertility services based on the definition of infertility: the inability to conceive after one year of unprotected sex or 12 cycles of insemination.

The couple failed to meet the criteria. In April, they told NBC News they submitted two requests for fertility coverage. Both were denied.

In 2021, another New York couple filed a class action suit against AETNA Inc, after paying $45,000 out-of-pocket for fertility treatments. 

Because the LGBTQ+ couple did not have the ability to conceive naturally, they could not meet the plan’s qualifying definition of infertility.

In May 2022, Bloomberg Law reported the Biden Administration considered changing the specific language around infertility, expanding eligibility for many LGBTQ+ people, both as couples and individuals.

‘We want equal access’

For Natalie and Caroline, taking legal action against the exclusion is about more than just building their own family.

Among their group of largely LGBTQ+ friends — many of whom also work in public service — the couple were the first to buy a home, and the first to get married.

They’re also the first to try for children.

“We want equal access for a lot of other people who are denied this coverage and don’t know what to do,” Carline says. “A lot of people are saying we should be grateful there’s a policy at all, but Natalie and I are paying premiums for other people to access care that we’re being specifically excluded from.”

Still, the couple are hopeful the suit will prompt a change in the policy, which they say discriminates against not only LGBTQ+ people, but anyone who builds a family outside of natural conception.

“This isn’t a morality thing,” Caroline says. “This is the human rights issue. 🔥

About Author

H.L. Comeriato is the staff writer for The Buckeye Flame. A queer and non-binary writer and reporter from Akron, Ohio, they covered public health for The Devil Strip via Report for America.

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