Congressional Record, Volume 154 Issue 71 (Thursday, May 1, 2008)

[Congressional Record Volume 154, Number 71 (Thursday, May 1, 2008)]
[House]
[Pages H2961-H2980]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

GENETIC INFORMATION NONDISCRIMINATION ACT OF 2008

Mr. GEORGE MILLER of California. Madam Speaker, pursuant to House
Resolution 1156, I call up the bill (H.R. 493) to prohibit
discrimination on the basis of genetic information with respect to
health insurance and employment, with a Senate amendment thereto, and
ask for its immediate consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore. The Clerk will designate the Senate
amendment.
The text of the Senate amendment is as follows:

Senate amendment:
Strike out all after the enacting clause and insert:

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``Genetic
Information Nondiscrimination Act of 2008''.
(b) Table of Contents.--The table of contents of this Act
is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

Sec. 101. Amendments to Employee Retirement Income Security Act of
1974.
Sec. 102. Amendments to the Public Health Service Act.
Sec. 103. Amendments to the Internal Revenue Code of 1986.
Sec. 104. Amendments to title XVIII of the Social Security Act relating
to medigap.
Sec. 105. Privacy and confidentiality.
Sec. 106. Assuring coordination.

TITLE II--PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF GENETIC
INFORMATION

Sec. 201. Definitions.
Sec. 202. Employer practices.
Sec. 203. Employment agency practices.
Sec. 204. Labor organization practices.
Sec. 205. Training programs.
Sec. 206. Confidentiality of genetic information.
Sec. 207. Remedies and enforcement.
Sec. 208. Disparate impact.
Sec. 209. Construction.
Sec. 210. Medical information that is not genetic information.
Sec. 211. Regulations.
Sec. 212. Authorization of appropriations.
Sec. 213. Effective date.

TITLE III--MISCELLANEOUS PROVISIONS

Sec. 301. Severability.
Sec. 302. Child labor protections.

SEC. 2. FINDINGS.

Congress makes the following findings:
(1) Deciphering the sequence of the human genome and other
advances in genetics open major new opportunities for medical
progress. New knowledge about the genetic basis of illness
will allow for earlier detection of illnesses, often before
symptoms have begun. Genetic testing can allow individuals to
take steps to reduce the likelihood that they will contract a
particular disorder. New knowledge about genetics may allow
for the development of better therapies that are more
effective against disease or have fewer side effects than
current treatments. These advances give rise to the potential
misuse of genetic information to discriminate in health
insurance and employment.
(2) The early science of genetics became the basis of State
laws that provided for the sterilization of persons having
presumed genetic ``defects'' such as mental retardation,
mental disease, epilepsy, blindness, and hearing loss, among
other conditions. The first sterilization law was enacted in
the State of Indiana in 1907. By 1981, a majority of States
adopted sterilization laws to ``correct'' apparent genetic
traits or tendencies. Many of these State laws have since
been repealed, and many have been modified to include
essential constitutional requirements of due process and
equal protection. However, the current explosion in the
science of genetics, and the history of sterilization laws by
the States based on early genetic science, compels
Congressional action in this area.
(3) Although genes are facially neutral markers, many
genetic conditions and disorders are associated with
particular racial and ethnic groups and gender. Because some
genetic traits are most prevalent in particular groups,
members of a particular group may be stigmatized or
discriminated against as a result of that genetic
information. This form of discrimination was evident in the
1970s, which saw the advent of programs to screen and
identify carriers of sickle cell anemia, a disease which
afflicts African-Americans. Once again, State legislatures
began to enact discriminatory laws in the area, and in the
early 1970s began mandating genetic screening of all African
Americans for sickle cell anemia, leading to discrimination
and unnecessary fear. To alleviate some of this stigma,
Congress in 1972 passed the National Sickle Cell Anemia
Control Act, which withholds Federal funding from States
unless sickle cell testing is voluntary.
(4) Congress has been informed of examples of genetic
discrimination in the workplace. These include the use of
pre-employment genetic screening at Lawrence Berkeley
Laboratory, which led to a court decision in favor of the
employees in that case Norman-Bloodsaw v. Lawrence Berkeley
Laboratory (135 F.3d 1260, 1269 (9th Cir. 1998)). Congress
clearly has a compelling public interest in relieving the
fear of discrimination and in prohibiting its actual practice
in employment and health insurance.
(5) Federal law addressing genetic discrimination in health
insurance and employment is incomplete in both the scope and
depth of its protections. Moreover, while many States have
enacted some type of genetic non-discrimination

[[Page H2962]]

law, these laws vary widely with respect to their approach,
application, and level of protection. Congress has collected
substantial evidence that the American public and the medical
community find the existing patchwork of State and Federal
laws to be confusing and inadequate to protect them from
discrimination. Therefore Federal legislation establishing a
national and uniform basic standard is necessary to fully
protect the public from discrimination and allay their
concerns about the potential for discrimination, thereby
allowing individuals to take advantage of genetic testing,
technologies, research, and new therapies.

TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY
ACT OF 1974.

(a) No Discrimination in Group Premiums Based on Genetic
Information.--Section 702(b) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1182(b)) is amended--
(1) in paragraph (2)(A), by inserting before the semicolon
the following: ``except as provided in paragraph (3)''; and
(2) by adding at the end the following:
``(3) No group-based discrimination on basis of genetic
information.--
``(A) In general.--For purposes of this section, a group
health plan, and a health insurance issuer offering group
health insurance coverage in connection with a group health
plan, may not adjust premium or contribution amounts for the
group covered under such plan on the basis of genetic
information.
``(B) Rule of construction.--Nothing in subparagraph (A) or
in paragraphs (1) and (2) of subsection (d) shall be
construed to limit the ability of a health insurance issuer
offering health insurance coverage in connection with a group
health plan to increase the premium for an employer based on
the manifestation of a disease or disorder of an individual
who is enrolled in the plan. In such case, the manifestation
of a disease or disorder in one individual cannot also be
used as genetic information about other group members and to
further increase the premium for the employer.''.
(b) Limitations on Genetic Testing; Prohibition on
Collection of Genetic Information; Application to All
Plans.--Section 702 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1182) is amended by adding at
the end the following:
``(c) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A group health plan, and a health insurance issuer
offering health insurance coverage in connection with a group
health plan, shall not request or require an individual or a
family member of such individual to undergo a genetic test.
``(2) Rule of construction.--Paragraph (1) shall not be
construed to limit the authority of a health care
professional who is providing health care services to an
individual to request that such individual undergo a genetic
test.
``(3) Rule of construction regarding payment.--
``(A) In general.--Nothing in paragraph (1) shall be
construed to preclude a group health plan, or a health
insurance issuer offering health insurance coverage in
connection with a group health plan, from obtaining and using
the results of a genetic test in making a determination
regarding payment (as such term is defined for the purposes
of applying the regulations promulgated by the Secretary of
Health and Human Services under part C of title XI of the
Social Security Act and section 264 of the Health Insurance
Portability and Accountability Act of 1996, as may be revised
from time to time) consistent with subsection (a).
``(B) Limitation.--For purposes of subparagraph (A), a
group health plan, or a health insurance issuer offering
health insurance coverage in connection with a group health
plan, may request only the minimum amount of information
necessary to accomplish the intended purpose.
``(4) Research exception.--Notwithstanding paragraph (1), a
group health plan, or a health insurance issuer offering
health insurance coverage in connection with a group health
plan, may request, but not require, that a participant or
beneficiary undergo a genetic test if each of the following
conditions is met:
``(A) The request is made, in writing, pursuant to research
that complies with part 46 of title 45, Code of Federal
Regulations, or equivalent Federal regulations, and any
applicable State or local law or regulations for the
protection of human subjects in research.
``(B) The plan or issuer clearly indicates to each
participant or beneficiary, or in the case of a minor child,
to the legal guardian of such beneficiary, to whom the
request is made that--
``(i) compliance with the request is voluntary; and
``(ii) non-compliance will have no effect on enrollment
status or premium or contribution amounts.
``(C) No genetic information collected or acquired under
this paragraph shall be used for underwriting purposes.
``(D) The plan or issuer notifies the Secretary in writing
that the plan or issuer is conducting activities pursuant to
the exception provided for under this paragraph, including a
description of the activities conducted.
``(E) The plan or issuer complies with such other
conditions as the Secretary may by regulation require for
activities conducted under this paragraph.
``(d) Prohibition on Collection of Genetic Information.--
``(1) In general.--A group health plan, and a health
insurance issuer offering health insurance coverage in
connection with a group health plan, shall not request,
require, or purchase genetic information for underwriting
purposes (as defined in section 733).
``(2) Prohibition on collection of genetic information
prior to enrollment.--A group health plan, and a health
insurance issuer offering health insurance coverage in
connection with a group health plan, shall not request,
require, or purchase genetic information with respect to any
individual prior to such individual's enrollment under the
plan or coverage in connection with such enrollment.
``(3) Incidental collection.--If a group health plan, or a
health insurance issuer offering health insurance coverage in
connection with a group health plan, obtains genetic
information incidental to the requesting, requiring, or
purchasing of other information concerning any individual,
such request, requirement, or purchase shall not be
considered a violation of paragraph (2) if such request,
requirement, or purchase is not in violation of paragraph
(1).
``(e) Application to All Plans.--The provisions of
subsections (a)(1)(F), (b)(3), (c), and (d), and subsection
(b)(1) and section 701 with respect to genetic information,
shall apply to group health plans and health insurance
issuers without regard to section 732(a).''.
(c) Application to Genetic Information of a Fetus or
Embryo.--Such section is further amended by adding at the end
the following:
``(f) Genetic Information of a Fetus or Embryo.--Any
reference in this part to genetic information concerning an
individual or family member of an individual shall--
``(1) with respect to such an individual or family member
of an individual who is a pregnant woman, include genetic
information of any fetus carried by such pregnant woman; and
``(2) with respect to an individual or family member
utilizing an assisted reproductive technology, include
genetic information of any embryo legally held by the
individual or family member.''.
(d) Definitions.--Section 733(d) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1191b(d)) is amended
by adding at the end the following:
``(5) Family member.--The term `family member' means, with
respect to an individual--
``(A) a dependent (as such term is used for purposes of
section 701(f)(2)) of such individual, and
``(B) any other individual who is a first-degree, second-
degree, third-degree, or fourth-degree relative of such
individual or of an individual described in subparagraph (A).
``(6) Genetic information.--
``(A) In general.--The term `genetic information' means,
with respect to any individual, information about--
``(i) such individual's genetic tests,
``(ii) the genetic tests of family members of such
individual, and
``(iii) the manifestation of a disease or disorder in
family members of such individual.
``(B) Inclusion of genetic services and participation in
genetic research.--Such term includes, with respect to any
individual, any request for, or receipt of, genetic services,
or participation in clinical research which includes genetic
services, by such individual or any family member of such
individual.
``(C) Exclusions.--The term `genetic information' shall not
include information about the sex or age of any individual.
``(7) Genetic test.--
``(A) In general.--The term `genetic test' means an
analysis of human DNA, RNA, chromosomes, proteins, or
metabolites, that detects genotypes, mutations, or
chromosomal changes.
``(B) Exceptions.--The term `genetic test' does not mean--
``(i) an analysis of proteins or metabolites that does not
detect genotypes, mutations, or chromosomal changes; or
``(ii) an analysis of proteins or metabolites that is
directly related to a manifested disease, disorder, or
pathological condition that could reasonably be detected by a
health care professional with appropriate training and
expertise in the field of medicine involved.
``(8) Genetic services.--The term `genetic services'
means--
``(A) a genetic test;
``(B) genetic counseling (including obtaining,
interpreting, or assessing genetic information); or
``(C) genetic education.
``(9) Underwriting purposes.--The term `underwriting
purposes' means, with respect to any group health plan, or
health insurance coverage offered in connection with a group
health plan--
``(A) rules for, or determination of, eligibility
(including enrollment and continued eligibility) for benefits
under the plan or coverage;
``(B) the computation of premium or contribution amounts
under the plan or coverage;
``(C) the application of any pre-existing condition
exclusion under the plan or coverage; and
``(D) other activities related to the creation, renewal, or
replacement of a contract of health insurance or health
benefits.''.
(e) ERISA Enforcement.--Section 502 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1132) is
amended--
(1) in subsection (a)(6), by striking ``(7), or (8)'' and
inserting ``(7), (8), or (9)'';
(2) in subsection (b)(3), by striking ``The Secretary'' and
inserting ``Except as provided in subsections (c)(9) and
(a)(6) (with respect to collecting civil penalties under
subsection (c)(9)), the Secretary''; and
(3) in subsection (c), by redesignating paragraph (9) as
paragraph (10), and by inserting after paragraph (8) the
following new paragraph:
``(9) Secretarial enforcement authority relating to use of
genetic information.--
``(A) General rule.--The Secretary may impose a penalty
against any plan sponsor of a group health plan, or any
health insurance issuer offering health insurance coverage in

[[Page H2963]]

connection with the plan, for any failure by such sponsor or
issuer to meet the requirements of subsection (a)(1)(F),
(b)(3), (c), or (d) of section 702 or section 701 or
702(b)(1) with respect to genetic information, in connection
with the plan.
``(B) Amount.--
``(i) In general.--The amount of the penalty imposed by
subparagraph (A) shall be $100 for each day in the
noncompliance period with respect to each participant or
beneficiary to whom such failure relates.
``(ii) Noncompliance period.--For purposes of this
paragraph, the term `noncompliance period' means, with
respect to any failure, the period--

``(I) beginning on the date such failure first occurs; and
``(II) ending on the date the failure is corrected.

``(C) Minimum penalties where failure discovered.--
Notwithstanding clauses (i) and (ii) of subparagraph (D):
``(i) In general.--In the case of 1 or more failures with
respect to a participant or beneficiary--

``(I) which are not corrected before the date on which the
plan receives a notice from the Secretary of such violation;
and
``(II) which occurred or continued during the period
involved;

the amount of penalty imposed by subparagraph (A) by reason
of such failures with respect to such participant or
beneficiary shall not be less than $2,500.
``(ii) Higher minimum penalty where violations are more
than de minimis.--To the extent violations for which any
person is liable under this paragraph for any year are more
than de minimis, clause (i) shall be applied by substituting
`$15,000' for `$2,500' with respect to such person.
``(D) Limitations.--
``(i) Penalty not to apply where failure not discovered
exercising reasonable diligence.--No penalty shall be imposed
by subparagraph (A) on any failure during any period for
which it is established to the satisfaction of the Secretary
that the person otherwise liable for such penalty did not
know, and exercising reasonable diligence would not have
known, that such failure existed.
``(ii) Penalty not to apply to failures corrected within
certain periods.--No penalty shall be imposed by subparagraph
(A) on any failure if--

``(I) such failure was due to reasonable cause and not to
willful neglect; and
``(II) such failure is corrected during the 30-day period
beginning on the first date the person otherwise liable for
such penalty knew, or exercising reasonable diligence would
have known, that such failure existed.

``(iii) Overall limitation for unintentional failures.--In
the case of failures which are due to reasonable cause and
not to willful neglect, the penalty imposed by subparagraph
(A) for failures shall not exceed the amount equal to the
lesser of--

``(I) 10 percent of the aggregate amount paid or incurred
by the plan sponsor (or predecessor plan sponsor) during the
preceding taxable year for group health plans; or
``(II) $500,000.

``(E) Waiver by secretary.--In the case of a failure which
is due to reasonable cause and not to willful neglect, the
Secretary may waive part or all of the penalty imposed by
subparagraph (A) to the extent that the payment of such
penalty would be excessive relative to the failure involved.
``(F) Definitions.--Terms used in this paragraph which are
defined in section 733 shall have the meanings provided such
terms in such section.''.
(f) Regulations and Effective Date.--
(1) Regulations.--The Secretary of Labor shall issue final
regulations not later than 12 months after the date of
enactment of this Act to carry out the amendments made by
this section.
(2) Effective date.--The amendments made by this section
shall apply with respect to group health plans for plan years
beginning after the date that is 1 year after the date of
enactment of this Act.

SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

(a) Amendments Relating to the Group Market.--
(1) No discrimination in group premiums based on genetic
information.--Section 2702(b) of the Public Health Service
Act (42 U.S.C. 300gg-1(b)) is amended--
(A) in paragraph (2)(A), by inserting before the semicolon
the following: ``except as provided in paragraph (3)''; and
(B) by adding at the end the following:
``(3) No group-based discrimination on basis of genetic
information.--
``(A) In general.--For purposes of this section, a group
health plan, and health insurance issuer offering group
health insurance coverage in connection with a group health
plan, may not adjust premium or contribution amounts for the
group covered under such plan on the basis of genetic
information.
``(B) Rule of construction.--Nothing in subparagraph (A) or
in paragraphs (1) and (2) of subsection (d) shall be
construed to limit the ability of a health insurance issuer
offering health insurance coverage in connection with a group
health plan to increase the premium for an employer based on
the manifestation of a disease or disorder of an individual
who is enrolled in the plan. In such case, the manifestation
of a disease or disorder in one individual cannot also be
used as genetic information about other group members and to
further increase the premium for the employer.''.
(2) Limitations on genetic testing; prohibition on
collection of genetic information; application to all
plans.--Section 2702 of the Public Health Service Act (42
U.S.C. 300gg-1) is amended by adding at the end the
following:
``(c) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A group health plan, and a health insurance issuer
offering health insurance coverage in connection with a group
health plan, shall not request or require an individual or a
family member of such individual to undergo a genetic test.
``(2) Rule of construction.--Paragraph (1) shall not be
construed to limit the authority of a health care
professional who is providing health care services to an
individual to request that such individual undergo a genetic
test.
``(3) Rule of construction regarding payment.--
``(A) In general.--Nothing in paragraph (1) shall be
construed to preclude a group health plan, or a health
insurance issuer offering health insurance coverage in
connection with a group health plan, from obtaining and using
the results of a genetic test in making a determination
regarding payment (as such term is defined for the purposes
of applying the regulations promulgated by the Secretary
under part C of title XI of the Social Security Act and
section 264 of the Health Insurance Portability and
Accountability Act of 1996, as may be revised from time to
time) consistent with subsection (a).
``(B) Limitation.--For purposes of subparagraph (A), a
group health plan, or a health insurance issuer offering
health insurance coverage in connection with a group health
plan, may request only the minimum amount of information
necessary to accomplish the intended purpose.
``(4) Research exception.--Notwithstanding paragraph (1), a
group health plan, or a health insurance issuer offering
health insurance coverage in connection with a group health
plan, may request, but not require, that a participant or
beneficiary undergo a genetic test if each of the following
conditions is met:
``(A) The request is made pursuant to research that
complies with part 46 of title 45, Code of Federal
Regulations, or equivalent Federal regulations, and any
applicable State or local law or regulations for the
protection of human subjects in research.
``(B) The plan or issuer clearly indicates to each
participant or beneficiary, or in the case of a minor child,
to the legal guardian of such beneficiary, to whom the
request is made that--
``(i) compliance with the request is voluntary; and
``(ii) non-compliance will have no effect on enrollment
status or premium or contribution amounts.
``(C) No genetic information collected or acquired under
this paragraph shall be used for underwriting purposes.
``(D) The plan or issuer notifies the Secretary in writing
that the plan or issuer is conducting activities pursuant to
the exception provided for under this paragraph, including a
description of the activities conducted.
``(E) The plan or issuer complies with such other
conditions as the Secretary may by regulation require for
activities conducted under this paragraph.
``(d) Prohibition on Collection of Genetic Information.--
``(1) In general.--A group health plan, and a health
insurance issuer offering health insurance coverage in
connection with a group health plan, shall not request,
require, or purchase genetic information for underwriting
purposes (as defined in section 2791).
``(2) Prohibition on collection of genetic information
prior to enrollment.--A group health plan, and a health
insurance issuer offering health insurance coverage in
connection with a group health plan, shall not request,
require, or purchase genetic information with respect to any
individual prior to such individual's enrollment under the
plan or coverage in connection with such enrollment.
``(3) Incidental collection.--If a group health plan, or a
health insurance issuer offering health insurance coverage in
connection with a group health plan, obtains genetic
information incidental to the requesting, requiring, or
purchasing of other information concerning any individual,
such request, requirement, or purchase shall not be
considered a violation of paragraph (2) if such request,
requirement, or purchase is not in violation of paragraph
(1).
``(e) Application to All Plans.--The provisions of
subsections (a)(1)(F), (b)(3), (c) , and (d) and subsection
(b)(1) and section 2701 with respect to genetic information,
shall apply to group health plans and health insurance
issuers without regard to section 2721(a).''.
(3) Application to genetic information of a fetus or
embryo.--Such section is further amended by adding at the end
the following:
``(f) Genetic Information of a Fetus or Embryo.--Any
reference in this part to genetic information concerning an
individual or family member of an individual shall--
``(1) with respect to such an individual or family member
of an individual who is a pregnant woman, include genetic
information of any fetus carried by such pregnant woman; and
``(2) with respect to an individual or family member
utilizing an assisted reproductive technology, include
genetic information of any embryo legally held by the
individual or family member.''.
(4) Definitions.--Section 2791(d) of the Public Health
Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at
the end the following:
``(15) Family member.--The term `family member' means, with
respect to any individual--
``(A) a dependent (as such term is used for purposes of
section 2701(f)(2)) of such individual; and
``(B) any other individual who is a first-degree, second-
degree, third-degree, or fourth-degree relative of such
individual or of an individual described in subparagraph (A).

[[Page H2964]]

``(16) Genetic information.--
``(A) In general.--The term `genetic information' means,
with respect to any individual, information about--
``(i) such individual's genetic tests,
``(ii) the genetic tests of family members of such
individual, and
``(iii) the manifestation of a disease or disorder in
family members of such individual.
``(B) Inclusion of genetic services and participation in
genetic research.--Such term includes, with respect to any
individual, any request for, or receipt of, genetic services,
or participation in clinical research which includes genetic
services, by such individual or any family member of such
individual.
``(C) Exclusions.--The term `genetic information' shall not
include information about the sex or age of any individual.
``(17) Genetic test.--
``(A) In general.--The term `genetic test' means an
analysis of human DNA, RNA, chromosomes, proteins, or
metabolites, that detects genotypes, mutations, or
chromosomal changes.
``(B) Exceptions.--The term `genetic test' does not mean--
``(i) an analysis of proteins or metabolites that does not
detect genotypes, mutations, or chromosomal changes; or
``(ii) an analysis of proteins or metabolites that is
directly related to a manifested disease, disorder, or
pathological condition that could reasonably be detected by a
health care professional with appropriate training and
expertise in the field of medicine involved.
``(18) Genetic services.--The term `genetic services'
means--
``(A) a genetic test;
``(B) genetic counseling (including obtaining,
interpreting, or assessing genetic information); or
``(C) genetic education.
``(19) Underwriting purposes.--The term `underwriting
purposes' means, with respect to any group health plan, or
health insurance coverage offered in connection with a group
health plan--
``(A) rules for, or determination of, eligibility
(including enrollment and continued eligibility) for benefits
under the plan or coverage;
``(B) the computation of premium or contribution amounts
under the plan or coverage;
``(C) the application of any pre-existing condition
exclusion under the plan or coverage; and
``(D) other activities related to the creation, renewal, or
replacement of a contract of health insurance or health
benefits.''.
(5) Remedies and enforcement.--Section 2722(b) of the
Public Health Service Act (42 U.S.C. 300gg-22(b)) is amended
by adding at the end the following:
``(3) Enforcement authority relating to genetic
discrimination.--
``(A) General rule.--In the cases described in paragraph
(1), notwithstanding the provisions of paragraph (2)(C), the
succeeding subparagraphs of this paragraph shall apply with
respect to an action under this subsection by the Secretary
with respect to any failure of a health insurance issuer in
connection with a group health plan, to meet the requirements
of subsection (a)(1)(F), (b)(3), (c), or (d) of section 2702
or section 2701 or 2702(b)(1) with respect to genetic
information in connection with the plan.
``(B) Amount.--
``(i) In general.--The amount of the penalty imposed under
this paragraph shall be $100 for each day in the
noncompliance period with respect to each participant or
beneficiary to whom such failure relates.
``(ii) Noncompliance period.--For purposes of this
paragraph, the term `noncompliance period' means, with
respect to any failure, the period--

``(I) beginning on the date such failure first occurs; and
``(II) ending on the date the failure is corrected.

``(C) Minimum penalties where failure discovered.--
Notwithstanding clauses (i) and (ii) of subparagraph (D):
``(i) In general.--In the case of 1 or more failures with
respect to an individual--

``(I) which are not corrected before the date on which the
plan receives a notice from the Secretary of such violation;
and
``(II) which occurred or continued during the period
involved;

the amount of penalty imposed by subparagraph (A) by reason
of such failures with respect to such individual shall not be
less than $2,500.
``(ii) Higher minimum penalty where violations are more
than de minimis.--To the extent violations for which any
person is liable under this paragraph for any year are more
than de minimis, clause (i) shall be applied by substituting
`$15,000' for `$2,500' with respect to such person.
``(D) Limitations.--
``(i) Penalty not to apply where failure not discovered
exercising reasonable diligence.--No penalty shall be imposed
by subparagraph (A) on any failure during any period for
which it is established to the satisfaction of the Secretary
that the person otherwise liable for such penalty did not
know, and exercising reasonable diligence would not have
known, that such failure existed.
``(ii) Penalty not to apply to failures corrected within
certain periods.--No penalty shall be imposed by subparagraph
(A) on any failure if--

``(I) 10 percent of the aggregate amount paid or incurred
by the employer (or predecessor employer) during the
preceding taxable year for group health plans; or
``(II) $500,000.

``(E) Waiver by secretary.--In the case of a failure which
is due to reasonable cause and not to willful neglect, the
Secretary may waive part or all of the penalty imposed by
subparagraph (A) to the extent that the payment of such
penalty would be excessive relative to the failure
involved.''.
(b) Amendment Relating to the Individual Market.--
(1) In general.--The first subpart 3 of part B of title
XXVII of the Public Health Service Act (42 U.S.C. 300gg-51 et
seq.) (relating to other requirements) is amended--
(A) by redesignating such subpart as subpart 2; and
(B) by adding at the end the following:

``SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE
BASIS OF GENETIC INFORMATION.

``(a) Prohibition on Genetic Information as a Condition of
Eligibility.--
``(1) In general.--A health insurance issuer offering
health insurance coverage in the individual market may not
establish rules for the eligibility (including continued
eligibility) of any individual to enroll in individual health
insurance coverage based on genetic information.
``(2) Rule of construction.--Nothing in paragraph (1) or in
paragraphs (1) and (2) of subsection (e) shall be construed
to preclude a health insurance issuer from establishing rules
for eligibility for an individual to enroll in individual
health insurance coverage based on the manifestation of a
disease or disorder in that individual, or in a family member
of such individual where such family member is covered under
the policy that covers such individual.
``(b) Prohibition on Genetic Information in Setting Premium
Rates.--
``(1) In general.--A health insurance issuer offering
health insurance coverage in the individual market shall not
adjust premium or contribution amounts for an individual on
the basis of genetic information concerning the individual or
a family member of the individual.
``(2) Rule of construction.--Nothing in paragraph (1) or in
paragraphs (1) and (2) of subsection (e) shall be construed
to preclude a health insurance issuer from adjusting premium
or contribution amounts for an individual on the basis of a
manifestation of a disease or disorder in that individual, or
in a family member of such individual where such family
member is covered under the policy that covers such
individual. In such case, the manifestation of a disease or
disorder in one individual cannot also be used as genetic
information about other individuals covered under the policy
issued to such individual and to further increase premiums or
contribution amounts.
``(c) Prohibition on Genetic Information as Preexisting
Condition.--
``(1) In general.--A health insurance issuer offering
health insurance coverage in the individual market may not,
on the basis of genetic information, impose any preexisting
condition exclusion (as defined in section 2701(b)(1)(A))
with respect to such coverage.
``(2) Rule of construction.--Nothing in paragraph (1) or in
paragraphs (1) and (2) of subsection (e) shall be construed
to preclude a health insurance issuer from imposing any
preexisting condition exclusion for an individual with
respect to health insurance coverage on the basis of a
manifestation of a disease or disorder in that individual.
``(d) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A health insurance issuer offering health insurance
coverage in the individual market shall not request or
require an individual or a family member of such individual
to undergo a genetic test.
``(2) Rule of construction.--Paragraph (1) shall not be
construed to limit the authority of a health care
professional who is providing health care services to an
individual to request that such individual undergo a genetic
test.
``(3) Rule of construction regarding payment.--
``(A) In general.--Nothing in paragraph (1) shall be
construed to preclude a health insurance issuer offering
health insurance coverage in the individual market from
obtaining and using the results of a genetic test in making a
determination regarding payment (as such term is defined for
the purposes of applying the regulations promulgated by the
Secretary under part C of title XI of the Social Security Act
and section 264 of the Health Insurance Portability and
Accountability Act of 1996, as may be revised from time to
time) consistent with subsection (a) and (c).
``(B) Limitation.--For purposes of subparagraph (A), a
health insurance issuer offering health insurance coverage in
the individual market may request only the minimum amount of
information necessary to accomplish the intended purpose.
``(4) Research exception.--Notwithstanding paragraph (1), a
health insurance issuer offering health insurance coverage in
the individual market may request, but not require, that an
individual or a family member of such individual undergo a
genetic test if each of the following conditions is met:
``(A) The request is made pursuant to research that
complies with part 46 of title 45, Code of Federal
Regulations, or equivalent Federal regulations, and any
applicable State or local law or regulations for the
protection of human subjects in research.
``(B) The issuer clearly indicates to each individual, or
in the case of a minor child, to the

[[Page H2965]]

legal guardian of such child, to whom the request is made
that--
``(i) compliance with the request is voluntary; and
``(ii) non-compliance will have no effect on enrollment
status or premium or contribution amounts.
``(C) No genetic information collected or acquired under
this paragraph shall be used for underwriting purposes.
``(D) The issuer notifies the Secretary in writing that the
issuer is conducting activities pursuant to the exception
provided for under this paragraph, including a description of
the activities conducted.
``(E) The issuer complies with such other conditions as the
Secretary may by regulation require for activities conducted
under this paragraph.
``(e) Prohibition on Collection of Genetic Information.--
``(1) In general.--A health insurance issuer offering
health insurance coverage in the individual market shall not
request, require, or purchase genetic information for
underwriting purposes (as defined in section 2791).
``(2) Prohibition on collection of genetic information
prior to enrollment.--A health insurance issuer offering
health insurance coverage in the individual market shall not
request, require, or purchase genetic information with
respect to any individual prior to such individual's
enrollment under the plan in connection with such enrollment.
``(3) Incidental collection.--If a health insurance issuer
offering health insurance coverage in the individual market
obtains genetic information incidental to the requesting,
requiring, or purchasing of other information concerning any
individual, such request, requirement, or purchase shall not
be considered a violation of paragraph (2) if such request,
requirement, or purchase is not in violation of paragraph
(1).
``(f) Genetic Information of a Fetus or Embryo.--Any
reference in this part to genetic information concerning an
individual or family member of an individual shall--
``(1) with respect to such an individual or family member
of an individual who is a pregnant woman, include genetic
information of any fetus carried by such pregnant woman; and
``(2) with respect to an individual or family member
utilizing an assisted reproductive technology, include
genetic information of any embryo legally held by the
individual or family member.''.
(2) Remedies and enforcement.--Section 2761(b) of the
Public Health Service Act (42 U.S.C. 300gg-61(b)) is amended
to read as follows:
``(b) Secretarial Enforcement Authority.--The Secretary
shall have the same authority in relation to enforcement of
the provisions of this part with respect to issuers of health
insurance coverage in the individual market in a State as the
Secretary has under section 2722(b)(2), and section
2722(b)(3) with respect to violations of genetic
nondiscrimination provisions, in relation to the enforcement
of the provisions of part A with respect to issuers of health
insurance coverage in the small group market in the State.''.
(c) Elimination of Option of Non-Federal Governmental Plans
To Be Excepted From Requirements Concerning Genetic
Information.--Section 2721(b)(2) of the Public Health Service
Act (42 U.S.C. 300gg-21(b)(2)) is amended--
(1) in subparagraph (A), by striking ``If the plan
sponsor'' and inserting ``Except as provided in subparagraph
(D), if the plan sponsor''; and
(2) by adding at the end the following:
``(D) Election not applicable to requirements concerning
genetic information.--The election described in subparagraph
(A) shall not be available with respect to the provisions of
subsections (a)(1)(F), (b)(3), (c), and (d) of section 2702
and the provisions of sections 2701 and 2702(b) to the extent
that such provisions apply to genetic information.''.
(d) Regulations and Effective Date.--
(1) Regulations.--Not later than 12 months after the date
of enactment of this Act, the Secretary of Health and Human
Services shall issue final regulations to carry out the
amendments made by this section.
(2) Effective date.--The amendments made by this section
shall apply--
(A) with respect to group health plans, and health
insurance coverage offered in connection with group health
plans, for plan years beginning after the date that is 1 year
after the date of enactment of this Act; and
(B) with respect to health insurance coverage offered,
sold, issued, renewed, in effect, or operated in the
individual market after the date that is 1 year after the
date of enactment of this Act.

SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986.

(a) No Discrimination in Group Premiums Based on Genetic
Information.--Subsection (b) of section 9802 of the Internal
Revenue Code of 1986 is amended--
(1) in paragraph (2)(A), by inserting before the semicolon
the following: ``except as provided in paragraph (3)''; and
(2) by adding at the end the following:
``(3) No group-based discrimination on basis of genetic
information.--
``(A) In general.--For purposes of this section, a group
health plan may not adjust premium or contribution amounts
for the group covered under such plan on the basis of genetic
information.
``(B) Rule of construction.--Nothing in subparagraph (A) or
in paragraphs (1) and (2) of subsection (d) shall be
construed to limit the ability of a group health plan to
increase the premium for an employer based on the
manifestation of a disease or disorder of an individual who
is enrolled in the plan. In such case, the manifestation of a
disease or disorder in one individual cannot also be used as
genetic information about other group members and to further
increase the premium for the employer.''.
(b) Limitations on Genetic Testing; Prohibition on
Collection of Genetic Information; Application to All
Plans.--Section 9802 of such Code is amended by redesignating
subsection (c) as subsection (f) and by inserting after
subsection (b) the following new subsections:
``(c) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A group health plan may not request or require an
individual or a family member of such individual to undergo a
genetic test.
``(2) Rule of construction.--Paragraph (1) shall not be
construed to limit the authority of a health care
professional who is providing health care services to an
individual to request that such individual undergo a genetic
test.
``(3) Rule of construction regarding payment.--
``(A) In general.--Nothing in paragraph (1) shall be
construed to preclude a group health plan from obtaining and
using the results of a genetic test in making a determination
regarding payment (as such term is defined for the purposes
of applying the regulations promulgated by the Secretary of
Health and Human Services under part C of title XI of the
Social Security Act and section 264 of the Health Insurance
Portability and Accountability Act of 1996, as may be revised
from time to time) consistent with subsection (a).
``(B) Limitation.--For purposes of subparagraph (A), a
group health plan may request only the minimum amount of
information necessary to accomplish the intended purpose.
``(4) Research exception.--Notwithstanding paragraph (1), a
group health plan may request, but not require, that a
participant or beneficiary undergo a genetic test if each of
the following conditions is met:
``(A) The request is made pursuant to research that
complies with part 46 of title 45, Code of Federal
Regulations, or equivalent Federal regulations, and any
applicable State or local law or regulations for the
protection of human subjects in research.
``(B) The plan clearly indicates to each participant or
beneficiary, or in the case of a minor child, to the legal
guardian of such beneficiary, to whom the request is made
that--
``(i) compliance with the request is voluntary; and
``(ii) non-compliance will have no effect on enrollment
status or premium or contribution amounts.
``(C) No genetic information collected or acquired under
this paragraph shall be used for underwriting purposes.
``(D) The plan notifies the Secretary in writing that the
plan is conducting activities pursuant to the exception
provided for under this paragraph, including a description of
the activities conducted.
``(E) The plan complies with such other conditions as the
Secretary may by regulation require for activities conducted
under this paragraph.
``(d) Prohibition on Collection of Genetic Information.--
``(1) In general.--A group health plan shall not request,
require, or purchase genetic information for underwriting
purposes (as defined in section 9832).
``(2) Prohibition on collection of genetic information
prior to enrollment.--A group health plan shall not request,
require, or purchase genetic information with respect to any
individual prior to such individual's enrollment under the
plan or in connection with such enrollment.
``(3) Incidental collection.--If a group health plan
obtains genetic information incidental to the requesting,
requiring, or purchasing of other information concerning any
individual, such request, requirement, or purchase shall not
be considered a violation of paragraph (2) if such request,
requirement, or purchase is not in violation of paragraph
(1).
``(e) Application to All Plans.--The provisions of
subsections (a)(1)(F), (b)(3), (c), and (d) and subsection
(b)(1) and section 9801 with respect to genetic information,
shall apply to group health plans without regard to section
9831(a)(2).''.
(c) Application to Genetic Information of a Fetus or
Embryo.--Such section is further amended by adding at the end
the following:
``(f) Genetic Information of a Fetus or Embryo.--Any
reference in this chapter to genetic information concerning
an individual or family member of an individual shall--
``(1) with respect to such an individual or family member
of an individual who is a pregnant woman, include genetic
information of any fetus carried by such pregnant woman; and
``(2) with respect to an individual or family member
utilizing an assisted reproductive technology, include
genetic information of any embryo legally held by the
individual or family member.''.
(d) Definitions.--Subsection (d) of section 9832 of such
Code is amended by adding at the end the following:
``(6) Family member.--The term `family member' means, with
respect to any individual--
``(A) a dependent (as such term is used for purposes of
section 9801(f)(2)) of such individual, and
``(B) any other individual who is a first-degree, second-
degree, third-degree, or fourth-degree relative of such
individual or of an individual described in subparagraph (A).
``(7) Genetic information.--
``(A) In general.--The term `genetic information' means,
with respect to any individual, information about--
``(i) such individual's genetic tests,

[[Page H2966]]

``(ii) the genetic tests of family members of such
individual, and
``(iii) the manifestation of a disease or disorder in
family members of such individual.
``(B) Inclusion of genetic services and participation in
genetic research.--Such term includes, with respect to any
individual, any request for, or receipt of, genetic services,
or participation in clinical research which includes genetic
services, by such individual or any family member of such
individual.
``(C) Exclusions.--The term `genetic information' shall not
include information about the sex or age of any individual.
``(8) Genetic test.--
``(A) In general.--The term `genetic test' means an
analysis of human DNA, RNA, chromosomes, proteins, or
metabolites, that detects genotypes, mutations, or
chromosomal changes.
``(B) Exceptions.--The term `genetic test' does not mean--
``(i) an analysis of proteins or metabolites that does not
detect genotypes, mutations, or chromosomal changes, or
``(ii) an analysis of proteins or metabolites that is
directly related to a manifested disease, disorder, or
pathological condition that could reasonably be detected by a
health care professional with appropriate training and
expertise in the field of medicine involved.
``(9) Genetic services.--The term `genetic services'
means--
``(A) a genetic test;
``(B) genetic counseling (including obtaining,
interpreting, or assessing genetic information); or
``(C) genetic education.
``(10) Underwriting purposes.--The term `underwriting
purposes' means, with respect to any group health plan, or
health insurance coverage offered in connection with a group
health plan--
``(A) rules for, or determination of, eligibility
(including enrollment and continued eligibility) for benefits
under the plan or coverage;
``(B) the computation of premium or contribution amounts
under the plan or coverage;
``(C) the application of any pre-existing condition
exclusion under the plan or coverage; and
``(D) other activities related to the creation, renewal, or
replacement of a contract of health insurance or health
benefits.''.
(e) Enforcement.--
(1) In general.--Subchapter C of chapter 100 of the
Internal Revenue Code of 1986 (relating to general
provisions) is amended by adding at the end the following new
section:

``SEC. 9834. ENFORCEMENT.

``For the imposition of tax on any failure of a group
health plan to meet the requirements of this chapter, see
section 4980D.''.
(2) Conforming amendment.--The table of sections for
subchapter C of chapter 100 of such Code is amended by adding
at the end the following new item:

``Sec. 9834. Enforcement.''.

(f) Regulations and Effective Date.--
(1) Regulations.--The Secretary of the Treasury shall issue
final regulations or other guidance not later than 12 months
after the date of the enactment of this Act to carry out the
amendments made by this section.
(2) Effective date.--The amendments made by this section
shall apply with respect to group health plans for plan years
beginning after the date that is 1 year after the date of the
enactment of this Act.

SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY
ACT RELATING TO MEDIGAP.

(a) Nondiscrimination.--Section 1882(s)(2) of the Social
Security Act (42 U.S.C. 1395ss(s)(2)) is amended by adding at
the end the following:
``(E) An issuer of a medicare supplemental policy shall not
deny or condition the issuance or effectiveness of the policy
(including the imposition of any exclusion of benefits under
the policy based on a pre-existing condition) and shall not
discriminate in the pricing of the policy (including the
adjustment of premium rates) of an individual on the basis of
the genetic information with respect to such individual.
``(F) Rule of construction.--Nothing in subparagraph (E) or
in subparagraphs (A) or (B) of subsection (x)(2) shall be
construed to limit the ability of an issuer of a medicare
supplemental policy from, to the extent otherwise permitted
under this title--
``(i) denying or conditioning the issuance or effectiveness
of the policy or increasing the premium for an employer based
on the manifestation of a disease or disorder of an
individual who is covered under the policy; or
``(ii) increasing the premium for any policy issued to an
individual based on the manifestation of a disease or
disorder of an individual who is covered under the policy (in
such case, the manifestation of a disease or disorder in one
individual cannot also be used as genetic information about
other group members and to further increase the premium for
the employer).''.
(b) Limitations on Genetic Testing and Genetic
Information.--
(1) In general.--Section 1882 of the Social Security Act
(42 U.S.C. 1395ss) is amended by adding at the end the
following:
``(x) Limitations on Genetic Testing and Information.--
``(1) Genetic testing.--
``(A) Limitation on requesting or requiring genetic
testing.--An issuer of a medicare supplemental policy shall
not request or require an individual or a family member of
such individual to undergo a genetic test.
``(B) Rule of construction.--Subparagraph (A) shall not be
construed to limit the authority of a health care
professional who is providing health care services to an
individual to request that such individual undergo a genetic
test.
``(C) Rule of construction regarding payment.--
``(i) In general.--Nothing in subparagraph (A) shall be
construed to preclude an issuer of a medicare supplemental
policy from obtaining and using the results of a genetic test
in making a determination regarding payment (as such term is
defined for the purposes of applying the regulations
promulgated by the Secretary under part C of title XI and
section 264 of the Health Insurance Portability and
Accountability Act of 1996, as may be revised from time to
time) consistent with subsection (s)(2)(E).
``(ii) Limitation.--For purposes of clause (i), an issuer
of a medicare supplemental policy may request only the
minimum amount of information necessary to accomplish the
intended purpose.
``(D) Research exception.--Notwithstanding subparagraph
(A), an issuer of a medicare supplemental policy may request,
but not require, that an individual or a family member of
such individual undergo a genetic test if each of the
following conditions is met:
``(i) The request is made pursuant to research that
complies with part 46 of title 45, Code of Federal
Regulations, or equivalent Federal regulations, and any
applicable State or local law or regulations for the
protection of human subjects in research.
``(ii) The issuer clearly indicates to each individual, or
in the case of a minor child, to the legal guardian of such
child, to whom the request is made that--

``(I) compliance with the request is voluntary; and
``(II) non-compliance will have no effect on enrollment
status or premium or contribution amounts.

``(iii) No genetic information collected or acquired under
this subparagraph shall be used for underwriting,
determination of eligibility to enroll or maintain enrollment
status, premium rating, or the creation, renewal, or
replacement of a plan, contract, or coverage for health
insurance or health benefits.
``(iv) The issuer notifies the Secretary in writing that
the issuer is conducting activities pursuant to the exception
provided for under this subparagraph, including a description
of the activities conducted.
``(v) The issuer complies with such other conditions as the
Secretary may by regulation require for activities conducted
under this subparagraph.
``(2) Prohibition on collection of genetic information.--
``(A) In general.--An issuer of a medicare supplemental
policy shall not request, require, or purchase genetic
information for underwriting purposes (as defined in
paragraph (3)).
``(B) Prohibition on collection of genetic information
prior to enrollment.--An issuer of a medicare supplemental
policy shall not request, require, or purchase genetic
information with respect to any individual prior to such
individual's enrollment under the policy in connection with
such enrollment.
``(C) Incidental collection.--If an issuer of a medicare
supplemental policy obtains genetic information incidental to
the requesting, requiring, or purchasing of other information
concerning any individual, such request, requirement, or
purchase shall not be considered a violation of subparagraph
(B) if such request, requirement, or purchase is not in
violation of subparagraph (A).
``(3) Definitions.--In this subsection:
``(A) Family member.--The term `family member' means with
respect to an individual, any other individual who is a
first-degree, second-degree, third-degree, or fourth-degree
relative of such individual.
``(B) Genetic information.--
``(i) In general.--The term `genetic information' means,
with respect to any individual, information about--

``(I) such individual's genetic tests,
``(II) the genetic tests of family members of such
individual, and
``(III) subject to clause (iv), the manifestation of a
disease or disorder in family members of such individual.

``(ii) Inclusion of genetic services and participation in
genetic research.--Such term includes, with respect to any
individual, any request for, or receipt of, genetic services,
or participation in clinical research which includes genetic
services, by such individual or any family member of such
individual.
``(iii) Exclusions.--The term `genetic information' shall
not include information about the sex or age of any
individual.
``(C) Genetic test.--
``(i) In general.--The term `genetic test' means an
analysis of human DNA, RNA, chromosomes, proteins, or
metabolites, that detects genotypes, mutations, or
chromosomal changes.
``(ii) Exceptions.--The term `genetic test' does not mean--

``(I) an analysis of proteins or metabolites that does not
detect genotypes, mutations, or chromosomal changes; or
``(II) an analysis of proteins or metabolites that is
directly related to a manifested disease, disorder, or
pathological condition that could reasonably be detected by a
health care professional with appropriate training and
expertise in the field of medicine involved.

``(D) Genetic services.--The term `genetic services'
means--
``(i) a genetic test;
``(ii) genetic counseling (including obtaining,
interpreting, or assessing genetic information); or
``(iii) genetic education.
``(E) Underwriting purposes.--The term `underwriting
purposes' means, with respect to a medicare supplemental
policy--
``(i) rules for, or determination of, eligibility
(including enrollment and continued eligibility) for benefits
under the policy;
``(ii) the computation of premium or contribution amounts
under the policy;

[[Page H2967]]

``(iii) the application of any pre-existing condition
exclusion under the policy; and
``(iv) other activities related to the creation, renewal,
or replacement of a contract of health insurance or health
benefits.
``(F) Issuer of a medicare supplemental policy.--The term
`issuer of a medicare supplemental policy' includes a third-
party administrator or other person acting for or on behalf
of such issuer.''.
(2) Application to genetic information of a fetus or
embryo.--Section 1882(x) of such Act, as added by paragraph
(1), is further amended by adding at the end the following:
``(4) Genetic information of a fetus or embryo.--Any
reference in this section to genetic information concerning
an individual or family member of an individual shall--
``(A) with respect to such an individual or family member
of an individual who is a pregnant woman, include genetic
information of any fetus carried by such pregnant woman; and
``(B) with respect to an individual or family member
utilizing an assisted reproductive technology, include
genetic information of any embryo legally held by the
individual or family member.''.
(3) Conforming amendment.--Section 1882(o) of the Social
Security Act (42 U.S.C. 1395ss(o)) is amended by adding at
the end the following:
``(4) The issuer of the medicare supplemental policy
complies with subsection (s)(2)(E) and subsection (x).''.
(c) Effective Date.--The amendments made by this section
shall apply with respect to an issuer of a medicare
supplemental policy for policy years beginning on or after
the date that is 1 year after the date of enactment of this
Act.
(d) Transition Provisions.--
(1) In general.--If the Secretary of Health and Human
Services identifies a State as requiring a change to its
statutes or regulations to conform its regulatory program to
the changes made by this section, the State regulatory
program shall not be considered to be out of compliance with
the requirements of section 1882 of the Social Security Act
due solely to failure to make such change until the date
specified in paragraph (4).
(2) NAIC standards.--If, not later than June 30, 2008, the
National Association of Insurance Commissioners (in this
subsection referred to as the ``NAIC'') modifies its NAIC
Model Regulation relating to section 1882 of the Social
Security Act (referred to in such section as the 1991 NAIC
Model Regulation, as subsequently modified) to conform to the
amendments made by this section, such revised regulation
incorporating the modifications shall be considered to be the
applicable NAIC model regulation (including the revised NAIC
model regulation and the 1991 NAIC Model Regulation) for the
purposes of such section.
(3) Secretary standards.--If the NAIC does not make the
modifications described in paragraph (2) within the period
specified in such paragraph, the Secretary of Health and
Human Services shall, not later than October 1, 2008, make
the modifications described in such paragraph and such
revised regulation incorporating the modifications shall be
considered to be the appropriate regulation for the purposes
of such section.
(4) Date specified.--
(A) In general.--Subject to subparagraph (B), the date
specified in this paragraph for a State is the earlier of--
(i) the date the State changes its statutes or regulations
to conform its regulatory program to the changes made by this
section, or
(ii) October 1, 2008.
(B) Additional legislative action required.--In the case of
a State which the Secretary identifies as--
(i) requiring State legislation (other than legislation
appropriating funds) to conform its regulatory program to the
changes made in this section, but
(ii) having a legislature which is not scheduled to meet in
2008 in a legislative session in which such legislation may
be considered, the date specified in this paragraph is the
first day of the first calendar quarter beginning after the
close of the first legislative session of the State
legislature that begins on or after July 1, 2008. For
purposes of the previous sentence, in the case of a State
that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of
the State legislature.

SEC. 105. PRIVACY AND CONFIDENTIALITY.

(a) In General.--Part C of title XI of the Social Security
Act is amended by adding at the end the following new
section:

``application of hipaa regulations to genetic information

``Sec. 1180. (a) In General.--The Secretary shall revise
the HIPAA privacy regulation (as defined in subsection (b))
so it is consistent with the following:
``(1) Genetic information shall be treated as health
information described in section 1171(4)(B).
``(2) The use or disclosure by a covered entity that is a
group health plan, health insurance issuer that issues health
insurance coverage, or issuer of a medicare supplemental
policy of protected health information that is genetic
information about an individual for underwriting purposes
under the group health plan, health insurance coverage, or
medicare supplemental policy shall not be a permitted use or
disclosure.
``(b) Definitions.--For purposes of this section:
``(1) Genetic information; genetic test; family member.--
The terms `genetic information', `genetic test', and `family
member' have the meanings given such terms in section 2791 of
the Public Health Service Act (42 U.S.C. 300gg-91), as
amended by the Genetic Information Nondiscrimination Act of
2007.
``(2) Group health plan; health insurance coverage;
medicare supplemental policy.--The terms `group health plan'
and `health insurance coverage' have the meanings given such
terms under section 2791 of the Public Health Service Act (42
U.S.C. 300gg-91), and the term `medicare supplemental policy'
has the meaning given such term in section 1882(g).
``(3) HIPAA privacy regulation.--The term `HIPAA privacy
regulation' means the regulations promulgated by the
Secretary under this part and section 264 of the Health
Insurance Portability and Accountability Act of 1996 (42
U.S.C. 1320d-2 note).
``(4) Underwriting purposes.--The term `underwriting
purposes' means, with respect to a group health plan, health
insurance coverage, or a medicare supplemental policy--
``(A) rules for, or determination of, eligibility
(including enrollment and continued eligibility) for, or
determination of, benefits under the plan, coverage, or
policy;
``(B) the computation of premium or contribution amounts
under the plan, coverage, or policy;
``(C) the application of any pre-existing condition
exclusion under the plan, coverage, or policy; and
``(D) other activities related to the creation, renewal, or
replacement of a contract of health insurance or health
benefits.
``(c) Procedure.--The revisions under subsection (a) shall
be made by notice in the Federal Register published not later
than 60 days after the date of the enactment of this section
and shall be effective upon publication, without opportunity
for any prior public comment, but may be revised, consistent
with this section, after opportunity for public comment.
``(d) Enforcement.--In addition to any other sanctions or
remedies that may be available under law, a covered entity
that is a group health plan, health insurance issuer, or
issuer of a medicare supplemental policy and that violates
the HIPAA privacy regulation (as revised under subsection (a)
or otherwise) with respect to the use or disclosure of
genetic information shall be subject to the penalties
described in sections 1176 and 1177 in the same manner and to
the same extent that such penalties apply to violations of
this part.''.
(b) Regulations; Effective Date.--
(1) Regulations.--Not later than 12 months after the date
of the enactment of this Act, the Secretary of Health and
Human Services shall issue final regulations to carry out the
revision required by section 1180(a) of the Social Security
Act, as added by subsection (a). The Secretary has the sole
authority to promulgate such regulations, but shall
promulgate such regulations in consultation with the
Secretaries of Labor and the Treasury.
(2) Effective date.--The amendment made by subsection (a)
shall take effect on the date that is 1 year after the date
of the enactment of this Act.

SEC. 106. ASSURING COORDINATION.

Except as provided in section 105(b)(1), the Secretary of
Health and Human Services, the Secretary of Labor, and the
Secretary of the Treasury shall ensure, through the execution
of an interagency memorandum of understanding among such
Secretaries, that--
(1) regulations, rulings, and interpretations issued by
such Secretaries relating to the same matter over which two
or more such Secretaries have responsibility under this title
(and the amendments made by this title) are administered so
as to have the same effect at all times; and
(2) coordination of policies relating to enforcing the same
requirements through such Secretaries in order to have a
coordinated enforcement strategy that avoids duplication of
enforcement efforts and assigns priorities in enforcement.

TITLE II--PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF GENETIC
INFORMATION

SEC. 201. DEFINITIONS.

In this title:
(1) Commission.--The term ``Commission'' means the Equal
Employment Opportunity Commission as created by section 705
of the Civil Rights Act of 1964 (42 U.S.C. 2000e-4).
(2) Employee; employer; employment agency; labor
organization; member.--
(A) In general.--The term ``employee'' means--
(i) an employee (including an applicant), as defined in
section 701(f) of the Civil Rights Act of 1964 (42 U.S.C.
2000e(f));
(ii) a State employee (including an applicant) described in
section 304(a) of the Government Employee Rights Act of 1991
(42 U.S.C. 2000e-16c(a));
(iii) a covered employee (including an applicant), as
defined in section 101 of the Congressional Accountability
Act of 1995 (2 U.S.C. 1301);
(iv) a covered employee (including an applicant), as
defined in section 411(c) of title 3, United States Code; or
(v) an employee or applicant to which section 717(a) of the
Civil Rights Act of 1964 (42 U.S.C. 2000e-16(a)) applies.
(B) Employer.--The term ``employer'' means--
(i) an employer (as defined in section 701(b) of the Civil
Rights Act of 1964 (42 U.S.C. 2000e(b)));
(ii) an entity employing a State employee described in
section 304(a) of the Government Employee Rights Act of 1991;
(iii) an employing office, as defined in section 101 of the
Congressional Accountability Act of 1995;
(iv) an employing office, as defined in section 411(c) of
title 3, United States Code; or
(v) an entity to which section 717(a) of the Civil Rights
Act of 1964 applies.
(C) Employment agency; labor organization.--The terms
``employment agency'' and ``labor organization'' have the
meanings given

[[Page H2968]]

the terms in section 701 of the Civil Rights Act of 1964 (42
U.S.C. 2000e).
(D) Member.--The term ``member'', with respect to a labor
organization, includes an applicant for membership in a labor
organization.
(3) Family member.--The term ``family member'' means, with
respect to an individual--
(A) a dependent (as such term is used for purposes of
section 701(f)(2) of the Employee Retirement Income Security
Act of 1974) of such individual, and
(B) any other individual who is a first-degree, second-
degree, third-degree, or fourth-degree relative of such
individual or of an individual described in subparagraph (A).
(4) Genetic information.--
(A) In general.--The term ``genetic information'' means,
with respect to any individual, information about--
(i) such individual's genetic tests,
(ii) the genetic tests of family members of such
individual, and
(iii) the manifestation of a disease or disorder in family
members of such individual.
(B) Inclusion of genetic services and participation in
genetic research.--Such term includes, with respect to any
individual, any request for, or receipt of, genetic services,
or participation in clinical research which includes genetic
services, by such individual or any family member of such
individual.
(C) Exclusions.--The term ``genetic information'' shall not
include information about the sex or age of any individual.
(5) Genetic monitoring.--The term ``genetic monitoring''
means the periodic examination of employees to evaluate
acquired modifications to their genetic material, such as
chromosomal damage or evidence of increased occurrence of
mutations, that may have developed in the course of
employment due to exposure to toxic substances in the
workplace, in order to identify, evaluate, and respond to the
effects of or control adverse environmental exposures in the
workplace.
(6) Genetic services.--The term ``genetic services''
means--
(A) a genetic test;
(B) genetic counseling (including obtaining, interpreting,
or assessing genetic information); or
(C) genetic education.
(7) Genetic test.--
(A) In general.--The term ``genetic test'' means an
analysis of human DNA, RNA, chromosomes, proteins, or
metabolites, that detects genotypes, mutations, or
chromosomal changes.
(B) Exceptions.--The term ``genetic test'' does not mean an
analysis of proteins or metabolites that does not detect
genotypes, mutations, or chromosomal changes.

SEC. 202. EMPLOYER PRACTICES.

(a) Discrimination Based on Genetic Information.--It shall
be an unlawful employment practice for an employer--
(1) to fail or refuse to hire, or to discharge, any
employee, or otherwise to discriminate against any employee
with respect to the compensation, terms, conditions, or
privileges of employment of the employee, because of genetic
information with respect to the employee; or
(2) to limit, segregate, or classify the employees of the
employer in any way that would deprive or tend to deprive any
employee of employment opportunities or otherwise adversely
affect the status of the employee as an employee, because of
genetic information with respect to the employee.
(b) Acquisition of Genetic Information.--It shall be an
unlawful employment practice for an employer to request,
require, or purchase genetic information with respect to an
employee or a family member of the employee except--
(1) where an employer inadvertently requests or requires
family medical history of the employee or family member of
the employee;
(2) where--
(A) health or genetic services are offered by the employer,
including such services offered as part of a wellness
program;
(B) the employee provides prior, knowing, voluntary, and
written authorization;
(C) only the employee (or family member if the family
member is receiving genetic services) and the licensed health
care professional or board certified genetic counselor
involved in providing such services receive individually
identifiable information concerning the results of such
services; and
(D) any individually identifiable genetic information
provided under subparagraph (C) in connection with the
services provided under subparagraph (A) is only available
for purposes of such services and shall not be disclosed to
the employer except in aggregate terms that do not disclose
the identity of specific employees;
(3) where an employer requests or requires family medical
history from the employee to comply with the certification
provisions of section 103 of the Family and Medical Leave Act
of 1993 (29 U.S.C. 2613) or such requirements under State
family and medical leave laws;
(4) where an employer purchases documents that are
commercially and publicly available (including newspapers,
magazines, periodicals, and books, but not including medical
databases or court records) that include family medical
history;
(5) where the information involved is to be used for
genetic monitoring of the biological effects of toxic
substances in the workplace, but only if--
(A) the employer provides written notice of the genetic
monitoring to the employee;
(B)(i) the employee provides prior, knowing, voluntary, and
written authorization; or
(ii) the genetic monitoring is required by Federal or State
law;
(C) the employee is informed of individual monitoring
results;
(D) the monitoring is in compliance with--
(i) any Federal genetic monitoring regulations, including
any such regulations that may be promulgated by the Secretary
of Labor pursuant to the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.), the Federal Mine Safety and
Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic
Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) State genetic monitoring regulations, in the case of a
State that is implementing genetic monitoring regulations
under the authority of the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.); and
(E) the employer, excluding any licensed health care
professional or board certified genetic counselor that is
involved in the genetic monitoring program, receives the
results of the monitoring only in aggregate terms that do not
disclose the identity of specific employees; or
(6) where the employer conducts DNA analysis for law
enforcement purposes as a forensic laboratory, and such
analysis is included in the Combined DNA Index System
pursuant to section 210304 of the Violent Crime Control and
Law Enforcement Act of 1994 (42 U.S.C. 14132), and requests
or requires genetic information of such employer's employees,
but only to the extent that such genetic information is used
for analysis of DNA identification markers for quality
control to detect sample contamination.
(c) Preservation of Protections.--In the case of
information to which any of paragraphs (1) through (6) of
subsection (b) applies, such information may not be used in
violation of paragraph (1) or (2) of subsection (a) or
treated or disclosed in a manner that violates section 206.

SEC. 203. EMPLOYMENT AGENCY PRACTICES.

(a) Discrimination Based on Genetic Information.--It shall
be an unlawful employment practice for an employment agency--
(1) to fail or refuse to refer for employment, or otherwise
to discriminate against, any individual because of genetic
information with respect to the individual;
(2) to limit, segregate, or classify individuals or fail or
refuse to refer for employment any individual in any way that
would deprive or tend to deprive any individual of employment
opportunities, or otherwise adversely affect the status of
the individual as an employee, because of genetic information
with respect to the individual; or
(3) to cause or attempt to cause an employer to
discriminate against an individual in violation of this
title.
(b) Acquisition of Genetic Information.--It shall be an
unlawful employment practice for an employment agency to
request, require, or purchase genetic information with
respect to an individual or a family member of the individual
except--
(1) where an employment agency inadvertently requests or
requires family medical history of the individual or family
member of the individual;
(2) where--
(A) health or genetic services are offered by the
employment agency, including such services offered as part of
a wellness program;
(B) the individual provides prior, knowing, voluntary, and
written authorization;
(C) only the individual (or family member if the family
member is receiving genetic services) and the licensed health
care professional or board certified genetic counselor
involved in providing such services receive individually
identifiable information concerning the results of such
services; and
(D) any individually identifiable genetic information
provided under subparagraph (C) in connection with the
services provided under subparagraph (A) is only available
for purposes of such services and shall not be disclosed to
the employment agency except in aggregate terms that do not
disclose the identity of specific individuals;
(3) where an employment agency requests or requires family
medical history from the individual to comply with the
certification provisions of section 103 of the Family and
Medical Leave Act of 1993 (29 U.S.C. 2613) or such
requirements under State family and medical leave laws;
(4) where an employment agency purchases documents that are
commercially and publicly available (including newspapers,
magazines, periodicals, and books, but not including medical
databases or court records) that include family medical
history; or
(5) where the information involved is to be used for
genetic monitoring of the biological effects of toxic
substances in the workplace, but only if--
(A) the employment agency provides written notice of the
genetic monitoring to the individual;
(B)(i) the individual provides prior, knowing, voluntary,
and written authorization; or
(ii) the genetic monitoring is required by Federal or State
law;
(C) the individual is informed of individual monitoring
results;
(D) the monitoring is in compliance with--
(i) any Federal genetic monitoring regulations, including
any such regulations that may be promulgated by the Secretary
of Labor pursuant to the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.), the Federal Mine Safety and
Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic
Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) State genetic monitoring regulations, in the case of a
State that is implementing genetic monitoring regulations
under the authority of the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.); and
(E) the employment agency, excluding any licensed health
care professional or board certified genetic counselor that
is involved in the genetic monitoring program, receives the
results

[[Page H2969]]

of the monitoring only in aggregate terms that do not
disclose the identity of specific individuals.
(c) Preservation of Protections.--In the case of
information to which any of paragraphs (1) through (5) of
subsection (b) applies, such information may not be used in
violation of paragraph (1), (2), or (3) of subsection (a) or
treated or disclosed in a manner that violates section 206.

SEC. 204. LABOR ORGANIZATION PRACTICES.

(a) Discrimination Based on Genetic Information.--It shall
be an unlawful employment practice for a labor organization--
(1) to exclude or to expel from the membership of the
organization, or otherwise to discriminate against, any
member because of genetic information with respect to the
member;
(2) to limit, segregate, or classify the members of the
organization, or fail or refuse to refer for employment any
member, in any way that would deprive or tend to deprive any
member of employment opportunities, or otherwise adversely
affect the status of the member as an employee, because of
genetic information with respect to the member; or
(3) to cause or attempt to cause an employer to
discriminate against a member in violation of this title.
(b) Acquisition of Genetic Information.--It shall be an
unlawful employment practice for a labor organization to
request, require, or purchase genetic information with
respect to a member or a family member of the member except--
(1) where a labor organization inadvertently requests or
requires family medical history of the member or family
member of the member;
(2) where--
(A) health or genetic services are offered by the labor
organization, including such services offered as part of a
wellness program;
(B) the member provides prior, knowing, voluntary, and
written authorization;
(C) only the member (or family member if the family member
is receiving genetic services) and the licensed health care
professional or board certified genetic counselor involved in
providing such services receive individually identifiable
information concerning the results of such services; and
(D) any individually identifiable genetic information
provided under subparagraph (C) in connection with the
services provided under subparagraph (A) is only available
for purposes of such services and shall not be disclosed to
the labor organization except in aggregate terms that do not
disclose the identity of specific members;
(3) where a labor organization requests or requires family
medical history from the members to comply with the
certification provisions of section 103 of the Family and
Medical Leave Act of 1993 (29 U.S.C. 2613) or such
requirements under State family and medical leave laws;
(4) where a labor organization purchases documents that are
commercially and publicly available (including newspapers,
magazines, periodicals, and books, but not including medical
databases or court records) that include family medical
history; or
(5) where the information involved is to be used for
genetic monitoring of the biological effects of toxic
substances in the workplace, but only if--
(A) the labor organization provides written notice of the
genetic monitoring to the member;
(B)(i) the member provides prior, knowing, voluntary, and
written authorization; or
(ii) the genetic monitoring is required by Federal or State
law;
(C) the member is informed of individual monitoring
results;
(D) the monitoring is in compliance with--
(i) any Federal genetic monitoring regulations, including
any such regulations that may be promulgated by the Secretary
of Labor pursuant to the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.), the Federal Mine Safety and
Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic
Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) State genetic monitoring regulations, in the case of a
State that is implementing genetic monitoring regulations
under the authority of the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.); and
(E) the labor organization, excluding any licensed health
care professional or board certified genetic counselor that
is involved in the genetic monitoring program, receives the
results of the monitoring only in aggregate terms that do not
disclose the identity of specific members.
(c) Preservation of Protections.--In the case of
information to which any of paragraphs (1) through (5) of
subsection (b) applies, such information may not be used in
violation of paragraph (1), (2), or (3) of subsection (a) or
treated or disclosed in a manner that violates section 206.

SEC. 205. TRAINING PROGRAMS.

(a) Discrimination Based on Genetic Information.--It shall
be an unlawful employment practice for any employer, labor
organization, or joint labor-management committee controlling
apprenticeship or other training or retraining, including on-
the-job training programs--
(1) to discriminate against any individual because of
genetic information with respect to the individual in
admission to, or employment in, any program established to
provide apprenticeship or other training or retraining;
(2) to limit, segregate, or classify the applicants for or
participants in such apprenticeship or other training or
retraining, or fail or refuse to refer for employment any
individual, in any way that would deprive or tend to deprive
any individual of employment opportunities, or otherwise
adversely affect the status of the individual as an employee,
because of genetic information with respect to the
individual; or
(3) to cause or attempt to cause an employer to
discriminate against an applicant for or a participant in
such apprenticeship or other training or retraining in
violation of this title.
(b) Acquisition of Genetic Information.--It shall be an
unlawful employment practice for an employer, labor
organization, or joint labor-management committee described
in subsection (a) to request, require, or purchase genetic
information with respect to an individual or a family member
of the individual except--
(1) where the employer, labor organization, or joint labor-
management committee inadvertently requests or requires
family medical history of the individual or family member of
the individual;
(2) where--
(A) health or genetic services are offered by the employer,
labor organization, or joint labor-management committee,
including such services offered as part of a wellness
program;
(B) the individual provides prior, knowing, voluntary, and
written authorization;
(C) only the individual (or family member if the family
member is receiving genetic services) and the licensed health
care professional or board certified genetic counselor
involved in providing such services receive individually
identifiable information concerning the results of such
services; and
(D) any individually identifiable genetic information
provided under subparagraph (C) in connection with the
services provided under subparagraph (A) is only available
for purposes of such services and shall not be disclosed to
the employer, labor organization, or joint labor-management
committee except in aggregate terms that do not disclose the
identity of specific individuals;
(3) where the employer, labor organization, or joint labor-
management committee requests or requires family medical
history from the individual to comply with the certification
provisions of section 103 of the Family and Medical Leave Act
of 1993 (29 U.S.C. 2613) or such requirements under State
family and medical leave laws;
(4) where the employer, labor organization, or joint labor-
management committee purchases documents that are
commercially and publicly available (including newspapers,
magazines, periodicals, and books, but not including medical
databases or court records) that include family medical
history;
(5) where the information involved is to be used for
genetic monitoring of the biological effects of toxic
substances in the workplace, but only if--
(A) the employer, labor organization, or joint labor-
management committee provides written notice of the genetic
monitoring to the individual;
(B)(i) the individual provides prior, knowing, voluntary,
and written authorization; or
(ii) the genetic monitoring is required by Federal or State
law;
(C) the individual is informed of individual monitoring
results;
(D) the monitoring is in compliance with--
(i) any Federal genetic monitoring regulations, including
any such regulations that may be promulgated by the Secretary
of Labor pursuant to the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.), the Federal Mine Safety and
Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic
Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) State genetic monitoring regulations, in the case of a
State that is implementing genetic monitoring regulations
under the authority of the Occupational Safety and Health Act
of 1970 (29 U.S.C. 651 et seq.); and
(E) the employer, labor organization, or joint labor-
management committee, excluding any licensed health care
professional or board certified genetic counselor that is
involved in the genetic monitoring program, receives the
results of the monitoring only in aggregate terms that do not
disclose the identity of specific individuals; or
(6) where the employer conducts DNA analysis for law
enforcement purposes as a forensic laboratory, and such
analysis is included in the Combined DNA Index System
pursuant to section 210304 of the Violent Crime Control and
Law Enforcement Act of 1994 (42 U.S.C. 14132), and requests
or requires genetic information of such employer's
apprentices or trainees, but only to the extent that such
genetic information is used for analysis of DNA
identification markers for quality control to detect sample
contamination.
(c) Preservation of Protections.--In the case of
information to which any of paragraphs (1) through (6) of
subsection (b) applies, such information may not be used in
violation of paragraph (1), (2), or (3) of subsection (a) or
treated or disclosed in a manner that violates section 206.

SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION.

(a) Treatment of Information as Part of Confidential
Medical Record.--If an employer, employment agency, labor
organization, or joint labor-management committee possesses
genetic information about an employee or member, such
information shall be maintained on separate forms and in
separate medical files and be treated as a confidential
medical record of the employee or member. An employer,
employment agency, labor organization, or joint labor-
management committee shall be considered to be in compliance
with the maintenance of information requirements of this
subsection with respect to genetic information subject to
this subsection that is maintained with and treated as a
confidential medical record under section 102(d)(3)(B) of the
Americans With Disabilities Act (42 U.S.C. 12112(d)(3)(B)).
(b) Limitation on Disclosure.--An employer, employment
agency, labor organization,

[[Page H2970]]

or joint labor-management committee shall not disclose
genetic information concerning an employee or member except--
(1) to the employee or member of a labor organization (or
family member if the family member is receiving the genetic
services) at the written request of the employee or member of
such organization;
(2) to an occupational or other health researcher if the
research is conducted in compliance with the regulations and
protections provided for under part 46 of title 45, Code of
Federal Regulations;
(3) in response to an order of a court, except that--
(A) the employer, employment agency, labor organization, or
joint labor-management committee may disclose only the
genetic information expressly authorized by such order; and
(B) if the court order was secured without the knowledge of
the employee or member to whom the information refers, the
employer, employment agency, labor organization, or joint
labor-management committee shall inform the employee or
member of the court order and any genetic information that
was disclosed pursuant to such order;
(4) to government officials who are investigating
compliance with this title if the information is relevant to
the investigation;
(5) to the extent that such disclosure is made in
connection with the employee's compliance with the
certification provisions of section 103 of the Family and
Medical Leave Act of 1993 (29 U.S.C. 2613) or such
requirements under State family and medical leave laws; or
(6) to a Federal, State, or local public health agency only
with regard to information that is described in section
201(4)(A)(iii) and that concerns a contagious disease that
presents an imminent hazard of death or life-threatening
illness, and that the employee whose family member or family
members is or are the subject of a disclosure under this
paragraph is notified of such disclosure.
(c) Relationship to HIPAA Regulations.--With respect to the
regulations promulgated by the Secretary of Health and Human
Services under part C of title XI of the Social Security Act
(42 U.S.C. 1320d et seq.) and section 264 of the Health
Insurance Portability and Accountability Act of 1996 (42
U.S.C. 1320d-2 note), this title does not prohibit a covered
entity under such regulations from any use or disclosure of
health information that is authorized for the covered entity
under such regulations. The previous sentence does not affect
the authority of such Secretary to modify such regulations.

SEC. 207. REMEDIES AND ENFORCEMENT.

(a) Employees Covered by Title VII of the Civil Rights Act
of 1964.--
(1) In general.--The powers, procedures, and remedies
provided in sections 705, 706, 707, 709, 710, and 711 of the
Civil Rights Act of 1964 (42 U.S.C. 2000e-4 et seq.) to the
Commission, the Attorney General, or any person, alleging a
violation of title VII of that Act (42 U.S.C. 2000e et seq.)
shall be the powers, procedures, and remedies this title
provides to the Commission, the Attorney General, or any
person, respectively, alleging an unlawful employment
practice in violation of this title against an employee
described in section 201(2)(A)(i), except as provided in
paragraphs (2) and (3).
(2) Costs and fees.--The powers, remedies, and procedures
provided in subsections (b) and (c) of section 722 of the
Revised Statutes of the United States (42 U.S.C. 1988), shall
be powers, remedies, and procedures this title provides to
the Commission, the Attorney General, or any person, alleging
such a practice.
(3) Damages.--The powers, remedies, and procedures provided
in section 1977A of the Revised Statutes of the United States
(42 U.S.C. 1981a), including the limitations contained in
subsection (b)(3) of such section 1977A, shall be powers,
remedies, and procedures this title provides to the
Commission, the Attorney General, or any person, alleging
such a practice (not an employment practice specifically
excluded from coverage under section 1977A(a)(1) of the
Revised Statutes of the United States).
(b) Employees Covered by Government Employee Rights Act of
1991.--
(1) In general.--The powers, remedies, and procedures
provided in sections 302 and 304 of the Government Employee
Rights Act of 1991 (42 U.S.C. 2000e-16b, 2000e-16c) to the
Commission, or any person, alleging a violation of section
302(a)(1) of that Act (42 U.S.C. 2000e-16b(a)(1)) shall be
the powers, remedies, and procedures this title provides to
the Commission, or any person, respectively, alleging an
unlawful employment practice in violation of this title
against an employee described in section 201(2)(A)(ii),
except as provided in paragraphs (2) and (3).
(2) Costs and fees.--The powers, remedies, and procedures
provided in subsections (b) and (c) of section 722 of the
Revised Statutes of the United States (42 U.S.C. 1988), shall
be powers, remedies, and procedures this title provides to
the Commission, or any person, alleging such a practice.
(3) Damages.--The powers, remedies, and procedures provided
in section 1977A of the Revised Statutes of the United States
(42 U.S.C. 1981a), including the limitations contained in
subsection (b)(3) of such section 1977A, shall be powers,
remedies, and procedures this title provides to the
Commission, or any person, alleging such a practice (not an
employment practice specifically excluded from coverage under
section 1977A(a)(1) of the Revised Statutes of the United
States).
(c) Employees Covered by Congressional Accountability Act
of 1995.--
(1) In general.--The powers, remedies, and procedures
provided in the Congressional Accountability Act of 1995 (2
U.S.C. 1301 et seq.) to the Board (as defined in section 101
of that Act (2 U.S.C. 1301)), or any person, alleging a
violation of section 201(a)(1) of that Act (42 U.S.C.
1311(a)(1)) shall be the powers, remedies, and procedures
this title provides to that Board, or any person, alleging an
unlawful employment practice in violation of this title
against an employee described in section 201(2)(A)(iii),
except as provided in paragraphs (2) and (3).
(2) Costs and fees.--The powers, remedies, and procedures
provided in subsections (b) and (c) of section 722 of the
Revised Statutes of the United States (42 U.S.C. 1988), shall
be powers, remedies, and procedures this title provides to
that Board, or any person, alleging such a practice.
(3) Damages.--The powers, remedies, and procedures provided
in section 1977A of the Revised Statutes of the United States
(42 U.S.C. 1981a), including the limitations contained in
subsection (b)(3) of such section 1977A, shall be powers,
remedies, and procedures this title provides to that Board,
or any person, alleging such a practice (not an employment
practice specifically excluded from coverage under section
1977A(a)(1) of the Revised Statutes of the United States).
(4) Other applicable provisions.--With respect to a claim
alleging a practice described in paragraph (1), title III of
the Congressional Accountability Act of 1995 (2 U.S.C. 1381
et seq.) shall apply in the same manner as such title applies
with respect to a claim alleging a violation of section
201(a)(1) of such Act (2 U.S.C. 1311(a)(1)).
(d) Employees Covered by Chapter 5 of Title 3, United
States Code.--
(1) In general.--The powers, remedies, and procedures
provided in chapter 5 of title 3, United States Code, to the
President, the Commission, the Merit Systems Protection
Board, or any person, alleging a violation of section
411(a)(1) of that title, shall be the powers, remedies, and
procedures this title provides to the President, the
Commission, such Board, or any person, respectively, alleging
an unlawful employment practice in violation of this title
against an employee described in section 201(2)(A)(iv),
except as provided in paragraphs (2) and (3).
(2) Costs and fees.--The powers, remedies, and procedures
provided in subsections (b) and (c) of section 722 of the
Revised Statutes of the United States (42 U.S.C. 1988), shall
be powers, remedies, and procedures this title provides to
the President, the Commission, such Board, or any person,
alleging such a practice.
(3) Damages.--The powers, remedies, and procedures provided
in section 1977A of the Revised Statutes of the United States
(42 U.S.C. 1981a), including the limitations contained in
subsection (b)(3) of such section 1977A, shall be powers,
remedies, and procedures this title provides to the
President, the Commission, such Board, or any person,
alleging such a practice (not an employment practice
specifically excluded from coverage under section 1977A(a)(1)
of the Revised Statutes of the United States).
(e) Employees Covered by Section 717 of the Civil Rights
Act of 1964.--
(1) In general.--The powers, remedies, and procedures
provided in section 717 of the Civil Rights Act of 1964 (42
U.S.C. 2000e-16) to the Commission, the Attorney General, the
Librarian of Congress, or any person, alleging a violation of
that section shall be the powers, remedies, and procedures
this title provides to the Commission, the Attorney General,
the Librarian of Congress, or any person, respectively,
alleging an unlawful employment practice in violation of this
title against an employee or applicant described in section
201(2)(A)(v), except as provided in paragraphs (2) and (3).
(2) Costs and fees.--The powers, remedies, and procedures
provided in subsections (b) and (c) of section 722 of the
Revised Statutes of the United States (42 U.S.C. 1988), shall
be powers, remedies, and procedures this title provides to
the Commission, the Attorney General, the Librarian of
Congress, or any person, alleging such a practice.
(3) Damages.--The powers, remedies, and procedures provided
in section 1977A of the Revised Statutes of the United States
(42 U.S.C. 1981a), including the limitations contained in
subsection (b)(3) of such section 1977A, shall be powers,
remedies, and procedures this title provides to the
Commission, the Attorney General, the Librarian of Congress,
or any person, alleging such a practice (not an employment
practice specifically excluded from coverage under section
1977A(a)(1) of the Revised Statutes of the United States).
(f) Prohibition Against Retaliation.--No person shall
discriminate against any individual because such individual
has opposed any act or practice made unlawful by this title
or because such individual made a charge, testified,
assisted, or participated in any manner in an investigation,
proceeding, or hearing under this title. The remedies and
procedures otherwise provided for under this section shall be
available to aggrieved individuals with respect to violations
of this subsection.
(g) Definition.--In this section, the term ``Commission''
means the Equal Employment Opportunity Commission.

SEC. 208. DISPARATE IMPACT.

(a) General Rule.--Notwithstanding any other provision of
this Act, ``disparate impact'', as that term is used in
section 703(k) of the Civil Rights Act of 1964 (42 U.S.C.
2000e-2(k)), on the basis of genetic information does not
establish a cause of action under this Act.
(b) Commission.--On the date that is 6 years after the date
of enactment of this Act, there shall be established a
commission, to be known as the Genetic Nondiscrimination
Study Commission (referred to in this section as the
``Commission'') to review the developing science of genetics
and to make recommendations to Congress regarding whether to
provide a disparate impact cause of action under this Act.

[[Page H2971]]

(c) Membership.--
(1) In general.--The Commission shall be composed of 8
members, of which--
(A) 1 member shall be appointed by the Majority Leader of
the Senate;
(B) 1 member shall be appointed by the Minority Leader of
the Senate;
(C) 1 member shall be appointed by the Chairman of the
Committee on Health, Education, Labor, and Pensions of the
Senate;
(D) 1 member shall be appointed by the ranking minority
member of the Committee on Health, Education, Labor, and
Pensions of the Senate;
(E) 1 member shall be appointed by the Speaker of the House
of Representatives;
(F) 1 member shall be appointed by the Minority Leader of
the House of Representatives;
(G) 1 member shall be appointed by the Chairman of the
Committee on Education and Labor of the House of
Representatives; and
(H) 1 member shall be appointed by the ranking minority
member of the Committee on Education and Labor of the House
of Representatives.
(2) Compensation and expenses.--The members of the
Commission shall not receive compensation for the performance
of services for the Commission, but shall be allowed travel
expenses, including per diem in lieu of subsistence, at rates
authorized for employees of agencies under subchapter I of
chapter 57 of title 5, United States Code, while away from
their homes or regular places of business in the performance
of services for the Commission.
(d) Administrative Provisions.--
(1) Location.--The Commission shall be located in a
facility maintained by the Equal Employment Opportunity
Commission.
(2) Detail of government employees.--Any Federal Government
employee may be detailed to the Commission without
reimbursement, and such detail shall be without interruption
or loss of civil service status or privilege.
(3) Information from federal agencies.--The Commission may
secure directly from any Federal department or agency such
information as the Commission considers necessary to carry
out the provisions of this section. Upon request of the
Commission, the head of such department or agency shall
furnish such information to the Commission.
(4) Hearings.--The Commission may hold such hearings, sit
and act at such times and places, take such testimony, and
receive such evidence as the Commission considers advisable
to carry out the objectives of this section, except that, to
the extent possible, the Commission shall use existing data
and research.
(5) Postal services.--The Commission may use the United
States mails in the same manner and under the same conditions
as other departments and agencies of the Federal Government.
(e) Report.--Not later than 1 year after all of the members
are appointed to the Commission under subsection (c)(1), the
Commission shall submit to Congress a report that summarizes
the findings of the Commission and makes such recommendations
for legislation as are consistent with this Act.
(f) Authorization of Appropriations.--There are authorized
to be appropriated to the Equal Employment Opportunity
Commission such sums as may be necessary to carry out this
section.

SEC. 209. CONSTRUCTION.

(a) In General.--Nothing in this title shall be construed
to--
(1) limit the rights or protections of an individual under
any other Federal or State statute that provides equal or
greater protection to an individual than the rights or
protections provided for under this title, including the
protections of an individual under the Americans with
Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) (including
coverage afforded to individuals under section 102 of such
Act (42 U.S.C. 12112)), or under the Rehabilitation Act of
1973 (29 U.S.C. 701 et seq.);
(2)(A) limit the rights or protections of an individual to
bring an action under this title against an employer,
employment agency, labor organization, or joint labor-
management committee for a violation of this title; or
(B) provide for enforcement of, or penalties for violation
of, any requirement or prohibition applicable to any
employer, employment agency, labor organization, or joint
labor-management committee subject to enforcement for a
violation under--
(i) the amendments made by title I of this Act;
(ii)(I) subsection (a) of section 701 of the Employee
Retirement Income Security Act of 1974 as such section
applies with respect to genetic information pursuant to
subsection (b)(1)(B) of such section;
(II) section 702(a)(1)(F) of such Act; or
(III) section 702(b)(1) of such Act as such section applies
with respect to genetic information as a health status-
related factor;
(iii)(I) subsection (a) of section 2701 of the Public
Health Service Act as such section applies with respect to
genetic information pursuant to subsection (b)(1)(B) of such
section;
(II) section 2702(a)(1)(F) of such Act; or
(III) section 2702(b)(1) of such Act as such section
applies with respect to genetic information as a health
status-related factor; or
(iv)(I) subsection (a) of section 9801 of the Internal
Revenue Code of 1986 as such section applies with respect to
genetic information pursuant to subsection (b)(1)(B) of such
section;
(II) section 9802(a)(1)(F) of such Act; or
(III) section 9802(b)(1) of such Act as such section
applies with respect to genetic information as a health
status-related factor;
(3) apply to the Armed Forces Repository of Specimen
Samples for the Identification of Remains;
(4) limit or expand the protections, rights, or obligations
of employees or employers under applicable workers'
compensation laws;
(5) limit the authority of a Federal department or agency
to conduct or sponsor occupational or other health research
that is conducted in compliance with the regulations
contained in part 46 of title 45, Code of Federal Regulations
(or any corresponding or similar regulation or rule);
(6) limit the statutory or regulatory authority of the
Occupational Safety and Health Administration or the Mine
Safety and Health Administration to promulgate or enforce
workplace safety and health laws and regulations; or
(7) require any specific benefit for an employee or member
or a family member of an employee or member under any group
health plan or health insurance issuer offering group health
insurance coverage in connection with a group health plan.
(b) Genetic Information of a Fetus or Embryo.--Any
reference in this title to genetic information concerning an
individual or family member of an individual shall--
(1) with respect to such an individual or family member of
an individual who is a pregnant woman, include genetic
information of any fetus carried by such pregnant woman; and
(2) with respect to an individual or family member
utilizing an assisted reproductive technology, include
genetic information of any embryo legally held by the
individual or family member.
(c) Relation to Authorities Under Title I.--With respect to
a group health plan, or a health insurance issuer offering
group health insurance coverage in connection with a group
health plan, this title does not prohibit any activity of
such plan or issuer that is authorized for the plan or issuer
under any provision of law referred to in clauses (i) through
(iv) of subsection (a)(2)(B).

SEC. 210. MEDICAL INFORMATION THAT IS NOT GENETIC
INFORMATION.

An employer, employment agency, labor organization, or
joint labor-management committee shall not be considered to
be in violation of this title based on the use, acquisition,
or disclosure of medical information that is not genetic
information about a manifested disease, disorder, or
pathological condition of an employee or member, including a
manifested disease, disorder, or pathological condition that
has or may have a genetic basis.

SEC. 211. REGULATIONS.

Not later than 1 year after the date of enactment of this
title, the Commission shall issue final regulations to carry
out this title.

SEC. 212. AUTHORIZATION OF APPROPRIATIONS.

There are authorized to be appropriated such sums as may be
necessary to carry out this title (except for section 208).

SEC. 213. EFFECTIVE DATE.

This title takes effect on the date that is 18 months after
the date of enactment of this Act.

TITLE III--MISCELLANEOUS PROVISIONS

SEC. 301. SEVERABILITY.

If any provision of this Act, an amendment made by this
Act, or the application of such provision or amendment to any
person or circumstance is held to be unconstitutional, the
remainder of this Act, the amendments made by this Act, and
the application of such provisions to any person or
circumstance shall not be affected thereby.

SEC. 302. CHILD LABOR PROTECTIONS.

(a) In General.--Section 16(e) of the Fair Labor Standards
Act of 1938 (29 U.S.C. 216(e)) is amended to read as follows:
``(e)(1)(A) Any person who violates the provisions of
sections 12 or 13(c), relating to child labor, or any
regulation issued pursuant to such sections, shall be subject
to a civil penalty not to exceed--
``(i) $11,000 for each employee who was the subject of such
a violation; or
``(ii) $50,000 with regard to each such violation that
causes the death or serious injury of any employee under the
age of 18 years, which penalty may be doubled where the
violation is a repeated or willful violation.
``(B) For purposes of subparagraph (A), the term `serious
injury' means--
``(i) permanent loss or substantial impairment of one of
the senses (sight, hearing, taste, smell, tactile sensation);
``(ii) permanent loss or substantial impairment of the
function of a bodily member, organ, or mental faculty,
including the loss of all or part of an arm, leg, foot, hand
or other body part; or
``(iii) permanent paralysis or substantial impairment that
causes loss of movement or mobility of an arm, leg, foot,
hand or other body part.
``(2) Any person who repeatedly or willfully violates
section 6 or 7, relating to wages, shall be subject to a
civil penalty not to exceed $1,100 for each such violation.
``(3) In determining the amount of any penalty under this
subsection, the appropriateness of such penalty to the size
of the business of the person charged and the gravity of the
violation shall be considered. The amount of any penalty
under this subsection, when finally determined, may be--
``(A) deducted from any sums owing by the United States to
the person charged;
``(B) recovered in a civil action brought by the Secretary
in any court of competent jurisdiction, in which litigation
the Secretary shall be represented by the Solicitor of Labor;
or
``(C) ordered by the court, in an action brought for a
violation of section 15(a)(4) or a repeated or willful
violation of section 15(a)(2), to be paid to the Secretary.
``(4) Any administrative determination by the Secretary of
the amount of any penalty under this subsection shall be
final, unless within 15 days after receipt of notice thereof
by certified mail the person charged with the violation takes
exception to the determination that the violations for which
the penalty is imposed occurred,

[[Page H2972]]

in which event final determination of the penalty shall be
made in an administrative proceeding after opportunity for
hearing in accordance with section 554 of title 5, United
States Code, and regulations to be promulgated by the
Secretary.
``(5) Except for civil penalties collected for violations
of section 12, sums collected as penalties pursuant to this
section shall be applied toward reimbursement of the costs of
determining the violations and assessing and collecting such
penalties, in accordance with the provision of section 2 of
the Act entitled `An Act to authorize the Department of Labor
to make special statistical studies upon payment of the cost
thereof and for other purposes' (29 U.S.C. 9a). Civil
penalties collected for violations of section 12 shall be
deposited in the general fund of the Treasury.''.
(b) Effective Date.--The amendments made by this section
shall take effect on the date of the enactment of this Act.

Motion Offered by Mr. George Miller of California

Mr. GEORGE MILLER of California. Madam Speaker, I have a motion at
the desk.
The SPEAKER pro tempore. The Clerk will designate the motion.
The text of the motion is as follows:

Motion offered by Mr. George Miller of California:
Mr. George Miller of California moves that the House concur
in the Senate amendment to H.R. 493.

The SPEAKER pro tempore. Pursuant to House Resolution 1156, the
motion shall be debatable for 1 hour, with 20 minutes equally divided
and controlled by the chairman and ranking minority member of the
Committee on Education and Labor, 20 minutes equally divided and
controlled by the chairman and ranking minority member of the Committee
on Energy and Commerce, and 20 minutes equally divided and controlled
by the chairman and ranking minority member of the Committee on Ways
and Means.
The gentleman from California (Mr. George Miller), the gentleman from
California (Mr. McKeon), the gentleman from Michigan (Mr. Dingell), the
gentleman from Michigan (Mr. Upton), the gentleman from California (Mr.
Stark), and the gentleman from Michigan (Mr. Camp) each will control 10
minutes.
The Chair recognizes the gentleman from California (Mr. George
Miller).
Mr. GEORGE MILLER of California. Madam Speaker, I ask unanimous
consent to yield my 10 minutes to the Chair of the Commerce Committee,
Mr. Dingell.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. DINGELL. Madam Speaker, I yield myself 2 minutes.
(Mr. DINGELL asked and was given permission to revise and extend his
remarks.)
Mr. DINGELL. Madam Speaker, today we consider H.R. 493, the Genetic
Information Nondiscrimination Act. I first wish to congratulate
Representative Slaughter for her leadership on this bill on which she
has worked for better than 13 years. It has been a privilege to join
her in that work, and I am delighted that it has brought us to today's
vote.
Recent advances in research have made it possible to identify the
genetic basis for human diseases. These breakthroughs, magnificent as
they are, have opened the door to early detection and treatment of
diseases and prevention strategies geared to a person's genetic makeup.
At the same time, this information can also be used to unfairly
discriminate against or stigmatize individuals when it comes to
insurance and employment.
To protect individuals from insurance discrimination, H.R. 493 would
prohibit health insurers, both in group and individual markets, from
canceling, denying, refusing to renew or changing the terms or premiums
of coverage based solely on genetic predispositions towards specific
diseases.
Additionally, in order to protect individuals from employment
discrimination, this bill would make it unlawful for employers or other
hiring entities to use an individual's genetic information regarding
hiring, firing, promotion or other terms and conditions of employment.
The legislation requires that genetic information be treated as a part
of the individual's confidential medical record and that employers
maintain separate forms or files for any genetic information that they
may obtain.
The House of Representatives passed this legislation a year ago with
a strong bipartisan vote of 420-3. Unfortunately, the measure has been
held up in the Senate, as usual. With these concerns now resolved, we
are close to providing Americans the ability to undergo genetic testing
that may indicate early treatment and prevention of diseases such as
cancer, heart disease, diabetes and Alzheimer's, without fear of losing
their health insurance or affecting adversely the conditions of their
employment.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. DINGELL. I yield myself 1 additional minute.
The bill currently before us includes clarifying language intended to
ease the concerns of some of my colleagues and is identical to the
version passed by the Senate last week. These changes include a
firewall between title I and II of the bill. The modifications clarify
that employers are not liable for health insurance violations under
civil rights laws unless the employer has separately violated a
provision of title II governing employers.
The changes also make it clear that while individuals are protected
from discrimination based on genetic predisposition, the authority of
insurance companies to base coverage and pricing on the actual presence
of a disease is not affected.
These changes broaden the base of support for the bill and allow us
to bring it to the House floor with the expectation that it will be
signed into law by the President.
I thank my colleagues on both sides of the aisle for their hard work
on this bill and for coming together to make this legislation a
reality.
Madam Speaker, I ask unanimous consent to yield back the remainder of
my time to my distinguished friend from California, the Honorable
George Miller, chairman of the Education and Labor Committee, and that
he be permitted to yield that time in accordance with his whims.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Michigan?
There was no objection.
Mr. McKEON. Madam Speaker, I rise in support of this legislation, and
yield myself such time as I may consume.
Madam Speaker, while it is not a perfect bill, I do believe it
contains a number of important improvements over prior versions of this
legislation, including that which I supported a little over a year ago
on the House floor. More importantly, it marks a commitment by this
Congress to ensure that the laws of the United States protect American
workers and health care consumers from discrimination on the basis of
their genetic makeup. Because that goal is so critical, I will vote for
this bill today, and urge my colleagues to do likewise.
Before I turn to the substance of my remarks, I would like to commend
my colleague and fellow Member on the Committee on Education and Labor,
Representative Judy Biggert, for her years of work and dedication on
this important issue. She has been persistent and effective on so many
issues that have come before this committee and this Congress and she
should be commended for adding this important bill to her list of
legislative accomplishments. I also want to commend the gentlewoman
from New York, the distinguished Chair of the Rules Committee, Ms.
Slaughter, who has been Mrs. Biggert's partner in this effort.
As I noted during our committee's consideration of this bill last
year, I believe the title of the legislation before us, the Genetic
Information Nondiscrimination Act, embodies a proposition that all
Members of our committee and indeed our Congress would endorse. Simply
put, no employee should face discrimination on the basis of his or her
genetic makeup or on any other characteristic other than his or her
ability to do the job. Similarly, no employee should risk his or her
health insurance status simply because of the possibility that they
might some day develop an illness.
This bill was drafted with those fundamental principles in mind, and
I believe that through the legislative process, we have taken steps
toward ensuring that the bill we send the President today ensures that
those principles are fulfilled, while minimizing the potential for
unintended consequences.
I would take this opportunity to point out a number of improvements
in the bill that I think merit attention.

[[Page H2973]]

{time} 1130

Foremost, I am pleased that the bill we will send today to the White
House for President Bush to sign embodies the same logic as a past
executive order issued by President Clinton to ensure that this
legislation would not inadvertently serve as a broad new Federal
mandate requiring all insurance plans and employers to cover all
treatments related to genetic-related conditions. That is exactly the
type of unintended consequences we were seeking to avoid, and I am
pleased we were able to work this out.
Second, I would highlight a provision in the legislation that ensures
that employers who are currently subject to a number of confidentiality
and recordkeeping requirements under law are not burdened by yet
another redundant set of paperwork requirements. The bill before us
today provides that, with respect to genetic information, if an
employer maintains employee records and treats them as it does
confidential medical records under the Americans With Disabilities Act,
it is in compliance with this new genetics law.
Third, I applaud a significant improvement in the bill; namely, its
extension of genetic nondiscrimination protection to all Americans.
One of the issues raised during our committee's consideration of the
bill was concern that the bill's protections did not adequately extend
to cover children in utero or at early stages of development, or in
connection with in vitro fertilization and other technologies. I am
very pleased that the final bill before us addresses this issue to the
satisfaction of all Members on both sides of the aisle who worked in
good faith to ensure the broadest protections possible.
The Senate amendment we consider today contains a number of other
improvements over prior versions, including important provisions
relating to those who participate in genetic clinical testing,
providing for use of genetic information in matters of public health
safety, and ensuring the most focused scheme of remedies possible.
These changes represent issues we were able to work through over the
past year and which demonstrate how the legislative process is meant to
work. We were presented with well-intentioned legislation, heard
meaningful testimony on it and its potential impact on employers and
employees alike, raised and debated legitimate concerns, and worked
through to bridge the gap between where we began and where we stand
today.
I thank the staff from both sides of the aisle and in both chambers
for making this a reality.
Before concluding my remarks, I would be remiss if I did not note for
the record that I am still concerned that this bill is in some respects
potentially overbroad. While we all agree with the goal of
nondiscrimination I discussed earlier, the facts remain that we are
poised today to adopt a sweeping new expansion to Federal Civil Rights
scheme, the most expansive change since the adoption of the Americans
With Disabilities Act of 1990.
As we send this bill to the President to sign into law, I would urge
my colleagues to join me in remaining vigilant in the months to come in
monitoring the administration of this new law to ensure that it
addresses the problems it is intended to correct, and does not simply
become yet another bureaucratic burden on employers or a lottery ticket
for plaintiffs' lawyers.
In that same light, as courts and administrative agencies interpret
and enforce these laws, I would urge them to heed the intent of
Congress; namely, that this bill's most egregious penalties must be
reserved for the most egregious violations of the law. If experience
under this new law shows that this is not the case, I trust my
colleagues will join me in supporting swift action to correct any
mistakes we have made.
With that, I will conclude my comments. As I noted at the outset of
my remarks, our actions today will ensure that the law of the United
States protects American workers and health care consumers from
discrimination on the basis of their genetic makeup, a goal I think is
shared by every Member of this House. I urge my colleagues to support
this legislation.
I yield the balance of my time to the gentlelady from Illinois (Mrs.
Biggert) and ask unanimous consent that she be allowed to control the
remainder of the time.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. GEORGE MILLER of California. I yield 3 minutes to the gentleman
from California, the subcommittee Chair of Ways and Means, Mr. Stark.
(Mr. STARK asked and was given permission to revise and extend his
remarks.)
Mr. STARK. Madam Speaker, I would add my congratulations and praise
to the gentlewoman from New York (Ms. Slaughter) and the gentlewoman
from Illinois (Mrs. Biggert) for the work that they have done to bring
this bill finally to the floor for passage. It is a bill that has
languished for over a decade. It is good to see that times have
changed. We moved expeditiously last year through three committees and
on to the floor, and it will leave this chamber today and head to the
White House for the President's signature. It is a small but long
overdue step toward approving our health care system and preventing
employment discrimination, and ensures that our laws governing
patients' rights are as current as the latest medical technology.
Simply stated, the legislation provides peace of mind, and encourages
people to take advantage of the miracles of modern medicine without
fear of reprisal or consequences at work or in health care or in
qualifying for insurance.
GINA, as it is known, prohibits insurers and employees from using the
genetic information to discriminate. Thus, a woman who has decided to
find out whether she carries the breast cancer gene need not worry
about losing her job or health insurance merely because she sought the
test. Enactment of this law is critical to protect patients and is
needed to encourage people to use robust genetic research and to
encourage more research. Additional research will help us determine
when we men will get colon cancer or prostate cancer, and not be afraid
to go and receive those tests for fear of being discriminated against.
This legislation enjoys broad bipartisan support of more than 500
groups representing patients, employees, physicians, providers, and
others who value the protection that this legislation provides. I urge
strong support for this bill.
I ask unanimous consent that I be able to yield the balance of our
time for the Ways and Means Committee to the gentleman from California
(Mr. George Miller), and that he control the balance of our time.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. UPTON. I yield myself such time as I may consume.
Madam Speaker, I rise in strong support of this legislation, and want
to commend all those that were instrumental in getting its passage to
the floor, particularly my good friend, Judy Biggert from Illinois.
We have made some wonderful advances in health care research over the
number of years. I can remember helping to lead the charge with my
colleague, Mr. Waxman, on a bipartisan bill to double the money for the
National Institutes of Health back in the nineties, and we had a
similar effort in the Senate between John McCain, the Republican leader
there of that same issue, and Paul Wellstone, a dear colleague who is
no longer with us. But, together we passed that bipartisan legislation.
And with those advances, of course we have to look at other things that
are pertinent, too, and that is why this Genetic Information
Nondiscrimination Act is so important.
I remember traveling to the University of Michigan and meeting with
one of the researchers there that in fact had received an NIH grant;
and he just weeks before, because of that grant, had identified the
breast cancer gene that strikes one in eight women across America. He
was excited. And it wouldn't have happened without that NIH money; but
with that discovery, it is clear that we have to in fact protect that
genetic information from being discriminated against by who knows who.
And I would say that, thanks to my colleagues, Mr. Deal, the ranking
member on the Health Subcommittee who is in a hearing right now, and
Joe

[[Page H2974]]

Barton, the ranking member, that we have all made advances and worked
closely with Chairman Dingell to mitigate what we believed were some
significant problems with the legislation as it was introduced.
Among other items, we wanted to make sure that any use of information
by certain entities regulated under the Health Insurance Portability
and Accountability Act not also be regulated by the Equal Employment
Opportunity Commission under title II of the bill. Such dual regulation
of the use of information would have been highly disruptive and
certainly inappropriate.
We also made numerous clarifications to make sure that the new
regulatory scheme did not disrupt reasonable and needed activities by
health plans to improve health care, coordinate benefits, process
benefits, or educate beneficiaries. It is important for the Congress to
be mindful that we are not writing on a blank slate each and every time
that we launch one of these new regulatory and liability schemes. And I
certainly join many here that are satisfied that these important
improvements made by the Committee on Energy and Commerce are preserved
in the bill. I want to commend the bipartisan and bicameral discussions
that led to this compromise, and I would urge that we all support it
when a roll call vote comes.
At this point, I would yield the balance of our time that our
committee controls to my friend from Illinois (Mrs. Biggert).
The SPEAKER pro tempore. Without objection, the gentlewoman from
Illinois will control the time.
There was no objection.
Mr. GEORGE MILLER of California. I yield 3 minutes to the gentlewoman
from Pennsylvania, Ms. Allyson Schwartz.
Ms. SCHWARTZ. Today, Americans buy health coverage believing they are
doing the right thing and expecting that they have secured access for
needed health services for themselves and their family. But,
unfortunately, this is simply not always true. Individuals, regardless
of their age or circumstances, are denied health coverage every day due
to the evidence or existence of preexisting conditions. This could be
anything from asthma to heart disease, and it could affect anyone from
our Nation's children to our grandparents to each of us.
For more than 10 years, the Health Insurance Portability and
Accountability Act has provided protection for some individuals and
families to ensure this information is not used to deny health coverage
by either an employer or an insurer; but gaps still remain.
With the evolution of biomedical research, our Nation's scientists
have discovered opportunities to use genetic information to prevent,
diagnose, and more effectively treat some of the most devastating
diseases of our lifetime. I am honored to represent some of these most
brilliant researchers and scientists in Southeastern Pennsylvania.
In addition to the great medical potential they are exploring,
genetic information also has the potential to reduce health care costs
with better prevention and disease management. We must ensure that
these new revelations do not come with a price: Discrimination by
employers, insurers, schools, or others based on genetic information of
those who are not even sick but are simply identified as being
predisposed to a specific disease. If we do not reassure our fellow
Americans that they are safe in taking full advantage of the
opportunities provided by exploring the genetic information, then these
advances in biomedical research could well be for naught.
For this reason, I applaud my colleague, Representative Slaughter,
for introducing the Genetic Information Nondiscrimination Act and for
being its champion for so many years. I am proud to support its passage
today. It is important for all Americans and their access to health
coverage.
Mr. CAMP of Michigan. Madam Speaker, I yield myself such time as I
may consume.
As many of my colleagues have stated, passing this bill is an
important step forward in protecting the health of every American. We
should be proud of our efforts to work on a bipartisan basis to craft
this legislation, and I want to recognize the efforts of the
gentlewoman from Illinois, Congresswoman Biggert. This bill should be a
model for our efforts to reform health care.
We all agree that individuals should not be discriminated against on
the basis of their genetic information. Employers and insurers should
not be allowed to use genetic markers to deny employment or health
coverage simply because they possess a particular gene. But genetic
information can also be used to help patients. Health plans have an
ability to interact with both patients and providers to highlight
recommended tests and courses of action.
For example, a person that has a gene for a certain type of cancer
would be recommended to receive more frequent cancer screenings.
Knowing this, the health insurer would know to approve coverage for
these additional screenings because they would be at a higher risk of
developing that type of cancer.
We all preach about transforming medicine to provide more
preventative care. Now, we are finally at a point where medical
technology can be effectively used to deliver the preventative care
that we envision.
I am certain that the use of genetic information is just the tip of
the iceberg. As medicine develops, so must our laws and regulations;
yet, we must be careful not to stifle these promising medical advances.
I am confident that we can both protect patient privacy and improve the
delivery of health care as this legislation does.
With that, I yield the remaining time from my committee to the
gentlewoman from Illinois to control.
The SPEAKER pro tempore. Without objection, the gentlewoman from
Illinois will control the time.
There was no objection.
Mr. GEORGE MILLER of California. I yield 2 minutes to the gentlewoman
from New Hampshire (Ms. Shea-Porter), a member of the committee.
Ms. SHEA-PORTER. Madam Speaker, I rise today in support of H.R. 493,
the Genetic Information Nondiscrimination Act.
As a member of the Education and Labor Committee, I knew that we had
served the American people well when the committee passed this bill and
then the House passed it almost unanimously in April 2007. Now, a year
later, we are on the verge of sending this important legislation to the
President with overwhelming bipartisan support in both Chambers.

{time} 1145

Science and medicine have made great strides in recent years,
especially with regard to genetic mapping and research. The potential
for finding the answers we desperately seek for so many diseases and
afflictions is greatly increased by the research being done. However,
in order for these efforts to be successful, the public must be assured
that these new discoveries will help and not hurt them.
Science will soon be able to tell us about many more diseases that
individuals are genetically predisposed to develop. That information
should be used only for the public good. It must not be used by
companies to pick and choose who gets insurance or who gets
discriminated against. They should not be allowed to charge higher
insurance premiums because of somebody's individual genetic makeup.
This critical piece of legislation will protect individuals from
discrimination. This is an important step that Congress is taking
today, and I am very happy that we are doing this in a unified spirit.
I commend Congresswomen Slaughter and Biggert for their efforts here.
And I would also like to thank Chairman Miller and my colleagues on the
Education and Labor Committee for their work on this and so many other
important issues. I urge my colleagues to vote ``yes.''
Mrs. BIGGERT. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, I rise today in strong support of H.R. 493, the
Genetic Information Nondiscrimination Act, which will prohibit health
insurers and employers from discriminating on the basis of genetic
information.
As many of my colleagues are aware, this legislation has been around
for quite some time. I have been working on for it more than 7 years,
and Congresswoman Slaughter has been working on it for more than 12
years. It's been a long road, and there have been

[[Page H2975]]

many times I thought this day would never come; but it is here.
Over this period of time, I have heard stories from my constituents
and other individuals across the country about how genetic information
was affecting their lives. Quite simply, they are stories of how our
laws have failed to keep pace with medical science.
A breast cancer survivor in Chicago told me that even though her
doctor recommended she undergo a genetic test to see if she had a 60
percent chance of developing ovarian cancer, which was quite common in
the type of breast cancer that they had, she refused the test. She said
I can't, I will lose my job.
It isn't that she didn't want to know; quite the opposite. She
desperately wanted to know, but she feared if she had an adverse result
from the test, she would lose her job. She is not alone; studies show
that 85 percent of Americans fear employers will use genetic
information to discriminate.
And then there is the woman from Missouri whose sister had suffered
from cancer was cautioned by her doctor that undergoing genetic testing
would cause her to lose her health insurance. She too chose not to
undergo a genetic test. She is not alone; studies show that 84 percent
of Americans express concern that health insurance companies would deny
coverage based on genetic information.
And then there is the man with a family history of PKD, decided to
take a genetic test but chose to use an alias and pay cash rather than
bill his insurance just to keep the test out of his medical file. And
he also is not alone; 26 percent of genetic counselors themselves admit
that they would use an alias and 68 percent said they would pay for the
test out of their pocket to protect themselves from discrimination.
The dean of a prominent university in Massachusetts told me that the
fear of genetic discrimination was hindering clinical trials, slowing
the development of life-saving techniques. At NIH, fear of genetic
discrimination is the most common reason people cite for not
participating in clinical trials on breast and colon cancers.
Madam Speaker, I have heard these stories over and over again from
individuals wanting to know their genetic risk of developing diseases
as far ranging as cancer, heart disease, diabetes, Parkinson's,
Alzheimer's, Tay-Sachs, and PKD.
The sad fact is that these individuals are avoiding genetic tests
that would empower them with the information that could save their
lives.
So I want to let all people know that when the House passes GINA
today, we will be just one step away, and that would be the signing by
the President, from realizing the medical benefits of genetic testing.
One step away from ensuring that people will be able to take a genetic
test without risking their jobs and health insurance. One step away
from ensuring that patients can stop using aliases and paying out of
pocket to keep their genetic tests secret. One step away from ensuring
that individuals will be able to participate in genetic clinical trials
without fear of discrimination.
And the last step is the President's signature, and I am happy to say
that he is expected to sign this bill.
Madam Speaker, it is clear to me that by passing GINA and freeing
people from fear of genetic discrimination, we can unlock the
tremendous life-saving and cost-saving potential of genetic research.
More Americans will participate in genetic clinical trials, and more
Americans will use these technologies to improve their health.
And with these improvements comes the prospect of dramatically
reducing the chronic care costs that cripple our health care system. We
now have more than 500 different health advocacy and business
organizations supporting this bill. Recent surveys shows that 93
percent of Americans believe that employers and insurers should not be
able to use genetic information to discriminate.
With numbers like these, it should be no surprise that the House
passed this bill last April 420-3, and the Senate passed it last week
95-0, and the President is expected to sign this measure into law.
Madam Speaker, I reserve the balance of my time.
Mr. GEORGE MILLER of California. Madam Speaker, I yield 3 minutes to
the gentlewoman from California (Ms. Woolsey), a subcommittee Chair in
the Committee on Education and Labor.
Ms. WOOLSEY. Madam Speaker, we have been waiting for this day for
over a decade. Finally we are here, and we are about to pass H.R. 493,
the Genetic Information Nondiscrimination Act that we called GINA which
was first introduced by Representative Slaughter in 1995 and which was
approved by the Senate last week.
It has been a long road, but the main sponsors of the legislation,
Representative Slaughter and Representative Biggert have persevered,
and I congratulate them both.
I am proud to be an original cosponsor of GINA which will prohibit
employers from using genetic information to discriminate against
workers, and will also prohibit health insurers from using such
information to raise premiums or to deny coverage.
We know that many States, including my home State of California,
prohibits employers and health insurers from discriminating on the
basis of genetic information, and that is good, but these laws vary
widely.
So it is important for the Federal Government, as it has with title
VII and the Americans with Disabilities Act, ADA, to step forward to
establish a national policy, making it clear that discriminating
against workers and others based on genetic information is
unacceptable.
Madam Speaker, this bill also contains the provisions of H.R. 2637,
the Child Labor Protection Act of 2007. It was a bill I introduced last
year that passed the House in June of 2007.
The provisions in H.R. 2637 will increase civil penalties from
$11,000 to $50,000 for violations that cause the death or serious
injury of a child worker, as if there is any penalty high enough to
make up for a child.
The legislation, though, provides that a penalty can be doubled when
the violation causing death or injury is repeated or willful. The child
labor bill was a narrowly drafted bipartisan effort. It is a good
foundation for future action on child labor laws.
So I am delighted that part of GINA includes my legislation,
legislation that can be used to offset the costs of GINA.
We are living, Madam Speaker, in an exciting age. We have just begun
to tap the potential of genetic testing. This bill adds the protection
that is needed so this research can go forward and be used wisely.
Mrs. BIGGERT. I reserve the balance of my time.
Mr. GEORGE MILLER of California. Madam Speaker, I yield 3 minutes to
the gentleman from New Jersey (Mr. Andrews).
(Mr. ANDREWS asked and was given permission to revise and extend his
remarks.)
Mr. ANDREWS. I thank the chairman for yielding, and I rise in strong
support of this legislation. I would like to thank all of those
involved in bringing us to this point, Ms. Slaughter, Mrs. Biggert, and
I especially want to mention Mark Zuckerman, Brian Kennedy, Michelle
Varnhagen, and Carlos Fenwick from our staff who worked so hard on
making this a reality. Thank you very much for your good work.
This is about as basic as it gets. It is a fundamental principle in
this country that when you walk in and apply for a job, you shouldn't
be judged on the color of your skin, your gender, your sexual
orientation, your ethnicity, your age, or your religion. To that today
we are adding the notion of your genetic background.
I think most Americans would understand as a matter of simple common
sense that if your grandmother had breast cancer, it should be
irrelevant as to whether you get a job or not. If your grandfather was
diabetic, it should be irrelevant as to whether you get health
insurance or not, and under what terms.
This simple, powerful, commonsense idea that is embodied in this
legislation will become embodied in the law very shortly because of the
good work that is being done here.
Beyond the basic fairness, the basic principle that we should be
judged by our abilities and not by our characteristics, is the point
that we discussed earlier during the rule debate. Many Americans
justifiably fear that if they share their genetic information with

[[Page H2976]]

researchers, that information may wind up hurting them. It may wind up
depriving them of a job, depriving them of health insurance, or raising
their health insurance premiums.
The very significant protections that are in this bill, soon to
become law, will provide a level of assurance for Americans that when
we participate in genetic research, as I have by donating my DNA sample
to the Coriell Institute in Camden, New Jersey, that we will be
protected against misuse of that information.
This unlocks an exhilarating potential for finding the cure for all
kinds of diseases and afflictions that have hurt so many people for so
long. So I believe this is a singular achievement. It is an honor to be
a part of it, and I know that generations of Americans will benefit not
only from the simple fairness that this law will impose in the
workplace, but for the great potential that this law will unlock for
the investors and inventors and researchers of this country.
No American should ever be denied a job or health insurance or a
promotion because of their genetic characteristics. Because of our
actions today, this will become the law.
I thank the chairman for his leadership. I thank Mrs. Biggert for her
leadership and Chairwoman Slaughter as well, and urge a ``yes'' vote in
favor of this legislation.
Mr. GEORGE MILLER of California. I yield 2 minutes to the gentleman
from New York (Mr. Engel), a member of the Energy and Commerce
Committee.
Mr. ENGEL. Madam Speaker, as a member of the Energy and Commerce
Committee and a member of the Health Subcommittee, I thank my friend,
the distinguished chairman of the Education and Labor Committee, for
allowing me time under his leadership.
I am a proud cosponsor of this bill. I am pleased to see it moving
forward after more than a decade of advocacy.
While researchers' ability to identify genetic markers for diseases
has given hope and promise to millions of people regarding how to make
more informed choices about their personal behavior, the promise of
this breakthrough is hindered, as many of my colleagues have said, by
well-founded fears of how information may be abused in the employment
and insurance industries.
While many states, including my own home State of New York, have laws
which prohibit discrimination in health insurance, and by employers
based on genetic testing and information, it is clear that the laws are
not fully comprehensive and that Federal action is necessary, certainly
to make it more uniform across all 50 States.

{time} 1200

Fear should not be a deterrent to knowledge. Disregarding available
tests for fear of discrimination prevents citizens from making smarter,
personalized choices about their own well-being. We know too much to
subscribe to one-size-fits-all medicine. And once again, it should be
our physicians, not our insurance companies, who influence our health
care decisions.
This is a wonderful bill, very much overdue for enactment, years and
years and years in the process. It's supported by hundreds of patient
advocate groups, and will make a true impact on the health care of our
Nation.
I urge all my colleagues to support the bill.
I yield back the balance of my time.
Mrs. BIGGERT. I have no further speakers, and I reserve the balance
of my time.
Mr. GEORGE MILLER of California. I yield 2 minutes to the gentlewoman
from California (Ms. Linda T. Sanchez), a member of the Education
Committee.
Ms. LINDA T. SANCHEZ of California. Mr. Speaker, I rise in strong
support of the Genetic Information Non-Discrimination Act, and thank my
colleague, Congresswoman Slaughter, for her tireless work term after
term to support this bill and ensure that it would eventually become
law.
Over the past several years, genetic discoveries have progressed at a
remarkable rate. Today, doctors and scientists have the ability to
detect genes linked to common conditions like colon cancer and heart
disease. Individuals who learn about their genetic risk factors can
make lifestyle changes and begin treatments that prevent these
conditions altogether.
But too many Americans don't take advantage of these amazing
breakthroughs for a very practical reason. They fear that the
information will be used to deny them health insurance or even a job.
While the best way to allay those fears would be to enact universal
health care coverage for all, this bill is a fantastic first step.
By prohibiting discrimination on the basis of our genes, this bill
will improve the chances that average Americans can benefit from
cutting edge genetic science. It will promote better health care by
helping Americans feel secure enough to learn about their genetic risk
factors.
As the daughter of a father who suffers from Alzheimer's and a mother
who suffers from arthritis, I personally understand the need to make
genetic testing a positive step in understanding one's genetic
predispositions and making health care choices. Genetic testing should
not be a hindrance to getting or keeping one's job or health care
benefits.
While this bill will accomplish many great things, I want to point
out just two very important ones. Number 1, it will arm people with
necessary and relevant information about their own health. And Number
2, it will ensure that people won't be penalized for seeking and using
this valuable information.
I urge all my colleagues to support the Genetic Information Non-
Discrimination Act.
Mrs. BIGGERT. I reserve the balance of my time.
Mr. GEORGE MILLER of California. I yield 2 minutes to the gentleman
from Pennsylvania (Mr. Sestak), a member of the Education and Labor
Committee.
Mr. SESTAK. Mr. Speaker, the completion of the human genome project 5
years ago made it possible to identify specific genes that trigger
diseases later in life. However, out of at fear of losing their jobs or
their health insurance, studies have shown that many Americans forego
the potential health benefits of genetic testing.
While involved in a course at the University of Pennsylvania on
genetic discrimination, the position paper Dr. Ruth Cowan's students
presented to me reemphasized that this concern of genetic
discrimination risks stifling further scientific advances in genetic
based research.
No genetic nondiscrimination laws in health care, such as in my State
of Pennsylvania, may mean foregoing cures based upon genetic research.
With a young daughter who underwent treatment for a malignant brain
tumor recently, I understand why, as scientific technology advances,
discrimination cannot grow with it, or we harm not only the quality of
life, but life itself.
With State laws varying in how to maintain the privacy of genetic
information, the Genetic Information Nondiscrimination Act will set a
national standard and take the first step toward advancing the
scientific and health benefits of genetic research and protecting the
genetic privacy of Americans.
I urge all my colleagues to support this bill.
Mrs. BIGGERT. I reserve the balance of my time.
Mr. GEORGE MILLER of California. I yield myself such time as I may
consume.
Mr. Speaker, today we are celebrating, or we will shortly with a vote
on the Genetic Information Nondiscrimination Act, known as GINA. And
today we celebrate it with a great sense of unanimity and agreement
about this legislation. But that clearly was not always true over more
than the past decade.
This legislation has been controversial to some. It has had a
shifting body of opponents to it over those many years. There are many
who tried to ascribe attributes to this legislation that either wasn't
intended to address or didn't exist at all. But the opposition was
formidable.
But when we celebrate the passage of this legislation today, we must
also celebrate the spirit of two women in the House of Representatives
that persevered through all of the political debate, as hot it was from
time to time, through all of the controversy, through much of the
ignorance and misinformation about the legislation, but who, throughout
that entire decade, understood the promise of this legislation,

[[Page H2977]]

both to those who would not be discriminated against in the future, but
also the promise in terms of medical research and information that
would become available to promote, not only cures and treatment, but
greater scientific understanding of the genome and our make-ups and its
impact on our health.
And those two women were Congresswoman Louise Slaughter from New
York, and our colleague who is with us in the Chamber today, Judy
Biggert from Illinois.
It's one thing to stand here and say we all agree today. But that
wasn't the case, and that was what they kept pushing against year after
year to get the Congress to understand the importance of this
legislation. We come to that understanding rather late, when you
consider that many of the States have taken the steps, many Nations
have taken this step, but it's terribly important that we do it so
people will be assured that no worker will be discriminated against
because of his or her genetic information.
As I mentioned, 41 States have already led the way in passing laws to
prohibit discrimination to individual health insurance markets. 34
States have passed laws to prohibit employers from discriminating in
the workplace. And the Federal Government has banned discrimination
against Federal Government employees. Every American deserves this
protection.
In the last two decades we've seen incredible scientific advances in
the diagnosis and the treatment of once untreatable, undetectable
conditions. Scientists now have the incredible ability to identify
genetic markers for disease that could and may never occur. Genetic
testing can also help prevent diseases by identifying them early.
Despite this amazing potential of genetic testing, advancements have
been stifled out of fear of what some may do with the results of those
tests. Many Americans forego testing because of that fear, the fear of
losing their jobs, the fear of losing their health insurance.
We pit that against the knowledge, the discovery and the treatment
that would have been possible to those individuals, but the fear
prevented them from coming forward. And this is not an isolated fear.
A 2006 research study showed that 85 percent of the respondents
believe that without protections, employers would use genetic
information to discriminate. 64 percent believe that insurers would use
the information to deny critical coverage.
The Genetic Information Nondiscrimination Act is clear. Title I of
the bill prohibits group health plans and insurers from collecting or
requesting genetic information with narrow exceptions. It also protects
the privacy of this personal information.
Title II of the bill prohibits employers from collecting or using
their employees' genetic information. It also prohibits employers from
discriminating against employees in hiring, firing and other terms of
conditions of employment based upon the genetic information.
This final bill makes it clear that, even though employers may not be
held accountable for violations committed by health plans under title
I, employers remain fully liable for any violations of title II,
including violations involving health benefits.
It is well settled in this country's employment discrimination laws,
such as title VII, the Age Discrimination Employment Act and the
Americans with Disabilities Act, that it is unlawful for employers to
discriminate against employees in their health benefits.
We intend for the courts to continue to interpret employer
obligations under GINA similarly to all other civil rights laws. GINA
will protect workers like David Escher, a former worker at the
Burlington Northern Santa Fe Railroad, who discovered his employer was
trying to prove his injury was caused by a genetic disorder rather than
work-related injury. This is precisely the type of discrimination and
misuse of genetic information that we seek to prohibit in this bill.
The protections provided by GINA are long overdue, and
Representatives Slaughter and Biggert have fought, over this last
decade, for these important changes, these important provisions in the
law. And I want to thank them for all of their hard work.
I also want to take a moment to thank the members of my staff,
Michelle Varnhagen, Mark Zuckerman, Brian Kennedy, Jody Calemine and
Michael Gaffin for all of their efforts.
From Congressman Andrews' staff, Carlos Fenwick.
Congresswoman Slaughter's staff, Michelle Adams, Cindy Pelligrini.
From Congresswoman Biggert's staff, Brian Petersen, Jaime Vickery.
And from Congressman McKeon's staff, Ed Gilroy and Jim Paretti.
From Congressman Dingell's staff, Pete Goodloe, Jeanne Ireland,
Jessica McNiece, Gregg Rothchild, and John Ford.
From Congressman Frank Pallone's staff, Bobby Clark.
From Congressman Rangel's and Stark's staff, Cybele Bjorklund and Deb
Mizeur for all of their assistance.
And in the Senate, from Senator Kennedy's staff, Dave Bowen, Portia
Wu and Lauren McFerren.
And from Senator Snowe's staff, Bill Pewen.
And from Senator Enzi's staff, Ilyse Schuman and Keith Flannagan. And
legislative counsel, Ed Grossman, Larry Johnson and Henry Christrup,
for all of their assistance and all of the effort that they put in to
making the changes and the distinctions between the actions in the
House and the Senate, and all of the controversy that this brought with
them.
With that, I'd like to reserve the balance of my time so that Ms.
Biggert may make her closing remarks. And again, I want to thank her so
much. Her membership on our committee makes us very proud. And her
political toughness to see this through to the end, along with Louise
Slaughter, is a wonderful story that we celebrate also with the passage
of this legislation.
I reserve the balance of my time.
Mrs. BIGGERT. I thank you, Mr. Chairman, for your kind words. And
it's been a long road, but we're here, and with your help.
Just let me say that there's three benefits that are so important for
this bill. Number one is that people will get a genetic test. And if it
shows that they have a propensity for having some disease, they can
then take preventive measures and take measures that are going to
improve the quality of their life. And it's personalized medicine.
People have got to take command of their medical lives.
Second of all, because people will take preventive measures, this is
going to reduce the cost of health care. It's going to reduce the cost
to businesses because their employees will be taking these preventive
measures, and it's going to reduce the cost to health care providers
because people, again, will be taking these measures.
And as I said before, through the clinical trials, it will increase
the ability to find cures for so many diseases if people get into
these.
So with that, I would really like to take a moment to thank
Representative Slaughter, Chairman Slaughter of the Rules Committee one
more time, Greg Walden of Oregon who has been a major sponsor of this
bill, Congressman Andrews of New Jersey, who has been so helpful, and
Mrs. Eshoo from California, who has been so involved. And then Senator
Snowe, Senator Kennedy and Senator Enzi for all their hard work on this
issue. It's truly been a pleasure to work with all of them.
I would also like to thank Mr. McKeon and Mr. Miller again, the
chairman and ranking member of the Education and Labor Committee, for
all their support. And then the other chairmen, Congressman Dingell and
Congressman Barton of the Energy and Commerce Committee, and Mr. Upton
of Michigan for coming down and working on this today. And then
Chairman Rangel and ranking member McCrery of the Ways and Means
Committee, and then Representative Camp for being the spokesman for
them. I applaud them for all their efforts.
I would also like to thank former Speaker Newt Gingrich, who has been
so supportive of this legislation. And I would be remiss if I didn't
mention Sharon Terry and the Coalition for Genetic Fairness, as well as
all of our other organizational supporters, for all their persistence
and their expertise on this issue.
And Dr. Francis Collins of NIH for his testimony before all three
committees in the House.

[[Page H2978]]

{time} 1215

Finally, I have to thank the staff, all of the staff, who worked so
tirelessly for years now behind the scenes on our behalf and put in
long, long hours on this legislation. And in particular, my thanks go
to Michelle Varnhagen and Jim Paretti from the Education and Labor
Committee staff, and then Michelle Adams from Ms. Slaughter's staff,
and Brian Peterson of my staff.
There's so many reasons why everybody should vote for this, and
certainly having passed the House by 420-3 last April and the Senate
95-0, you say, This is a no-brainer; why didn't this happen a long time
ago? And what's been alluded to is to get three committees in the House
of Representatives to work on all of the issues, and they are so
technical in how they relate to each other and how it relates to
privacy and the other HIPAA and ADA and all of the things that had to
be brought in here, I think everyone works so hard just to have a
wonderful result. And it's no surprise that we're here, but it just
took a long time.
With that, I would urge all my colleagues to vote for this measure.
I yield back the balance of my time.
Mr. GEORGE MILLER of California. Mr. Speaker, I also would be remiss
if I did not thank Dr. Francis Collins for all of his work and
assistance and guidance to the Congress on this matter and for
everything else he does in such a wonderful fashion.
Ms. PELOSI. Mr. Speaker, I rise today in strong support of the
Genetic Information Nondiscrimination Act.
I would like to thank Congresswoman Louise Slaughter for her
outstanding leadership on this issue. For 13 years, she has worked to
pass this bill protect Americans from genetic discrimination. She's
both the powerful chair of the Rules Committee, and a microbiologist,
so she knows what she is talking about.
The sequencing of the human genetic code is one of the great
scientific accomplishments in the history of the world. It has the
potential to treat and prevent disease. It is evidence of science's
almost-biblical power to heal.
But with this scientific breakthrough comes a responsibility to
protect Americans from the misuse of their genetic information. Today,
the Congress will begin to fulfill that responsibility by passing this
legislation.
This legislation prevents health insurers from adverse coverage or
pricing decisions based on a person's genetic predisposition toward a
disease. It ensures an employer cannot make adverse employment
decisions based on what is in a person's genetic code. It also makes it
illegal for an insurer or employer to request or demand a gene test.
Because of this legislation, Americans will be free to undergo
genetic testing for diseases such as cancer, heart disease, diabetes,
and Alzheimer's, without fearing for their job or health insurance.
There is life-saving information in those tests. And for scientists,
there is information that allows for huge breakthroughs.
This legislation is supported by the vast majority of the American
people, 93 percent of whom do not want employers to have access to
their genetic information.
This is such good policy that this legislation is supported by more
than 500 organizations, including a broad coalition of civil rights and
religious organizations. Health advocacy groups ranging from the
American Academy of Pediatrics to the March of Dimes to the Susan G.
Komen Breast Cancer Foundation have endorsed it.
In the Congress, it has broad bipartisan support. It also has the
support of the President.
Let us not wait another day to pass this legislation so it can move
to the President's desk for his signature and become law.
Mr. GENE GREEN of Texas. Mr. Speaker, I rise today in support of H.R.
493, the Genetic Non-Discrimination Act. This bill is the product of 10
years of hard work by my colleague Ms. Slaughter and I applaud her for
her efforts to pass this bill.
The sequencing of the human genome was an amazing scientific
advancement, and has contributed to the rise of genetic testing to
inform patients of their proclivity for disease.
Thanks to genetic testing, individuals with a risk of an illness can
take precautionary steps ahead of time to ward off disease, which will
contribute to lower health care costs over time.
However, it is critical that we protect individuals from any
discrimination that could result from the information these tests
reveal.
The results should not be used by health insurers to deny anyone
coverage or increase their premiums because of a pre-disposition to a
certain disease.
And the results should not be used by employers to discriminate
against employees based on their predisposition to disease.
The passage of this bill will encourage individuals to seek genetic
testing if they so desire without fear of losing their health insurance
and give them the ability to seek early medical treatment.
One segment of the health care marketplace was excluded from the
bill's protections--the long-term care insurance market. This bill was
never intended to regulate the long-term care insurance market, and I
understand that current statute treats long-term care insurance
differently.
However, individuals that determine that they are at high-risk for
developing Alzheimer's disease will undoubtedly begin planning for
their long-term care and probably purchase long-term care insurance.
Despite all of the good intentions in this legislation, the bill
would allow long-term care insurance underwriters to refuse to cover or
charge individuals predisposed to such disease higher premiums for a
disease they have yet to develop and may never develop.
As we move forward, Congress should ensure that future legislation
extends the patient protections inherent in this bill to consumers who
want to plan for their future and purchase long-term care.
With that, I am pleased to support this important legislation and
send this bill to the President.
Mr. LANGEVIN. Mr. Speaker, I rise in strong support of H.R. 493, the
Genetic Information Nondiscrimination Act, which extends crucial
Federal protections against discrimination based on an individual's
genetic information.
The new millennium has seen unprecedented scientific advances in
genetic research that have brought a renewed hope of solving today's
most difficult medical puzzles. Since the human genome was fully mapped
in 2003, many in the scientific and medical communities have viewed
genetic medicine as the next step toward finding better diagnoses,
treatments and possible cures for a wide spectrum of diseases. These
advances have also raised legitimate ethical concerns about the
potential misuse of genetic information in workforce and insurance
related decisions. Although current law already addresses certain
aspects of this issue, the importance of protecting individuals from
discrimination and safeguarding the right to privacy cannot be
overstated.
This bill will guarantee more comprehensive protections from
discrimination in health insurance and employment on the basis of
genetic information. Specifically, it will prohibit group health plans
and health insurers from denying coverage to a healthy individual or
charging that person higher premiums based solely on a genetic
predisposition to develop a disease in the future. Furthermore, it bars
employers, employment agencies, labor organizations or training
programs from using an individual's genetic information when making
hiring, firing, job placement or promotion decisions.
Genetics is a field of study that offers tremendous promise for
medical advancement, but we must give thoughtful consideration to the
implications of these emerging discoveries on society. No individual
should fear discrimination based on genetic technologies. H.R. 493 will
allay concerns about the potential for discrimination, encourage
individuals to participate in genetic research, and take advantage of
genetic testing, new technologies, and new therapies. I thank
Congresswoman Slaughter for her leadership on this issue and urge my
colleagues to support its passage.
Mr. STUPAK. Mr. Speaker, I rise in support of H.R. 493, the Genetic
Information Nondiscrimination Act, GINA.
After 13 years--this bill will finally make its way to the
President's desk, to help protect families from genetic discrimination.
Congratulations to the Congresswoman from New York, Ms. Slaughter,
for her work in drafting this bill and guiding it through the
cumbersome referral to three committees.
Together, with Chairman Dingell, Ms. DeGette and Mr. Smith, we were
able to include an important provision to protect families from unfair
treatment on the basis of the genetic material of their fetuses or
children in the process of adoption.
Without this bill, families may face genetic information
discrimination from testing of embryos and fetuses, as well as children
who are in the process of adoption.
As genetic testing becomes increasingly common, these provisions will
ensure that genetic material gathered through pre-implementation
genetic diagnoses, amniocentesis, or other future techniques is not
used to limit families' access to health care.
Again, I thank Ms. Slaughter for her commitment to reflect these
changes throughout the bill in order to avoid any further confusion as
to whether or not families can be discriminated against on the basis of
the genetic material of their unborn child or child under consideration
for adoption.
I was proud to work with many Members to include this provision.
I encourage my colleagues to vote for this important legislation.

[[Page H2979]]

Mr. KENNEDY. Mr. Speaker, I rise today in strong support of H.R. 493,
the Genetic Information Nondiscrimination Act. I would like to thank my
good friends and colleagues, Representative Louise Slaughter and
Representative Judy Biggert, for their tireless advocacy to bring this
bill to the House floor today and then on to the White House for
President Bush's signature.
There is nothing more personal and more deserving of protection than
the genetic make-up of each and every individual in our Nation.
Advances in science and technology during the past decade have allowed
us to map the human genome and opened the doors to treatment and
diagnostic capabilities that we are only now beginning to realize. With
this power comes great responsibility to protect individuals who learn
that they may be more susceptible to diseases such as breast cancer or
mental illness.
Just as our Nation does not allow discrimination based on race or
disability, we must not allow discrimination based on our own genetic
identity. The Genetic Information Nondiscrimination Act will prevent
health insurers and employers from improperly using our genetic
information to make coverage or employment decisions. I urge my
colleagues to support this protection of our most basic human right by
voting for H.R. 493.
Mr. VAN HOLLEN. Madam Speaker, I rise in strong support of the Senate
amendment to H.R. 493, the Genetic Information Nondiscrimination Act.
This bipartisan legislation is long overdue. Recent scientific
breakthroughs in sequencing the human genetic code have already
transformed the battle against a broad range of medical conditions.
Scientists have now identified genetic markers for a variety of chronic
health conditions which will increase the potential for early treatment
and prevention. However, as much as these advances will improve health
care delivery in this country, it has increased the potential for
employers and insurers to discriminate based on an individual's genetic
makeup. Such a threat deters the public and science from taking full
advantage of the life-saving and cost-saving potential of genetic
research.
That why we need to pass this much-needed bill. Discriminating
against someone because of their DNA is simply unacceptable. Mr.
Speaker, I urge colleagues to support this bipartisan legislation so
that Americans do not have to live in fear of losing their job or
health insurance because of their genetic predisposition towards
certain medical conditions.
Mr. CAPPS. Mr. Speaker, I rise in strong support of the Senate
amendment to H.R. 493, the Genetic Information Nondiscrimination Act.
The identification of genetic markers for disease is one of the most
remarkable scientific accomplishments we have made. And this ability to
identify risks for certain conditions holds so much promise for our
ability to identify and practice greater preventive health care in this
country. I can never emphasize enough just how important preventive
health care is to our well-being.
However, as with almost all great scientific advancements, we have
also opened the door to a whole slew of unintended consequences. And I
fear that preventive health care is put at risk when patients decline
genetic testing for fear of insurance or employment discrimination.
This bill before us will put aside those fears by offering protection
from employment discrimination and closes the loopholes that deter
individuals from pursuing information that can save their lives and the
lives of others. After all, the biomedical research community is in
dire need of greater clinical trial participation. But many patients
are wary because they worry that participation in a clinical trial will
reveal a genetic predisposition that employers or insurers can use as a
basis for discrimination.
H.R. 493 will provide individuals the security of knowing that they
can take advantage of genetic testing and participate in research
without the fear that their employment or insurance status be put at
risk.
I commend my colleagues Louise Slaughter, Judy Biggert and Anna Eshoo
for their tireless work on this bill over the last 13 years. I urge all
of my colleagues to vote in favor of H.R. 493.
Ms. SPEIER. Mr. Speaker, Congress today is making an important first
step toward protecting Americans from discrimination based on their
genetic information. I support this bill and the premise that a
predisposition to disease should never be a factor in access to
employment or insurance coverage.
However, this is only a first step. I am compelled to remind this
House, and all Americans, that this bill does not guarantee genetic
information will not be abused by employers or insurers. The passage of
this legislation should not give consumers a false sense of security.
Until access to health care is available regardless of current or
future health conditions, the potential for genetic discrimination will
remain. And until we completely limit access to employee health
records, there will be the potential for discrimination by employers.
Mr. Speaker, passage of the Genetic Information Non-Discrimination
Act today is a strong step toward protecting sensitive genetic
information, but no journey is completed in just one step. I look
forward to addressing the underlying problems not fixed by this bill so
we can truly protect Americans' privacy and guard against
discrimination based on preexisting health conditions.
Ms. BALDWIN. Mr. Speaker, I rise today in strong support of the
Genetic Information Nondiscrimination Act.
The scientific advancement that has been made in sequencing the human
genome is groundbreaking. We have only just begun to understand how we
can harness the vast amount of information that is included in our
genetic code to benefit human health and longevity. The ability to
predict disease will greatly increase our opportunities for early
treatment and prevention efforts and this can have a real impact on
people's lives.
So I am proud to support the Genetic Information Nondiscrimination
Act. This bill will provide strong protections to prevent employers and
insurers from denying health coverage or job opportunities on the basis
of predictive genetic information. Providing this protection will
ensure that Americans are not unfairly penalized, either by health
insurers or by employers, for something that is a part of their genetic
makeup. In addition, these protections will encourage individuals to
participate in genetic research, which will lead to new technologies
and new therapies.
This important nondiscrimination protection is necessitated by the
advancements in science, like the mapping of the human genome. And
Congress is responsible for making sure that our laws keep up with
these scientific advancements, so that we can fully realize the value
of these discoveries.
Mr. Speaker, I am proud to support the Genetic Nondiscrimination Act,
and I urge my colleagues to join me in voting in favor of it.
Mr. GEORGE MILLER of California. I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Pastor). All time for debate has
expired.
Pursuant to House Resolution 1156, the previous question is ordered.
The question is on the motion offered by the gentleman from
California (Mr. George Miller).
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. GEORGE MILLER of California. Mr. Speaker, on that I demand the
yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, this 15-
minute vote on the motion to concur will be followed by 5-minute votes
on ordering the previous question on House Resolution 1167; adopting
House Resolution 1165, if ordered; and suspending the rules and
adopting House Concurrent Resolution 308.
The vote was taken by electronic device, and there were--yeas 414,
nays 1, not voting 16, as follows:

[Roll No. 234]

YEAS--414

Abercrombie
Ackerman
Aderholt
Akin
Alexander
Allen
Altmire
Andrews
Arcuri
Baca
Bachmann
Bachus
Baird
Baldwin
Barrett (SC)
Bartlett (MD)
Barton (TX)
Bean
Becerra
Berkley
Berman
Berry
Biggert
Bilbray
Bilirakis
Bishop (GA)
Bishop (NY)
Bishop (UT)
Blumenauer
Blunt
Boehner
Bonner
Bono Mack
Boozman
Boren
Boswell
Boucher
Boustany
Boyd (FL)
Boyda (KS)
Brady (PA)
Brady (TX)
Braley (IA)
Broun (GA)
Brown (SC)
Brown, Corrine
Brown-Waite, Ginny
Buchanan
Burton (IN)
Butterfield
Buyer
Calvert
Camp (MI)
Campbell (CA)
Cannon
Cantor
Capito
Capps
Capuano
Cardoza
Carnahan
Carney
Carson
Carter
Castle
Castor
Chabot
Chandler
Clarke
Clay
Cleaver
Clyburn
Coble
Cohen
Cole (OK)
Conaway
Conyers
Cooper
Costa
Costello
Courtney
Cramer
Crenshaw
Crowley
Cuellar
Culberson
Cummings
Davis (AL)
Davis (CA)
Davis (IL)
Davis (KY)
Davis, David
Davis, Lincoln
Davis, Tom
DeFazio
DeGette
Delahunt
DeLauro
Dent
Diaz-Balart, L.
Diaz-Balart, M.
Dicks
Dingell
Donnelly
Doolittle
Doyle
Drake
Dreier
Duncan
Edwards
Ehlers
Ellison
Ellsworth
Emanuel
Emerson
Engel
English (PA)
Eshoo
Etheridge
Everett
Fallin
Farr
Fattah
Feeney
Ferguson
Filner
Flake
Fortenberry
Foster
Foxx
Frank (MA)
Franks (AZ)
Frelinghuysen
Gallegly
Garrett (NJ)
Gerlach
Giffords
Gilchrest
Gillibrand
Gingrey
Gonzalez
Goode
Goodlatte
Gordon
Granger
Graves
Green, Al
Green, Gene
Grijalva

[[Page H2980]]

Gutierrez
Hall (NY)
Hall (TX)
Hare
Harman
Hastings (FL)
Hastings (WA)
Hayes
Heller
Hensarling
Herger
Herseth Sandlin
Higgins
Hill
Hinchey
Hinojosa
Hirono
Hobson
Hodes
Hoekstra
Holden
Holt
Hooley
Hoyer
Hulshof
Hunter
Inglis (SC)
Inslee
Issa
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (GA)
Johnson (IL)
Johnson, E. B.
Johnson, Sam
Jones (NC)
Jordan
Kagen
Kanjorski
Kaptur
Keller
Kennedy
Kildee
Kilpatrick
Kind
King (IA)
King (NY)
Kingston
Kirk
Klein (FL)
Kline (MN)
Knollenberg
Kucinich
Kuhl (NY)
Lamborn
Lampson
Langevin
Larsen (WA)
Larson (CT)
Latham
LaTourette
Latta
Lee
Levin
Lewis (CA)
Lewis (GA)
Lewis (KY)
Linder
Lipinski
LoBiondo
Loebsack
Lofgren, Zoe
Lowey
Lucas
Lungren, Daniel E.
Lynch
Mack
Mahoney (FL)
Maloney (NY)
Manzullo
Marchant
Markey
Marshall
Matheson
Matsui
McCarthy (CA)
McCarthy (NY)
McCaul (TX)
McCollum (MN)
McCotter
McCrery
McDermott
McGovern
McHenry
McHugh
McIntyre
McKeon
McMorris Rodgers
McNerney
McNulty
Meek (FL)
Meeks (NY)
Melancon
Mica
Michaud
Miller (FL)
Miller (MI)
Miller (NC)
Miller, Gary
Miller, George
Mitchell
Mollohan
Moore (KS)
Moore (WI)
Moran (KS)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murphy, Tim
Murtha
Musgrave
Myrick
Nadler
Napolitano
Neal (MA)
Neugebauer
Nunes
Oberstar
Obey
Olver
Ortiz
Pallone
Pascrell
Pastor
Pearce
Pence
Perlmutter
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pitts
Platts
Poe
Pomeroy
Porter
Price (GA)
Price (NC)
Pryce (OH)
Putnam
Radanovich
Rahall
Ramstad
Rangel
Regula
Rehberg
Reichert
Renzi
Reyes
Reynolds
Richardson
Rodriguez
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Ros-Lehtinen
Roskam
Ross
Rothman
Roybal-Allard
Royce
Ruppersberger
Ryan (OH)
Ryan (WI)
Salazar
Sali
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Saxton
Schakowsky
Schiff
Schmidt
Schwartz
Scott (GA)
Scott (VA)
Sensenbrenner
Serrano
Sessions
Sestak
Shadegg
Shays
Shea-Porter
Sherman
Shimkus
Shuler
Shuster
Simpson
Sires
Skelton
Slaughter
Smith (NE)
Smith (NJ)
Smith (TX)
Smith (WA)
Snyder
Solis
Souder
Space
Speier
Spratt
Stark
Stearns
Stupak
Sullivan
Sutton
Tancredo
Tanner
Tauscher
Taylor
Terry
Thompson (CA)
Thompson (MS)
Thornberry
Tiahrt
Tiberi
Tierney
Towns
Tsongas
Turner
Udall (CO)
Udall (NM)
Upton
Van Hollen
Velazquez
Visclosky
Walberg
Walden (OR)
Walsh (NY)
Walz (MN)
Wamp
Wasserman Schultz
Waters
Watson
Watt
Waxman
Weiner
Welch (VT)
Weldon (FL)
Weller
Westmoreland
Wexler
Whitfield (KY)
Wilson (OH)
Wilson (SC)
Wittman (VA)
Wolf
Woolsey
Wu
Wynn
Yarmuth
Young (AK)
Young (FL)

NAYS--1

Paul

NOT VOTING--16

Barrow
Blackburn
Burgess
Cubin
Deal (GA)
Doggett
Forbes
Fossella
Gohmert
Honda
Israel
Jones (OH)
LaHood
Payne
Rush
Wilson (NM)

{time} 1240

Ms. FOXX and Mr. BURTON of Indiana changed their vote from ``nay'' to
``yea.''
So the motion was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.

____________________