Genetic Discrimination in Health Insurance: Current Legal Protections and Industry Practices

2007 ◽  
Vol 44 (3) ◽  
pp. 350-368 ◽  
Author(s):  
Karen Pollitz ◽  
Beth N. Peshkin ◽  
Eliza Bangit ◽  
Kevin Lucia
Keyword(s):  
Health Insurance ◽  
Genetic Information ◽  
Genetic Test ◽  
Genetic Discrimination ◽  
Health Condition ◽  
Future Health ◽  
Individual Health ◽  
Increased Risk ◽  
The Individual ◽  
Test Result

Most states have enacted genetic nondiscrimination laws in health insurance, and federal legislation is pending in Congress. Scientists worry fear of discrimination discourages some patients from participating in clinical trials and hampers important medical research. This paper describes a study of medical underwriting practices in the individual health insurance market related to genetic information. Underwriters from 23 companies participated in a survey that asked them to underwrite four pairs of hypothetical applicants for health insurance. One person in each pair had received a positive genetic test result indicating increased risk of a future health condition—breast cancer, hemochromatosis, or heart disease—for a total of 92 underwriting decisions on applications involving genetic information. In seven of these 92 applications, underwriters said they would deny coverage, place a surcharge on premiums, or limit covered benefits based on an applicant's genetic information.

State Approaches to Premium Rate Reforms in the Individual Health Insurance Market

2014 ◽  
Author(s):  
Sabrina Corlette Corlette ◽  
Kevin W. Lucia Lucia ◽  
Justin Giovannelli Giovannelli
Keyword(s):  
Health Insurance ◽  
Insurance Market ◽  
Premium Rate ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual

The Role Of The Individual Health Insurance Market And Prospects For Change

2004 ◽  
Vol 23 (6) ◽  
pp. 79-90 ◽  
Author(s):  
Melinda Beeuwkes Buntin ◽  
M. Susan Marquis ◽  
Jill M. Yegian
Keyword(s):  
Health Insurance ◽  
Insurance Market ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual

scholarly journals Genetic discrimination: emerging ethical challenges in the context of advancing technology

2019 ◽  
Author(s):  
Carolyn Riley Chapman ◽  
Kripa Sanjay Mehta ◽  
Brendan Parent ◽  
Arthur L Caplan
Keyword(s):  
Health Insurance ◽  
Genetic Testing ◽  
Genetic Information ◽  
Predictive Power ◽  
The United States ◽  
Legal Framework ◽  
Genetic Discrimination ◽  
Ethical Challenges ◽  
Health Related ◽  
Discrimination In Employment

Abstract Genetic testing is becoming more widespread, and its capabilities and predictive power are growing. In this paper, we evaluate the ethical justifications for and strength of the US legal framework that aims to protect patients, research participants, and consumers from genetic discrimination in employment and health insurance settings in the context of advancing genetic technology. The Genetic Information Nondiscrimination Act (GINA) and other laws prohibit genetic and other health-related discrimination in the United States, but these laws have significant limitations, and some provisions are under threat. If accuracy and predictive power increase, specific instances of use of genetic information by employers may indeed become ethically justifiable; however, any changes to laws would need to be adopted cautiously, if at all, given that people have consented to genetic testing with the expectation that there would be no genetic discrimination in employment or health insurance settings. However, if our society values access to healthcare for both the healthy and the sick, we should uphold strict and broad prohibitions against genetic and health-related discrimination in the context of health insurance, including employer-based health insurance. This is an extremely important but often overlooked consideration in the current US debate on healthcare.

Genomics, Insurance and Human Rights: Is there a Place for Regulatory Frameworks in Africa?

2006 ◽  
Vol 2 (1) ◽  
pp. 20-34
Author(s):  
Vincent O. Nmehielle
Keyword(s):  
Human Rights ◽  
Health Insurance ◽  
Genetic Information ◽  
Insurance Industry ◽  
Genetic Discrimination ◽  
Insurance Companies ◽  
Genetic Profile ◽  
Regulatory Frameworks ◽  
Health Care Context ◽  
Insurance Decisions

AbstractThis article examines the human rights dimension of genetic discrimination in Africa, exploring the place of regulatory frameworks while taking into account the disadvantaged position of the average African. This is in response to the tendency of insurance companies toward making health insurance decisions on the basis of individual genetic information, which could result in genetic discrimination or health insurance discrimination based on a person's genetic profile. The author considers such questions as the intersection between human rights (right to life, health, privacy, human dignity and against genetic discrimination) in relation to the insurance industry, as well as the obligations of state and non-state actors to promote, respect, and protect the enjoyment of these rights. The article argues that African nations should not stand aloof in trying to balance the competing interests (scientific, economic and social) presented by the use of genetic information in the health care context and that ultimately it is the responsibility of states to develop domestic policies to protect their most vulnerable citizens and to prevent entrenched private discrimination based on an individual's genes.

Beyond “Genetic Discrimination”: Toward the Broader Harm of Geneticism

1995 ◽  
Vol 23 (4) ◽  
pp. 345-353 ◽  
Author(s):  
Susan M. Wolf
Keyword(s):  
Health Insurance ◽  
Genetic Information ◽  
Genetic Discrimination ◽  
Genetic Knowledge ◽  
Analytic Framework ◽  
Genetic Tests ◽  
Race And Gender ◽  
And Gender ◽  
Almost All ◽  
As If

The current explosion of genetic knowledge and the rapid proliferation of genetic tests has rightly provoked concern that we are approaching a future in which people will be labeled and disadvantaged based on genetic information. Indeed, some have already suffered harm, including denial of health insurance. This concern has prompted an outpouring of analysis. Yet almost all of it approaches the problem of genetic disadvantage under the rubric of “genetic discrimination.”This rubric is woefully inadequate to the task at hand. It ignores years of commentary on race and gender demonstrating the limits of antidiscrimination analysis as an analytic framework and corrective tool. Too much discussion of genetic disadvantage proceeds as if scholars of race and gender had not spent decades critiquing and developing antidiscrimination theory.Indeed, there are multiple links among race, gender, and genetics. Dorothy Roberts has discussed the historical links between racism and genetics, while she and others have begun to map connections between gender and genetics.

scholarly journals Same Game, Different Names: Cream-Skimming in the Post-ACA Individual Health Insurance Market

2020 ◽  
Vol 57 ◽  
pp. 004695802093376
Author(s):  
Daniel W. Sacks ◽  
Coleman Drake ◽  
Jean M. Abraham ◽  
Kosali Simon
Keyword(s):  
Health Insurance ◽  
Lower Cost ◽  
Insurance Market ◽  
State Regulations ◽  
Individual Health ◽  
Cream Skimming ◽  
Individual Market ◽  
Health Insurance Market ◽  
Market Coverage ◽  
The Individual

One of the Affordable Care Act’s (ACA) signature reforms was creating centralized Health Insurance Marketplaces to offer comprehensive coverage in the form of comprehensive insurance complying with the ACA’s coverage standards. Yet, even after the ACA’s implementation, millions of people were covered through noncompliant plans, primarily in the form of continued enrollment in “grandmothered” and “grandfathered” plans that predated ACA’s full implementation and were allowed under federal and state regulations. Newly proposed and enacted federal legislation may grow the noncompliant segment in future years, and the employment losses of 2020 may grow reliance on individual market coverage further. These factors make it important to understand how the noncompliant segment affects the compliant segment, including the Marketplaces. We show, first, that the noncompliant segment of the individual insurance market substantially outperformed the compliant segment, charging lower premiums but with vastly lower costs, suggesting that insurers have a strong incentive to enter the noncompliant segment. We show, next, that state’s decisions to allow grandmothered plans is associated with stronger financial performance of the noncompliant market, but weaker performance of the compliant segment, as noncompliant plans attract lower-cost enrollees. This finding indicates important linkages between the noncompliant and compliant segments and highlights the role state policy can play in the individual insurance market. Taken together, our results point to substantial cream-skimming, with noncompliant plans enrolling the healthiest enrollees, resulting in higher average claims cost in the compliant segment.

Genetic Exceptionalism and Legislative Pragmatism

2007 ◽  
Vol 35 (S2) ◽  
pp. 59-65 ◽  
Author(s):  
Mark A. Rothstein
Keyword(s):  
Health Insurance ◽  
Genetic Information ◽  
Medical Information ◽  
Genetic Discrimination ◽  
Genome Project ◽  
Genetic Privacy ◽  
State Laws ◽  
Genetic Exceptionalism ◽  
Discrimination In Employment ◽  
The Human Genome Project

One of the most important and contentious policy issues surrounding genetics is whether genetic information should be treated separately from other medical information. The view that genetics raises distinct issues is what Thomas Murray labeled “genetic exceptionalism,” borrowing from the earlier term “HIV exceptional-ism.” The issue of whether the use of genetic information should be addressed separately from other health information is not merely an academic concern, however. Since the Human Genome Project began in 1990, nearly every state has enacted legislation prohibiting genetic discrimination in health insurance; two-thirds of the states have enacted laws prohibiting genetic discrimination in employment, and other state laws have been enacted dealing with genetic discrimination in life insurance, genetic privacy, and genetic testing. Bills in Congress also would prohibit genetic discrimination in health insurance and employment.

Sign in / Sign up

Export Citation Format

Share Document