Tuesday, May 27, 2008

Satz on GINA (and, Inter Alia, the ADA)

Ani Satz has this very interesting op-ed today in the Atlanta Journal-Constitution on the Genetic Information Nondiscrimination Act (which President Bush signed last week) and its interaction with other health laws and the ADA. It begins:

On Wednesday, President Bush signed the Genetic Information Nondiscrimination Act, affording genetic information special protections. A product of more than a decade of debate, this moment was bittersweet. GINA may harm many of the individuals it is designed to protect.

The act increases protections only for some medical information, privileging those with genetic conditions over those with nongenetic ones. This necessarily places greater pressure on insurers to use nongenetic medical information to segregate risk. Further, it creates unequal disability protections. GINA protects individuals with genetic conditions from health insurance and employment discrimination even if they have no symptoms of the condition. The Americans with Disabilities Act protects only individuals with symptoms in regard to employment, services and public accommodation.

GINA also creates the perception that genetic testing is unique and not basic health care. This may further limit already restricted coverage of such technologies under public and private health insurance. In addition, heightened protections for genetic testing may discourage insurers from covering such services out of fear that they will open themselves to increased risk of litigation for breaching patient privacy. Further, insurers and employers are likely to lose incentive to provide genetic testing when they are not allowed access to the results, as they are for other diagnostic tests.

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