Traditional Health Insurance and Modern Health Information Don’t Mix
By Margaret Stapleton, Senior Attorney
Lots of things about health insurance are ironic. Example: Getting health care (which prevents more serious trouble or restores health) can trigger difficulties staying insured due to premium adjustments upward and preexisting-condition exclusions if the patient needs to change insurance plans.
But the biggest irony is that, in some states, it’s okay for insurers to look at information of questionable relevance (past medical treatment), but now nowhere in the United States is it okay to look at information of quite certain relevance (genetic test results).
Newly enacted federal legislation sets up the irony. On May 21, 2008, President Bush signed the Genetic Information Nondiscrimination Act of 2008 (GINA), H.R. 493, into law. Although it took such legislation 13 years to work to gain passage, it passed unanimously in the Senate and 414 to 1 in the House.
GINA prohibits the use of genetic information and tests in all health insurance underwriting decisions. It prohibits insurers from requiring individuals to have genetic testing and from using a person’s genetic information in determining eligibility, adjusting premiums, or excluding preexisting conditions from coverage for either group or individual policies. After GINA, genetic information is not usable by insurers.
The logic that drove GINA’s adoption (information is good; people should not be afraid to get information that will help them make health care decisions and manage their health) should also drive similar prohibitions on using individual medical and family history, past treatments, medical test results, medication usage, etc., in insurance underwriting decisions. Allowing insurers to inquire about and make adverse decisions based on such considerations is dangerous and unfair. It discourages people from learning about their health status and from getting necessary and beneficial treatment, and it punishes those who behave responsibly and get appropriate treatment .
Bottom line: If individual or group health insurance is going to remain a fact of life in the United States, then it is time to make insurance free of health status or history considerations. Age, maybe; location, maybe; but not health status or history. Such reform would restore insurance to its original purpose-spreading risk widely-something that has been lost in the current world of insurers’ cherry picking the healthy and rejecting or pricing out the rest.
Tags: ethics, Health, Health Care, Health Insurance
October 17th, 2008 at 11:51 am
Interesting post. Insurance is often a confusing topic. It’s good to know what going on in the world of insurance and how that can impact your life.
October 29th, 2008 at 8:15 pm
life insurers…
In these hard times, people are trying to stretch their health care dollars so I appreciate the service you are providing. Thank you….