Does the new law actually leave gay couples in the dark?
Margie M. Palmer | GSD Reporter
Gov. Jerry Brown recently signed a bill assuring infertility insurance to LGBT couples, but some question whether AB 460 falls short.
Infertility — the state of being unable to produce offspring — is defined in state law. Under current law, insurers are required to offer coverage for infertility; when purchased, the coverage is subject to non-discrimination.
But some people, including individuals and couples, were being denied coverage because they are not in a heterosexual marriage.
AB 460 author Assemblymember Tom Ammiano said his goal was to clarify existing mandates for non-discrimination. Ultimately, he wanted to ensure that unmarried individuals and same-sex couples would receive the same benefits as married straight couples.
San Diego fertility expert Dr. Samuel H. Wood, however, points out that the landscape is still a bit uneven.
The most common non-advanced procedures, such as artificial insemination, are now covered. This is great news for lesbian couples, who no longer need to pay upward of $1,000 per cycle, plus the cost of frozen sperm.
Gay couples, however, seem to have been left in the dark.
“When it comes to reproduction, lesbians and gay men have very different needs and the new law ignores that fact,” Dr. Wood said. “The vast amount of insurance policies don’t cover surrogacy even for heterosexual couples; it’s rare. To bring the law up to an even playing field everyone would need to have the same chance to benefit from insurance coverage.”
For men, obtaining sperm isn’t the problem; obtaining, inseminating and gestating an egg is what starts to get expensive.
“The only way to get an egg is through an in vitro fertilization cycle,” Wood said. “Doing that with a traditional surrogate can be a messy situation since the woman who is carrying the baby is its biological mother.
“There can be legal problems if she changes her mind and this is really a sub-optimal way for a gay couple to have a baby,” he said.
The in vitro fertilization method is also very expensive, Dr. Wood said, often costing approximately $30,000 to $35,000 for the surrogate alone, plus legal and other fees, which could easily top out at $50,000.
Gestational surrogacy, the process in which a third-party egg is inseminated and transferred into a non-related surrogate, can cost as much as $90,000.
“None of this is covered under traditional insurance, so to even the playing field, legislators need to make a decision as to whether gay men should receive coverage for surrogates and then to determine if heterosexual couples should get that too,” Wood said.
San Diego-based attorney Alexis Scott said the real question is whether covering the cost of egg donors and surrogates would turn insurance companies into a body-for-hire service.
“If they have their hands in it, I think even more restrictions will be placed on the procedures,” she said. “They could continually deny coverage based on the mere fact that they don’t approve of the donor or the surrogate. This could spiral into more issues than anyone could potentially foresee.”
Because heterosexual couples still need to pay for egg donors and surrogates, Scott said the law is technically still equal.
“I don’t foresee this being changed in the near future based on the fact that this type of procedure is not likely to be classified as anything but elective,” she said.
Insurance companies say they’ll follow the new guidelines but aren’t issuing any other comment. A spokesperson for Kaiser Permanente said they have a neutral position on AB 460.
Calls and emails to the California Association of Health Plans were not returned prior to deadline.
The new law (AB 460) took effect Jan. 1.
—Margie M. Palmer is an award-winning columnist and part-time editorial dominatrix who has been published extensively in both online and print media. This former Jersey Girl has been a San Diego resident since June 2000 and despite getting way too excited when it comes to reporting on local news, she does not fist-pump. You can reach her at firstname.lastname@example.org”.