Aetna was one of the insurance companies that made starting a family financially difficult for many people. For same-sex couples, it felt more like a gut-punch, especially when they realized they had to pay tens of thousands of dollars out of pocket while their heterosexual colleagues enjoyed the perks of insurance-covered fertility treatments. Enter Mara Berton and June Higginbotham, two California lesbians who were sick and tired of being literally priced out of their dreams of parenthood.
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These two weren’t just angry—they were motivated. And now, thanks to a landmark legal victory, other LGBTQ couples won’t have to go through the same emotional and financial hurdles. Aetna, that once-guilty culprit, has been forced to change its tune, agreeing to cover IVF and other fertility treatments for same-sex couples just like they would for heterosexual ones. The deal, which will benefit 2.8 million LGBTQ people across the U.S., is as sweet as a baby’s first giggle.
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So, how did this all go from unfair policy to national settlement? Well, let’s dive into the wild (and sometimes absurd) world of fertility benefits and the fight for equality.
The IVF Struggle Is Real: Aetna’s Hilariously Outdated Policy
Let’s rewind to a time when Aetna thought it was perfectly reasonable to tell a same-sex couple that they’d have to attempt 12 rounds of artificial insemination before being eligible for fertility treatment benefits. Sounds like something out of a “What Were They Thinking?” meme, right? Well, this was Berton and Higginbotham’s reality.
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After deciding to start a family using donor sperm, Berton went to Aetna to ask about fertility benefits. What she got instead was a rude awakening: her insurance told her that she didn’t meet their definition of “infertility” because, well, she didn’t have a male partner. According to Aetna, she had to first endure 12 rounds of artificial insemination (something doctors don’t even recommend) before she could be considered “eligible.” Yikes.
Berton appealed the decision multiple times, but was rejected every time. Cue the facepalm. As she said, it was “dehumanizing”—and who could blame her? “Insurance should not be involved in these types of decisions,” Berton explained. “It shouldn’t dictate your journey to becoming a parent.”
When Berton and Higginbotham realized the policy was keeping them from their family dreams, they teamed up with a bunch of other fed-up same-sex couples to launch a class action lawsuit. They were fighting for more than just their own happiness—they were fighting for every couple who’d been told, “Sorry, you’re just not the right kind of ‘infertile.’”
A Landmark Victory: Aetna Gets With the Program
Fast forward to last week: After years of legal battles, judge Haywood Gilliam Jr. ruled in favor of the plaintiffs, paving the way for a settlement that forces Aetna to cover fertility treatments for same-sex couples. This is the first time an insurance company has been required to adopt such a policy nationally. That means all 2.8 million LGBTQ members covered by Aetna will now be able to access the fertility benefits they deserve. For Berton and Higginbotham, it’s a massive win—and not just for them, but for every LGBTQ couple out there.
“The settlement is such a huge step forward,” says Higginbotham. “I know people who’ve had their timelines delayed, or who had fewer kids than they wanted, because the treatments weren’t covered. This is righting a huge wrong.”
And for good measure, Aetna will also pay at least $2 million in damages to California-based members who qualify. So yeah, this isn’t just a win for equality—it’s a financial win too.
Beyond the Dollars: Changing the Way We Think About Family Building
While Berton and Higginbotham’s win is undeniably sweet, it’s part of a larger shift happening across the country. In fact, California is about to implement a new state law in January that will expand fertility benefits to all state-regulated health plans, including those for same-sex couples and single people. Aetna wasn’t covered by this new law, but it shows that change is happening everywhere.
And then there’s the American Society for Reproductive Medicine, which in 2023 updated the medical definition of infertility to include LGBTQ folks and people without partners. It was a long-overdue move that made it harder for insurers like Aetna to keep pulling the rug out from under LGBTQ families. “You need two kinds of gametes to have a baby,” says Sean Tipton, the Society’s Chief Advocacy and Policy Director. “It doesn’t matter where those gametes come from.”
So, where does that leave us? Well, it’s a start. But there’s still work to be done. While Aetna’s decision is a massive step forward, other insurers are lagging behind. So if you’re reading this, and you’re in a battle for fertility treatment coverage, keep pushing. You never know when the next giant will fall.
The End of the Road (Or Is It?)
For Berton and Higginbotham, the emotional and financial toll of starting their family was worth it—because now they’ve got two beautiful twin girls to keep them busy (they’re into swings and destroying bookshelves). But what they really hope is that their case inspires other couples to fight for their right to build families without insurance companies standing in the way.
“I know people who didn’t have kids because they couldn’t afford it,” says Berton. “I hope this settlement helps change that for them.”
At the end of the day, this isn’t just about IVF or fertility treatments. It’s about ensuring that all people—regardless of sexual orientation, gender, or relationship status—have the same access to family-building opportunities. And with this win, LGBTQ couples across the nation can finally breathe a little easier, knowing that they don’t have to pay a premium to create the families they’ve always dreamed of.
So here’s to more victories, more equal access, and fewer “Wait, what?” moments from insurance companies. Because if the fight for equality can help make families and insurance policies more inclusive, maybe there’s hope for all of us after all.
Source: CBS News (CalMatters)