title: Laws restricting health insurers' use of genetic information: impact on genetic discrimination.
abstract: Since 1991, 28 states have enacted laws that prohibit insurers' use of genetic information in pricing, issuing, or structuring health insurance. This article evaluates whether these laws reduce the extent of genetic discrimination by health insurers. From the data collected at multiple sites, we find that there are almost no well-documented cases of health insurers either asking for or using presymptomatic genetic test results in their underwriting decisions, either (a) before or after these laws have been enacted or (b) in states with or without these laws. By using both in-person interviews with insurers and a direct market test, we found that a person with a serious genetic condition who is presymptomatic faces little or no difficulty in obtaining health insurance. Furthermore, there are few indications that the degree of difficulty varies according to whether a state regulates the use of genetic information. Nevertheless, these laws have made it less likely that insurers will use genetic information in the future. Although insurers and agents are only vaguely aware of these laws, the laws have shaped industry norms and attitudes about the legitimacy of using this information.
authors.affiliation: Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA. mhall@law.wfu.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Hall
authors.forename: S S
authors.initials: SS
authors.lastname: Rich
mesh_terms: D005817:Genetic Counseling; D005820:Genetic Testing; D005826:Genetics, Medical / Q000331:legislation & jurisprudence*; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D007407:Interviews as Topic; D017057:Medically Uninsured; D011287:Prejudice; D014481:United States