TRENTON, N.J. – A federal lawsuit brought by a New Jersey lesbian couple who want to have a baby may mean insurance coverage for women who currently don’t meet the state’s definition of infertile.
Erin Krupa was denied insurance coverage for infertility treatments essentially because she failed to show she couldn’t get pregnant by having sex with a man. New Jersey law for insurance purposes defines infertility as the result of failure to conceive after a certain period of unprotected sex.
Krupa’s insurer eventually agreed to the coverage, based on her doctor’s diagnosis, and she has incurred nearly $25,000 in out-of-pocket medical expenses.
But she and Marianne Krupa say in their lawsuit that they are pursuing the case as a civil rights issue – “the right of all New Jersey women who dream of becoming mothers to access the reproductive health care they need to realize that dream on an equal basis.”
Two other women have joined them as plaintiffs in the case, filed Aug. 1 against state Banking and Insurance Commissioner Richard Badolato. His spokesman did not return a message left for comment.
Meanwhile, some state lawmakers plan to advance legislation to change the law when legislators return from break in September. The proposal would revise the definition of infertility to include lesbians, women without partners and those who have protected sex.
“The law needs to be changed,” said Senate Majority Leader Loretta Weinberg, a Democrat and the bill’s sponsor in the Senate. “It’s just time to push this to the forefront.”
New Jersey’s law currently requires most insurers to cover expenses deemed medically necessary as part of infertility treatment. It defines infertility as the result of a failure to conceive after two years of unprotected sex for women younger than 35 or after one year for those older than 35.
Fifteen states have laws requiring insurers to offer coverage for infertility treatment and diagnosis, according to the National Conference of State Legislatures. Maryland and California have changed their laws to require coverage for same-sex couples.
According to the lawsuit, the Krupas moved to New Jersey in 2011 from North Carolina and decided to start a family. Erin Krupa was diagnosed with non-cancerous endometriosis, and her doctor determined she required infertility treatment. But she was denied coverage of the treatment because she failed to meet the law’s definition of infertile, the suit says. Her insurer eventually agreed to offer coverage based on a letter from the couple’s doctor, despite not being legally required to do so, the suit says.
Both Sen. Nia Gill and Assemblyman Craig Coughlin, who chair committees overseeing the legislation in their respective chambers, said they expect the bill will get a hearing and likely be put to a vote.
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