The loophole through which an insurer tried to exclude a lesbian couple from assisted reproduction

It took seven years for the Government to correct the exclusion of women without a male partner from assisted reproduction that the Popular Party consummated in 2014. it happened in november, but five months have passed and some of them are still struggling today to see their right recognized. This is the case of Ángela Valls and his wife Carmen González, a Muface mutualist to whom Adeslas, the insurer to which she belongs, initially denied treatment. The company backtracked last week after making it public on Twitter, but at the time it justified its initial decision in a precept contained in the concert with Muface, published in the Official State Gazette last December, which literally continues to exclude women who do not have a diagnosis of infertility, although the portfolio of services that they must comply with does include them.

The Minister of Health, Carolina Darias, signed on November 5 the ministerial order that has replaced the one promoted by the popular Ana Mato during the Rajoy Government. That legislation altered the requirements to access assisted reproduction techniques financed by the State and reduced them to fertility problems as a necessary condition, which left out lesbians, bisexuals with a female partner and women without a partner. The new norm has updated the portfolio of common services of the National Health System to include them and has also added trans people with gestational capacity.

Although the vast majority of the autonomous communities had already been reversing the PP order, the exclusion still affected the civil servants, military officers and judges forced to be in the mutual Muface, Mujeju and Isfas, governed by the portfolio of state services. All women "can now access assisted human reproduction on an equal footing", announced in November Mufacewhich warned the insurers with which it has an agreement (Adeslas, Asisa and DKV) that "they are obliged to finance these treatments" regardless of whether the woman has a male partner or not, since the condition will no longer be having fertility problems .

However, the resolution published in December that contains the agreement between the civil servants' mutual fund and the insurers contains an ambiguity: on the one hand, it indicates that the entities have to cover "at least" the services included in the portfolio of common services, that is, that is, assisted reproduction for all women, according to the new norm. But in the part dedicated specifically to these techniques, it ensures that the order to be applied will be SSI/2065/2014, of October 31, that is, the one approved by the Popular Party, instead of SND/1215/2021, of November 5, which returned the right to all women.

But, in addition, it literally details that the assisted reproduction coverage will cover women "in whom there is a diagnosis of sterility due to gynecological pathology that prevents pregnancy, regardless of the existence or not of a partner", thus contradicting the new legislation . This article of the concert is the one that, according to Carmen González, Adeslas resorted to last Monday, April 18, to deny them treatment. The entity rectified after a few days, after the couple complained on Twitter and the official Muface account intervened to ensure that the couple has the right, according to the law, to provide the service. The insurer has not responded to the questions of this medium because it is a personal matter.

For her part, a spokeswoman for the Ministry of Finance and Public Administration, to which Muface depends, maintains that the norm has changed and that the current order is that of November 2021, despite the fact that the previous one is cited in the concert. Asked if they plan to correct the errors of the concert, the mutual responds that in all the concerts "there is an automatic inclusion clause" when a new regulation is published that insurers are obliged to comply with. In fact, the company corrected its decision when the case became public.

It wasn't the first time they had been denied. "On this occasion we began in vitro fertilization after four cycles of artificial insemination. We requested the first of them in November, when the order was approved, knowing that we already had the right, but they told us no, appealing to that precept of the agreement" says Carmen. The couple filed a claim arguing that insurers are obliged to cover what the portfolio of services includes. After a month, they received a favorable response. When they finished the four cycles of insemination without success and went on to in vitro fertilization, they found themselves with the same obstacle again.

"It cannot be that they grant it to you or not depending on the person who touches you or if you complain", denounces Carmen, who focuses on the "non-compliance with the law" that supposes the denial of treatment based on the sexual orientation or marital status of the woman. "In the published concert it is clear that there is an error, which is probably not intentional, but which has served Adeslas to deny us the right," the woman believes. The couple has wanted to make the case public because they fear that with the current wording published in the BOE and "the restrictive interpretations" that insurers may make, there will be more women who are experiencing the same thing.

"It has to be written in a way that no one can interpret otherwise because unfortunately we have seen that there are those who, perhaps based on ideology, cling to the most restrictive despite breaking the law," continues Carmen, who She is a teacher in the Community of Madrid and, as such, forced to be a Muface member. "If this in vitro fertilization that we are going to do now does not work, we are entitled to two more attempts. Is it going to happen to us again?" asks the woman, who has faced the still present fringes of a discrimination that spread for seven years.

In this time, lesbian and bisexual women with a female partner and women without a partner have had to face interrupted treatment in public health, disbursement of large amounts of money in private clinics to be mothers and even litigation in court. Several judgments have also recognized that it is an exclusive norm. This was the case in the decision that set a precedent and that issued by the Social Court No. 18 of Madrid in 2015which he assumed produced "discrimination based on sexual orientation".

The consequences of the journey that Carmen and Ángela have had to go through are measured in a high emotional cost that they already experienced last June. The new order had not yet entered into force and there was no rectification by Adeslas. They met with an unalterable 'no'. Then, the law protected the exclusion, but not now. "It's a blow and a strong suffering. They tell you no again, you feel that they don't support you just because of who you are. That in addition to being an intrusion on privacy. When they told us no, the whole office found out that We were two lesbian women because we complained," says Carmen.

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