[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[S. 1600 Introduced in Senate (IS)]







104th CONGRESS
  2d Session
                                S. 1600

   To establish limitations on health plans with respect to genetic 
                  information, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES



                March 7 (legislative day, March 6), 1996

  Mrs. Feinstein (for herself and Mr. Mack) introduced the following 
 bill; which was read twice and referred to the Committee on Labor and 
                            Human Resources

_______________________________________________________________________

                                 A BILL


 
   To establish limitations on health plans with respect to genetic 
                  information, and for other purposes.

    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 Fairness Act of 1996''.

SEC. 2. DEFINITIONS.

    As used in this Act:
            (1) Family member.--The term ``family member'' means, with 
        respect to an individual, another individual related by blood 
        to that individual or a spouse or adopted child of the 
        individual.
            (2) Genetic information.--The term ``genetic information'' 
        means the information about genes, gene products or inherited 
        characteristics that may be derived from an individual or a 
        family member.
            (3) Genetic services.--The term ``genetic services'' means 
        health services provided to obtain, assess, and interpret 
        genetic information for diagnostic and therapeutic purposes, 
        and for genetic education and counseling.
            (4) Genetic test.--The term ``genetic test'' means a 
        procedure that is generally accepted in the scientific and 
        medical communities and that is performed for the purposes of 
        identifying the presence, absence, or alternation of any gene 
        or chromosome.
            (5) Health plan.--The term ``health plan'' means--
                    (A) a group health plan (as such term is defined in 
                section 607 of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1167)), and a multiple employer 
                welfare arrangement (as defined in section 3(40) of 
                such Act) that provides health insurance coverage; or
                    (B) any contractual arrangement for the provision 
                of a payment for health care, including any health 
                insurance arrangement or 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.
            (6) Insurer.--The term ``insurer'' means--
                    (A) an insurance company, health care service 
                contractor, fraternal benefit organization, insurance 
                agent, third party administrator, insurance support 
                organization or other person subject to regulation 
                under State health insurance laws;
                    (B) a managed care organization; or
                    (C) an employee welfare benefit plan regulated 
                under the Employee Retirement Income Security Act of 
                1974 (29 U.S.C. 1001 et seq.).
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 3. PROHIBITIONS.

    (a) Genetic Information.--An insurer offering a health plan may 
not--
            (1) terminate, restrict, limit, or otherwise apply 
        conditions to coverage of an individual or family member under 
        the plan, or restrict the sale of the plan to an individual or 
        family member;
            (2) cancel or refuse to renew the coverage of an individual 
        or family member under the plan;
            (3) deny coverage or exclude an individual or family member 
        from coverage under the plan;
            (4) impose a rider that excludes coverage for certain 
        benefits and services under the plan;
            (5) establish differentials in premium rates or cost 
        sharing for coverage under the plan; or
            (6) otherwise discriminate against an individual or family 
        member in the provision of health care;
on the basis of any genetic information concerning an individual or 
family member or on the basis of an individual's or family member's 
request for or receipt of genetic services.
    (b) Genetic Tests.--An insurer offering a health plan may not 
require an applicant for coverage under the plan, or an individual or 
family member who is presently covered under the plan, to be the 
subject of a genetic test or to be subjected to questions relating to 
genetic information.
    (c) Notice of Rights.--An insurer offering a health plan shall, in 
the enrollment information provided by the insurer concerning such 
plan, provide an enrollee with a written statement disclosing the 
rights of the enrollee under this Act. Such statement shall be in a 
form and manner that is noticeable to and understandable by an average 
enrollee.
    (d) Enforcement.--
            (1)  Plans other than employee welfare benefit plans.--The 
        requirements established under subsections (a), (b), and (c) 
        shall be enforced by the State insurance commissioner for the 
        State involved or the official or officials designated by the 
        State, except that in no case shall a State enforce such 
        requirements as they relate to employee welfare benefit plans.
            (2) Employee welfare benefit plans.--With respect to 
        employee welfare benefit plans, the Secretary 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 
        (29 U.S.C. 1132, 1134, 1136, and 1140).
            (3) Private right of action.--A person may, after that 
        person has exhausted all available administrative remedies, 
        bring a civil action--
                    (A) to enjoin any act or practice which violates 
                subsection (a), (b), or (c);
                    (B) to obtain other appropriate equitable relief--
                            (i) to redress such violations; or
                            (ii) to require the Secretary of Health and 
                        Human Services to enforce any such subsections, 
                        or
                    (C) to obtain other legal relief, including 
                monetary damages.
            (4) 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 (3) in 
        any action.
            (5) Venue.--For purposes of this subsection the venue 
        provisions of section 1391 of title 28, United States Code, 
        shall apply.
            (6) Regulations.--The Secretary may promulgate such 
        regulations as may be necessary or appropriate to carry out 
        this section.

SEC. 4. EFFECTIVE DATE.

    This Act shall apply to any health plan offered or renewed on or 
after the end of the 90-day period beginning on the date of the 
enactment of this Act.
                                 <all>