Consequences of Genetic Non-Discrimination Act Examined

July 23, 2008

The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

Russell Korobkin, J.D., of the University of California Los Angeles School of Law, and Rahul Rajkumar, M.D., J.D., of Brigham and Women's Hospital in Boston, write that under GINA, someone at genetic risk for colon cancer or with a family history wouldn't face increased premiums for insurance coverage, but those with adenomatous polyps might.

This approach is inconsistent, the authors write. Though it spreads the cost of those genetically at risk across a larger pool, it doesn't protect others who are at no more fault for their increased risk. Plus insurance companies will focus more heavily on current health while setting rates, making affordable insurance harder to obtain, they add.

"The arbitrary nature of the categories GINA creates suggests that we should fully commit ourselves to the step that the legislation approaches but is too hesitant to take: the prohibition of medical underwriting -- the rating and pricing of health insurance on the basis of any health information, not just genetic information. Health insurance premiums should be assessed on the basis of a 'community rate' and should be set the same for all people within a given age group -- possibly with exceptions somehow made for risk factors that are deemed to be within each person's reasonable control," the authors write.

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