[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 89 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 89

To prohibit discrimination against individuals and their family members 
on the basis of genetic information, or a request for genetic services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 21, 1997

   Ms. Snowe introduced the following bill; which was read twice and 
         referred to the Committee on Labor and Human Resources

_______________________________________________________________________

                                 A BILL


 
To prohibit discrimination against individuals and their family members 
on the basis of genetic information, or a request for genetic services.

    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 
Nondiscrimination in Health Insurance Act of 1997''.

SEC. 2. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.

    (a) In General.--Subpart B of part 7 of subtitle B of title I of 
the Employee Retirement Income Security Act of 1974 is amended by 
inserting after section 712 the following:

``SEC. 713. PROHIBITION OF HEALTH INSURANCE DISCRIMINATION ON THE BASIS 
              OF GENETIC INFORMATION.

    ``(a) In General.--In the case of benefits consisting of medical 
care provided under a group health plan or in the case of group health 
insurance coverage offered by a health insurance issuer in connection 
with a group health plan, the plan or issuer may not deny, cancel, or 
refuse to renew such benefits or such coverage, or vary the premiums, 
terms, or conditions for such benefits or such coverage, for any 
participant or beneficiary under the plan--
            ``(1) on the basis of genetic information; or
            ``(2) on the basis that the participant or beneficiary has 
        requested or received genetic services.
    ``(b) Limitation on Collection and Disclosure of Information.--
            ``(1) In general.--A group health plan, or a health 
        insurance issuer offering group health insurance coverage in 
        connection with a group health plan, may not request or require 
        a participant or beneficiary (or an applicant for coverage as a 
        participant or beneficiary) to disclose to the plan or issuer 
        genetic information about the participant, beneficiary, or 
        applicant.
            ``(2) Requirement of prior authorization.--A group health 
        plan, or a health insurance issuer offering health insurance 
        coverage in connection with a group health plan, may not 
        disclose genetic information about a participant or beneficiary 
        (or an applicant for coverage as a participant or beneficiary) 
        without the prior written authorization of the participant, 
        beneficiary, or applicant or of the legal representative 
        thereof. Such authorization is required for each disclosure and 
        shall include an identification of the person to whom the 
        disclosure would be made.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Genetic information.--The term `genetic information' 
        means information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a family 
        member of the individual.
            ``(2) 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 counselling.
            ``(3) 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.''.
    (b) Damages.--Section 502(c) of such Act (29 U.S.C. 1132(c)) is 
amended by adding at the end the following:
    ``(7) Any group health plan (as defined in section 733(a)) and any 
health insurance issuer (as defined in section 733(b)(2)) who fails to 
meet the requirements of section 713 with respect to any participant, 
beneficiary, or applicant referred to in such section may in the 
court's discretion be liable to such participant, beneficiary, or 
applicant for compensatory, consequential, and punitive damages.''.
    (c) Clerical Amendment.--The table of contents in section 1 of such 
Act is amended by inserting after the item relating to section 712 the 
following:

``Sec. 713. Prohibition of health insurance discrimination on the basis 
                            of genetic information.''.
    (d) Effective Date.--The amendments made by this section shall 
apply with respect to group health plans for plan years beginning after 
1 year after the date of the enactment of this Act.

SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

    (a) Amendment Relating to the Group Market.--
            (1) In general.--Subpart 2 of part A of title XXVII of the 
        Public Health Service Act is amended by inserting after section 
        2705 the following:

``SEC. 2706. PROHIBITION OF HEALTH INSURANCE DISCRIMINATION ON THE 
              BASIS OF GENETIC INFORMATION.

    ``(a) In General.--In the case of benefits consisting of medical 
care provided under a group health plan or in the case of group health 
insurance coverage offered by a health insurance issuer in connection 
with a group health plan, the plan or issuer may not deny, cancel, or 
refuse to renew such benefits or such coverage, or vary the premiums, 
terms, or conditions for such benefits or such coverage, for any 
participant or beneficiary under the plan--
            ``(1) on the basis of genetic information; or
            ``(2) on the basis that the participant or beneficiary has 
        requested or received genetic services.
    ``(b) Limitation on Collection and Disclosure of Information.--
            ``(1) In general.--A group health plan, or a health 
        insurance issuer offering group health insurance coverage in 
        connection with a group health plan, may not request or require 
        a participant or beneficiary (or an applicant for coverage as a 
        participant or beneficiary) to disclose to the plan or issuer 
        genetic information about the participant, beneficiary, or 
        applicant.
            ``(2) Requirement of prior authorization.--A group health 
        plan, or a health insurance issuer offering health insurance 
        coverage in connection with a group health plan, may not 
        disclose genetic information about a participant or beneficiary 
        (or an applicant for coverage as a participant or beneficiary) 
        without the prior written authorization of the participant, 
        beneficiary, or applicant or of the legal representative 
        thereof. Such authorization is required for each disclosure and 
        shall include an identification of the person to whom the 
        disclosure would be made.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Genetic information.--The term `genetic information' 
        means information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a family 
        member of the individual.
            ``(2) 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 counselling.
            ``(3) 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) Effective date.--The amendment made by this subsection 
        shall apply with respect to group health plans for plan years 
        beginning after 1 year after the date of the enactment of this 
        Act.
    (b) Amendment Relating to the Individual Market.--
            (1) In general.--Subpart 3 of part B of title XXVII of such 
        Act is amended by inserting after section 2751 the following:

``SEC. 2752. PROHIBITION OF HEALTH INSURANCE DISCRIMINATION ON THE 
              BASIS OF GENETIC INFORMATION.

    ``The provisions of section 2705 shall apply to health insurance 
coverage offered by a health insurance issuer in the individual market 
in the same manner as it applies to health insurance coverage offered 
by a health insurance issuer in connection with a group health plan in 
the small or large group market.''.
            (2) Effective date.--The amendment made by this subsection 
        shall apply with respect to health insurance coverage offered, 
        sold, issued, renewed, in effect, or operated in the individual 
        market after 1 year after the date of the enactment of this 
        Act.
    (c) Action for Damages.--Section 2761 of such Act (29 U.S.C. 300gg-
61) is amended by adding at the end the following:
    ``(c) Action for Damages
            ``(1) In general.--In any case in which a group health plan 
        or a health insurance issuer fails to meet the applicable 
        requirements of section 2706 or 2752 with respect to any 
        individual who is a plan participant or beneficiary in such a 
        plan, a covered individual, or an applicant for coverage, such 
        individual may bring a civil action under this section. In any 
        such action, such plan or issuer may in the court's discretion 
        be liable to such individual for compensatory, consequential, 
        and punitive damages.
            ``(2) Additional provisions.--For purposes of this 
        subsection, the provisions of subsections (d), (e), (f), (g), 
        (h), and (j) of section 502 of the Employee Retirement Income 
        Security Act of 1974 shall apply in connection with such 
        action, the plaintiff in such action, and the Secretary of 
        Health and Human Services in the same manner and to the same 
        extent as such provisions apply in connection with actions 
        under such section 502, plaintiffs in such actions, and the 
        Secretary of Labor.''.

SEC. 4. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY ACT RELATING 
              TO MEDIGAP.

    (a) In General.--Section 1882(s)(2) of the Social Security Act (42 
U.S.C. 1395ss(s)) is amended by adding at the end the following:
    ``(D)(i) An issuer of a medicare supplemental policy (as defined in 
section 1882(g)) may not deny or condition the issuance or 
effectiveness of the policy, and may not discriminate in the pricing of 
the policy of an eligible individual--
            ``(I) on the basis of genetic information; or
            ``(II) on the basis that the individual or a family member 
        of the individual has requested or received genetic services.
    ``(ii) For purposes of this subparagraph--
            ``(I) The term `genetic information' means information 
        about genes, gene products, or inherited characteristics that 
        may derive from an individual or a family member of the 
        individual.
            ``(II) 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 counselling.
            ``(III) 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.''.
    (b) Action for Damages.--Section 1882(s) of the Social Security Act 
(42 U.S.C. 1395ss(s)) is amended further by adding at the end the 
following:
    ``(4)(A) In any case in which a medicare supplemental policy fails 
to meet the applicable requirements of paragraph (2)(D) with respect to 
any individual who is a covered individual or an applicant for 
coverage, such individual may bring a civil action under this 
paragraph. In any such action, the issuer of such policy may in the 
court's discretion be liable to such individual for compensatory, 
consequential, and punitive damages.
    ``(B) For purposes of this paragraph, the provisions of subsections 
(d), (e), (f), (g), (h), and (j) of section 502 of the Employee 
Retirement Income Security Act of 1974 shall apply in connection with 
such action, the plaintiff in such action, and the Secretary of Health 
and Human Services in the same manner and to the same extent as such 
provisions apply in connection with actions under such section 502, 
plaintiffs in such actions, and the Secretary of Labor.''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to medicare supplemental policies offered, sold, 
issued, renewed, in effect, or operated in the individual market after 
1 year after the date of the enactment of this Act.

SEC. 5. AMENDMENTS OF INTERNAL REVENUE CODE OF 1986.

    (a) In General.--Chapter 100 of the Internal Revenue Code of 1986 
(relating to group health plan portability, access, and renewability 
requirements) is amended by adding at the end the following:

``Subchapter B--Prohibition of Discrimination By Group Health Plans on 
                      Basis of Genetic Information

                              ``Sec. 9811. Prohibition of 
                                        discrimination by group health 
                                        plans on basis of genetic 
                                        information.

``SEC. 9811. PROHIBITION OF DISCRIMINATION BY GROUP HEALTH PLANS ON 
              BASIS OF GENETIC INFORMATION.

    ``(a) In General.--In the case of benefits consisting of medical 
care provided under a group health plan or in the case of group health 
insurance coverage offered by a health insurance issuer in connection 
with a group health plan, the plan or issuer may not deny, cancel, or 
refuse to renew such benefits or such coverage, or vary the premiums, 
terms, or conditions for such benefits or such coverage, for any 
participant or beneficiary under the plan--
            ``(1) on the basis of genetic information; or
            ``(2) on the basis that the participant or beneficiary has 
        requested or received genetic services.
    ``(b) Limitation on Collection and Disclosure of Information.--
            ``(1) In general.--A group health plan, or a health 
        insurance issuer offering group health insurance coverage in 
        connection with a group health plan, may not request or require 
        a participant or beneficiary (or an applicant for coverage as a 
        participant or beneficiary) to disclose to the plan or issuer 
        genetic information about the participant, beneficiary, or 
        applicant.
            ``(2) Requirement of prior authorization.--A group health 
        plan, or a health insurance issuer offering health insurance 
        coverage in connection with a group health plan, may not 
        disclose genetic information about a participant or beneficiary 
        (or an applicant for coverage as a participant or beneficiary) 
        without the prior written authorization of the participant, 
        beneficiary, or applicant or of the legal representative 
        thereof. Such authorization is required for each disclosure and 
        shall include an identification of the person to whom the 
        disclosure would be made.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Genetic information.--The term `genetic information' 
        means information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a family 
        member of the individual.
            ``(2) 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 counselling.
            ``(3) 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.''.
    (b) Technical and Conforming Amendments.--
            (1) Paragraph (1) of section 4980D(f) of such Code 
        (relating to failure to meet certain group health plan 
        requirements) is amended by adding at the end the following new 
        sentence: ``For purposes of applying this section with respect 
        to the requirements of subchapter B of chapter 100, the term 
        `group health plan' includes a health insurance issuer (within 
        the meaning of section 9811).''
            (2) Chapter 100 of such Code is amended by striking the 
        chapter heading and inserting the following:

    ``CHAPTER 100--REQUIREMENTS RELATING TO GROUP HEALTH PLANS, ETC.

                              ``Subchapter A. Group health plan 
                                        portability, access, and 
                                        renewability requirements.
                              ``Subchapter B. Prohibition of 
                                        discrimination by group health 
                                        plans on basis of genetic 
                                        information.

``Subchapter A--Group Health Plan Portability, Access, and Renewability 
                            Requirements''.

            (3) The table of chapters for such Code is amended by 
        striking the item relating to chapter 100 and inserting the 
        following:

                              ``Chapter 100. Requirements relating to 
                                        group health plans, etc.''
            (4) Subsection (a) of section 4980D of such Code is amended 
        by striking ``(relating to group health plan portability, 
        access, and renewability requirements)'' and inserting 
        ``(relating to group health plans, etc., requirements)''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to group health plans for plan years beginning after 
1 year after the date of the enactment of this Act.
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