Key Takeaways in this Legal Dispute:
- The Claim: The plaintiffs argue that Aetna’s exclusion of GAFR procedures from their insurance coverage violates Section 1557 of the Affordable Care Act, which prohibits sex-based discrimination in federally funded health programs.
- The Impact: The plaintiffs allege that Aetna’s policy has caused them significant emotional and financial hardship, including exacerbating gender dysphoria, leading to social withdrawal, depression, and financial burdens due to out-of-pocket surgery costs.
- The Legal Battle: The lawsuit seeks a declaratory judgment to force Aetna to stop excluding GAFR procedures, injunctive relief to end the policy, and compensatory damages for the plaintiffs and potentially other affected individuals.
By Samuel A. Lopez – USA Herald
[CONNECTICUT] – The courtroom has long been a battleground for social and legal change, and Binah Gordon, Kay Mayers, and S.N. v. Aetna Life Insurance Company represents the latest chapter in that fight. As a journalist with decades of legal and insurance industry expertise, I’ve covered countless cases involving high-stakes litigation, but this one stands out for its complexity and societal implications.
Filed in September 2024, this federal lawsuit accuses Aetna of unlawfully denying coverage for gender-affirming facial reconstruction (GAFR) procedures, deeming them cosmetic rather than medically necessary. The plaintiffs allege that this policy violates Section 1557 of the Affordable Care Act, which prohibits sex-based discrimination in healthcare programs receiving federal funds.
Their demand? A declaratory judgment, an injunction to stop Aetna’s exclusionary practices, and financial redress for those affected.
In the complaint, the plaintiffs’ detail specific ways, in which they claim Aetna’s policy has caused them harm. These include:
