[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4008 Introduced in House (IH)]





104th CONGRESS
  2d Session
                                H. R. 4008

To prohibit health insurers and group health plans from discriminating 
        against individuals on the basis of genetic information.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 2, 1996

 Mr. Solomon introduced the following bill; which was referred to the 
Committee on Commerce, and in addition to the Committee on Economic and 
 Educational Opportunities, for a period to be subsequently determined 
 by the Speaker, in each case for consideration of such provisions as 
        fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To prohibit health insurers and group health plans from discriminating 
        against individuals on the basis of genetic information.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Genetic Information Health Insurance 
Nondiscrimination Act of 1996''.

SEC. 2. PROHIBITION OF HEALTH INSURANCE DISCRIMINATION ON THE BASIS OF 
              GENETIC INFORMATION.

    (a) In General.--
            (1) Application to insurers.--An insurer may not deny, 
        cancel, or refuse to renew health insurance coverage, may not 
        vary the premiums, terms, or conditions for health insurance 
        coverage, and may not otherwise discriminate with respect to an 
        individual with respect to health insurance coverage--
                    (A) on the basis of genetic information, or
                    (B) on the basis of the request for, or receipt of, 
                genetic information or a genetic test.
            (2) Application to group health plans.--A group health plan 
        may not establish rules relating to who may be a participant or 
        beneficiary with respect to the plan, may not vary the 
        premiums, terms, or conditions for benefits under the plan, and 
        otherwise may not otherwise discriminate with respect to a 
        participant or beneficiary under the plan--
                    (A) on the basis of genetic information, or
                    (B) on the basis of the request for, or receipt of, 
                genetic information or a genetic test.
    (b) Limitation on Collection and Disclosure of Genetic 
Information.--
            (1) Limitation on collection.--An insurer may not request 
        or require an individual to whom the insurer provides health 
        insurance coverage (or an individual who desires the insurer to 
        provide health insurance coverage), and a group health plan may 
        not request or require a participant or beneficiary under the 
        plan (or an individual who desires to become such a participant 
        or beneficiary), to disclose any genetic information or to 
        obtain any genetic test.
            (2) Restriction on disclosure.--Subject to paragraph (3), 
        an insurer or group health plan may not disclose genetic 
        information about an individual (regardless of how the 
        information was obtained) without a prior written authorization 
        of the individual (or legal representative of the individual) 
        that includes--
                    (A) a description of the information being 
                disclosed,
                    (B) the name of the individual or person to whom 
                the disclosure is being made, and
                    (C) the purpose of the disclosure.
        Such authorization is required for each disclosure.
            (3) Exceptions to disclosure restriction.--Genetic 
        information concerning an individual may be disclosed by an 
        insurer or group health plan if such disclosure--
                    (A) is authorized under criminal laws relating to 
                the identification of individuals, or is authorized 
                under Federal or State law and is necessary for the 
                purpose of a criminal or death investigation, a 
                criminal or juvenile proceeding, an inquest, or a child 
                fatality review by a multidisciplinary child abuse 
                team;
                    (B) is required under the specific order of a 
                court;
                    (C) is authorized under law for the purpose of 
                establishing paternity;
                    (D) is for the purpose of furnishing genetic 
                information relating to a decedent to the blood 
                relatives of the decedent for the purpose of medical 
                diagnosis; or
                    (E) is for the purpose of identifying a body.
    (c) Disclosure of Rights.--Each insurer and group health plan shall 
provide for disclosure of the rights under this section in such manner 
as the Secretary may require.
    (d) Enforcement.--
            (1) Insurers.--
                    (A) Enforcement by state insurance commissioner.--
                            (i) In general.--The requirements 
                        established under subsections (a), (b), and (c) 
                        insofar as they apply to insurers shall be 
                        enforced by the State insurance commissioner 
                        for the State involved or the official or 
                        officials designated by the State.
                            (ii) Enforcement plan.--Each State shall 
                        require that an insurer offering or renewing 
                        health insurance coverage in such State meet 
                        such requirements pursuant to an enforcement 
                        plan filed by the State with the Secretary.
                    (B) Enforcement by secretary.--In the case of the 
                failure of a State to file such a plan or substantially 
                enforce the plan, the Secretary shall implement an 
                enforcement plan in such State. Under the Secretary's 
                enforcement plan, each insurer operating in such State 
                that violates a requirement of subsection (a), (b), or 
                (c) shall be subject to civil enforcement under 
                sections 502, 504, 506, and 510 of the Employee 
                Retirement Income Security Act of 1974. For purposes of 
                applying the previous sentence, any reference in the 
                sections referred to in such sentence to the Secretary 
                of Labor is deemed a reference to the Secretary of 
                Health and Human Services.
            (2) Group health plans.--With respect to group health 
        plans, the Secretary of Labor shall enforce the requirements 
        established under subsections (a), (b), and (c) in the same 
        manner as provided for under sections 502, 504, 506, and 510 of 
        the Employee Retirement Income Security Act of 1974.
            (2) Private right of action.--A person may bring a civil 
        action--
                    (A) to enjoin any act or practice which violates 
                subsection (a) or (b),
                    (B) to obtain other appropriate equitable relief 
                (i) to redress such violations, or (ii) to enforce any 
                such subsections, or
                    (C) to obtain other legal relief, including 
                monetary damages.
            (3) Jurisdiction.--State courts of competent jurisdiction 
        and district courts of the United States have concurrent 
        jurisdiction of actions under this subsection. The district 
        courts of the United States shall have jurisdiction, without 
        respect to the amount in controversy or the citizenship of the 
        parties, to grant the relief provided for in paragraph (2) in 
        any action.
            (4) Venue.--For purposes of this subsection the venue 
        provisions of section 1391 of title 28, United States Code, 
        shall apply.
            (5) Regulations.--The Secretary and the Secretary of Labor 
        (in consultation with the Secretary in relation to the 
        application of this section with respect to group health plans) 
        may promulgate such regulations as may be necessary or 
        appropriate to carry out this section.
    (e) Applicability.--
            (1) Preemption of state law.--A State may establish or 
        enforce requirements for insurers or health insurance coverage 
        with respect to the subject matter of this section, but only if 
        such requirements are not less restrictive than the 
        requirements established under subsections (a), (b), and (c).
            (2) Rule of construction.--Nothing in this section shall be 
        construed to affect or modify the provisions of section 514 of 
        the Employee Retirement Income Security Act of 1974.
            (3) Continuation.--Nothing in this section shall be 
        construed as requiring a group health plan to provide benefits 
        to a particular participant or beneficiary.
    (f) Definitions.--For purposes of this Act:
            (1) Genetic information.--The term ``genetic information'' 
        means the information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a blood-
        relative of the individual.
            (2) Genetic test.--The term ``genetic test'' means a test 
        for determining the presence or absence of genetic 
        characteristics in an individual.
            (3) Group health plan.--The term ``group health plan means 
        any employee welfare benefit plan, governmental plan, or church 
        plan (as defined under paragraphs (1), (32), and (33) of 
        section 3 of the Employee Retirement Income Security Act of 
        1974) that provides or pays for medical benefits whether 
        directly, through insurance, or otherwise.
            (4) Health insurance coverage.--The term ``health insurance 
        coverage'' means a contractual arrangement for the provision 
        of, or payment for, health care, including any arrangement 
        consisting of a hospital or medical expense incurred policy or 
        certificate, hospital or medical service plan contract, or 
        health maintenance organization subscriber contract and 
        including such an arrangement in connection with a group health 
        plan.
            (5) Insurer.--The term ``insurer'' means an insurance 
        company, insurance service, or insurance organization 
        (including a health maintenance organization) which is licensed 
        to engage in the business of insurance in a State and which is 
        subject to State law which regulates insurance (within the 
        meaning of section 514(b)(2)) and which provides health 
        insurance coverage. Such term does not include a group health 
        plan.
            (6) Participant; beneficiary.--The terms ``participant'' 
        and ``beneficiary'' have the meanings given such terms in 
        paragraphs (7) and (8), respectively, of section 3 of the 
        Employee Retirement Income Security Act of 1974.
            (7) Secretary.--Except as specifically provided, the term 
        ``Secretary'' means the Secretary of Health and Human Services.
            (8) State.--The term ``State'' includes the District of 
        Columbia, Puerto Rico, the Northern Mariana Islands, the Virgin 
        Islands, American Samoa, and Guam.
    (g) Authorization of Funding Under ERISA.--Section 508 of the 
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1138) is 
amended by inserting ``and under the Genetic Information Health 
Insurance Nondiscrimination Act of 1996'' before the period.
    (h) Effective Date.--This section shall apply to health insurance 
coverage offered or renewed and to group health plans after the end of 
the 90-day period beginning on the date of the enactment of this Act.
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