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S1528......................................................by STATE AFFAIRS GENETIC TESTING - Adds to existing law to prohibit discrimination on the basis of genetic testing for health insurance, life insurance or employment purposes. 02/24 Senate intro - 1st rdg - to printing 02/25 Rpt prt - to St Aff
S1528|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-fifth Legislature Second Regular Session - 2000IN THE SENATE SENATE BILL NO. 1528 BY STATE AFFAIRS COMMITTEE 1 AN ACT 2 RELATING TO GENETIC DISCRIMINATION; AMENDING CHAPTER 13, TITLE 41, IDAHO CODE, 3 BY THE ADDITION OF A NEW SECTION 41-1334, IDAHO CODE, TO PROHIBIT DISCRIM- 4 INATION ON THE BASIS OF GENETIC INFORMATION FOR HEALTH INSURANCE; AMENDING 5 CHAPTER 19, TITLE 41, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 6 41-1940, IDAHO CODE, TO PROHIBIT GENETIC DISCRIMINATION FOR LIFE INSURANCE 7 PURPOSES; AMENDING CHAPTER 21, TITLE 41, IDAHO CODE, BY THE ADDITION OF A 8 NEW SECTION 41-2147, IDAHO CODE, TO PROHIBIT GENETIC DISCRIMINATION FOR 9 DISABILITY INSURANCE PURPOSES; AMENDING CHAPTER 23, TITLE 41, IDAHO CODE, 10 BY THE ADDITION OF A NEW SECTION 41-2317, IDAHO CODE, TO PROHIBIT GENETIC 11 DISCRIMINATION; AND AMENDING TITLE 44, IDAHO CODE, BY THE ADDITION OF A 12 NEW CHAPTER 26, TITLE 44, IDAHO CODE, TO PROVIDE FOR CONFIDENTIALITY OF 13 GENETIC INFORMATION. 14 Be It Enacted by the Legislature of the State of Idaho: 15 SECTION 1. That Chapter 13, Title 41, Idaho Code, be, and the same is 16 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 17 ignated as Section 41-1334, Idaho Code, and to read as follows: 18 41-1334. GENETIC DISCRIMINATION PROHIBITED. No insurer providing individ- 19 ual or group health insurance, or managed care organization providing health 20 care services, shall refuse to insure, refuse to continue to insure, or limit 21 the amount, extent or kind of coverage available to an individual, or charge 22 an individual a different rate for coverage on the basis of genetic informa- 23 tion. Genetic information, indicating a predisposition to a disease or condi- 24 tion, shall not be considered a preexisting condition in the absence of a 25 diagnosis of such disease or condition based on other medical information. 26 Genetic information obtained by any organization covered by this section may 27 be used solely for diagnostic, therapeutic and/or medical research purposes. 28 As used in this section: 29 (1) "Genetic information" means information about genes, gene products or 30 inherited characteristics derived from genetic testing to determine the pres- 31 ence or absence of variations or mutations, including carrier status, in an 32 individual's genetic material or genes that are scientifically or medically 33 believed to cause a disease, disorder or syndrome or are associated with a 34 statistically increased risk of developing a disease, disorder or syndrome 35 that is asymptomatic at the time of testing. 36 (2) "Genetic testing" or "genetic test" means a test used to diagnose a 37 presymptomatic genetic factor or genetic trait, including analysis of human 38 deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), chromosomes, proteins 39 or metabolites. The term does not include a routine history and physical exam- 40 ination or a routine chemical, blood or urine analysis. 41 SECTION 2. That Chapter 19, Title 41, Idaho Code, be, and the same is 42 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 2 1 ignated as Section 41-1940, Idaho Code, and to read as follows: 2 41-1940. GENETIC DISCRIMINATION PROHIBITED. No person shall commit or 3 permit any unfair discrimination against an individual in the issuance, with- 4 holding, extension or renewal of a policy of life insurance or an annuity on 5 the basis of genetic information regarding the applicant. 6 For the purposes of this section: 7 (1) "Genetic information" means information about genes, gene products or 8 inherited characteristics derived from genetic testing to determine the pres- 9 ence or absence of variations or mutations, including carrier status, in an 10 individual's genetic material or genes that are scientifically or medically 11 believed to cause a disease, disorder or syndrome or are associated with a 12 statistically increased risk of developing a disease, disorder or syndrome 13 that is asymptomatic at the time of testing. 14 (2) "Genetic testing" or "genetic test" means a test used to diagnose a 15 presymptomatic genetic factor or genetic trait, including analysis of human 16 deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), chromosomes, proteins 17 or metabolites. The term does not include a routine history and physical exam- 18 ination or a routine chemical, blood or urine analysis. 19 (3) "Unfair discrimination" means the rejection of an application for an 20 insurance policy or the determination of rates, terms or conditions of such an 21 insurance policy on the basis of genetic information unless the applicant's 22 medical condition and history and actuarial projections establish the proba- 23 bility that additional claims are likely to result from a genetic condition or 24 genetic trait identified through that information. 25 SECTION 3. That Chapter 21, Title 41, Idaho Code, be, and the same is 26 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 27 ignated as Section 41-2147, Idaho Code, and to read as follows: 28 41-2147. GENETIC DISCRIMINATION PROHIBITED. No person shall commit or 29 permit any unfair discrimination against an individual in the issuance, with- 30 holding, extension or renewal of a disability income insurance contract on the 31 basis of genetic information regarding the applicant. 32 For the purposes of this section: 33 (1) "Genetic information" means information about genes, gene products or 34 inherited characteristics derived from genetic testing to determine the pres- 35 ence or absence of variations or mutations, including carrier status, in an 36 individual's genetic material or genes that are scientifically or medically 37 believed to cause a disease, disorder or syndrome or are associated with a 38 statistically increased risk of developing a disease, disorder or syndrome 39 that is asymptomatic at the time of testing. 40 (2) "Genetic testing" or "genetic test" means a test used to diagnose a 41 presymptomatic genetic factor or genetic trait, including analysis of human 42 deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), chromosomes, proteins 43 or metabolites. The term does not include a routine history and physical exam- 44 ination or a routine chemical, blood or urine analysis. 45 (3) "Unfair discrimination" means the rejection of an application for an 46 insurance policy or the determination of rates, terms or conditions of such an 47 insurance policy on the basis of genetic information unless the applicant's 48 medical condition and history and actuarial projections establish the proba- 49 bility that additional claims are likely to result from a genetic condition or 50 genetic trait identified through that information. 51 SECTION 4. That Chapter 23, Title 41, Idaho Code, be, and the same is 3 1 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 2 ignated as Section 41-2317, Idaho Code, and to read as follows: 3 41-2317. GENETIC DISCRIMINATION PROHIBITED. No person shall commit or 4 permit any unfair discrimination against an individual in the issuance, with- 5 holding, extension or renewal of a credit life insurance policy on the basis 6 of genetic information regarding the applicant. 7 For the purposes of this section: 8 (1) "Genetic information" means information about genes, gene products or 9 inherited characteristics derived from genetic testing to determine the pres- 10 ence or absence of variations or mutations, including carrier status, in an 11 individual's genetic material or genes that are scientifically or medically 12 believed to cause a disease, disorder or syndrome or are associated with a 13 statistically increased risk of developing a disease, disorder or syndrome 14 that is asymptomatic at the time of testing. 15 (2) "Genetic testing" or "genetic test" means a test used to diagnose a 16 presymptomatic genetic factor or genetic trait, including analysis of human 17 deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), chromosomes, proteins 18 or metabolites. The term does not include a routine history and physical exam- 19 ination or a routine chemical, blood or urine analysis. 20 (3) "Unfair discrimination" means the rejection of an application for an 21 insurance policy or the determination of rates, terms or conditions of such an 22 insurance policy on the basis of genetic information unless the applicant's 23 medical condition and history and actuarial projections establish the proba- 24 bility that additional claims are likely to result from a genetic condition or 25 genetic trait identified through that information. 26 SECTION 5. That Title 44, Idaho Code, be, and the same is hereby amended 27 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap- 28 ter 26, Title 44, Idaho Code, and to read as follows: 29 CHAPTER 26 30 GENETIC TESTING 31 44-2601. CONFIDENTIALITY OF GENETIC INFORMATION. (1) It shall be unlawful 32 for any employer, individually or through his employees, agents, or any person 33 or entity acting on his behalf: 34 (a) To request or require genetic information for an employee or person 35 seeking employment; or 36 (b) To discharge, expel or otherwise discriminate against any person on 37 the basis of genetic information; or 38 (c) Otherwise consider genetic information in employment decision-making. 39 (2) No person may sell to, or interpret for, an employer, any genetic 40 information pertaining to an employee without the written authorization of 41 that employee. 42 (3) For the purposes of this section: 43 (a) "Genetic information" means information about genes, gene products or 44 inherited characteristics derived from genetic testing to determine the 45 presence or absence of variations or mutations, including carrier status, 46 in an individual's genetic material or genes that are scientifically or 47 medically believed to cause a disease, disorder or syndrome or are associ- 48 ated with a statistically increased risk of developing a disease, disorder 49 or syndrome that is asymptomatic at the time of testing. 50 (b) "Genetic testing" or "genetic test" means a test used to diagnose a 51 presymptomatic genetic factor or genetic trait, including analysis of 4 1 human deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), chromosomes, 2 proteins or metabolites. The term does not include a routine history and 3 physical examination or a routine chemical, blood or urine analysis.
STATEMENT OF PURPOSE RS 10030 Rapid progress in mapping the human genome has resulted in a growing number of genetic tests which allow physicians to identify individuals who are at increased risk of developing medical conditions with a genetic component These tests allow for greater monitoring for early manifestations of such conditions, thus allowing earlier intervention and treatment Eventually genetic research should reduce health care costs, as the prevention and/or treatment of genetic conditions catches up with genetic testing. However, genetic tests also provide the capacity for abuse by insurers and employers who may view such individuals as avoidable risks. This bill would prohibit health insurers and employers from discriminating against individuals who may have a genetic predisposition to a medical condition, but who have not yet developed any of the symptoms of that condition. It would require any discrimination in rates or coverage offered by life insurers to be based on scientific assessment of increased risks posed by a genetic condition rather than allowing blanket refusal of coverage. The bill also protects individuals' privacy interests in their genetic information by prohibiting insurers or employers from requiring them to submit to genetic tests or to disclose the results of a genetic test. By prohibiting discrimination on the basis of genetic information, the bill creates a "level playing field" for health insurers and employers by discouraging selective insurance and employment. This spreads the cost of insuring affected individuals across all carriers and employers, rather than rewarding those who discriminate and penalizing those who insure or employ such individuals. Many individuals avoid genetic testing because they do not wish to jeopardize their health insurance or employment. This bill addresses this fear and encourages individuals to seek genetic testing when appropriate. This will lead to better medical care at reduced cost, because early intervention is generally more cost effective and may result in better patient outcomes than later remedial care. Current Idaho law prohibits health insurers and managed care providers from considering genetic information as a preexisting condition in policies offered to employers in Title 41, Sections 2221(bl 3940(b) and 4708(3)(b). This bill extends this important public policy to individual policy holders. It further clarifies that health insurers and managed care providers may not evade the prohibition by denying insurance on the basis of such genetic information or charging discriminatory rates. Prohibition of required genetic testing or required disclosure of genetic test results will discourage abuse by employers and insurers. This bill removes a major incentive for employers to discriminate by prohibiting such discrimination in health insurance. FISCAL NOTE This legislation would have no fiscal impact on state funds. Contact: Senator Sheila Sorensen 332-1319 Kathy Ball American Civil Liberties Union of Idaho 392-6041, kathybalf@nidlink.com Professor Daniel Levin Boise State University 426-4080, dlevin@boisestate.edu STATEMENT OF PURPOSE/FISCAL NOTE S 1528