The U.S. District Court for the Northern District of Illinois recently ruled that Illinois resident Kelsey Murphy can proceed with a proposed class-action lawsuit against Blue Cross Blue Shield of Illinois (BCBSIL), Bloomberg Law reported.
The lawsuit, Murphy v. Health Care Serv. Corp., alleges that BCBSIL's fertility treatment coverage policy violates the Affordable Care Act's (ACA) anti-discrimination provision.
The court denied BCBSIL's motion to dismiss Murphy's suit over the health insurer's alleged violation of Section 1557 of the ACA. This provision bans bias in health-care programs and activities when it comes to characteristics, such as sex, that other civil-rights laws protect.
Murphy and her partner must rely on fertility treatments like in vitro fertilization in order to have children. BCBSIL denied her coverage in 2020, claiming she didn't meet her policy's requirements. The insurer said the policy wasn't discriminatory because it gave participants several alternative ways to prove infertility. BCBSIL's 2020 policy defined infertility as an inability to conceive after a year of unprotected sex or "attempts to produce conception."
However, the court ruled that the policy defined "unprotected sex" as sex between a man and a woman. Thus, a woman would qualify for coverage if she wasn't able to conceive after one year of having unprotected sex with a manbut a lesbian would have to demonstrate infertility in another way. The lesbian would have to bear out-of-pocket costs just to prove she couldn't conceive, the court concluded.
Andrew Davis