[Congressional Record (Bound Edition), Volume 149 (2003), Part 17]
[Senate]
[Pages 24111-24125]
[From the U.S. Government Publishing Office, www.gpo.gov]




           GENETIC INFORMATION NONDISCRIMINATION ACT OF 2003

  Mr. FRIST. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 247, S. 1053, 
the Genetic Information Nondiscrimination Act; that the committee-
reported substitute amendment be agreed to and treated as original text 
for purposes of further amendment, and the Snowe substitute, which is 
at the desk, be agreed to; further, that there be 30 minutes of debate 
equally divided in the usual form under the control of the chairman and 
ranking members of the HELP Committee or their designees; that no other 
amendments be in order; further, that upon the use or yielding back of 
time the bill be read a third time; that at 2:15 p.m. on Tuesday, 
October 14, the Senate resume consideration of S. 1053 and there be 15 
minutes of debate equally divided, followed by a vote on passage of the 
bill, all without intervening action or debate.
  The ACTING PRESIDENT pro tempore. Is there objection?
  Mr. REID. No objection.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  The clerk will report the bill by title.
  The assistant legislative clerk read as follows:

       A bill (S. 1053) to prohibit discrimination on the basis of 
     genetic information with respect to health insurance and 
     employment.

  There being no objection, the Senate proceeded to consider the bill 
which had been reported from the Committee on Health, Education, Labor, 
and Pensions, with an amendment to strike all after the enacting clause 
and inserting in lieu thereof the following:

                                S. 1053

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

     [SECTION 1. SHORT TITLE.

       [This Act may be cited as the ``Genetic Information 
     Nondiscrimination Act of 2003''.

        [TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

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

       [(a) Prohibition of Health Discrimination on the Basis of 
     Genetic Information or Genetic Services.--
       [(1) No enrollment restriction for genetic services.--
     Section 702(a)(1)(F) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1182(a)(1)(F)) is amended by 
     inserting before the period the following: ``(including 
     information about a request for or receipt of genetic 
     services)''.
       [(2) 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 by 
     adding at the end the following:
       [``(3) No discrimination in group premiums based on genetic 
     information.--For purposes of this section, a group health 
     plan, or a health insurance issuer offering group health 
     insurance coverage in connection with a group health plan, 
     shall not adjust premium or contribution amounts for a group 
     on the basis of genetic information concerning an individual 
     in the group or a family member of the individual (including 
     information about a request for or receipt of genetic 
     services).
       [(b) Limitations on Genetic Testing and the Collection of 
     Genetic Information.--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, or 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.--Nothing in this part shall be 
     construed to limit the authority of a health care 
     professional, who is providing health care services with 
     respect to an individual or who is acting on behalf of a 
     group health plan or a health insurance issuer, to request 
     that such individual or a family member of such individual 
     undergo a genetic test. Such a health care professional shall 
     not require that such individual or family member undergo a 
     genetic test.

[[Page 24112]]

       [``(d) Compliance With Certain Confidentiality Standards 
     With Respect to Genetic Information.--With respect to the use 
     or disclosure of genetic information by a group health plan, 
     or a health insurance issuer offering health insurance 
     coverage in connection with a group health plan, such 
     information shall be deemed to be protected health 
     information for purposes of, and shall be subject to, the 
     standards promulgated by the Secretary of Health and Human 
     Services under--
       [``(1) part C of title XI of the Social Security Act (42 
     U.S.C. 1320d et seq.); or
       [``(2) section 264(c) of the Health Insurance Portability 
     and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 
     2033).
       [``(e) Collection of Genetic Information.--
       [``(1) Limitation on requesting or requiring genetic 
     information.--Except as provided in paragraph (2), a group 
     health plan, or a health insurance issuer offering health 
     insurance coverage in connection with a group health plan, 
     shall not request or require genetic information concerning 
     an individual or a family member of the individual (including 
     information about a request for or receipt of genetic 
     services).
       [``(2) Information needed for treatment, payment, and 
     health care operations.--Notwithstanding paragraph (1), a 
     group health plan, or a health insurance issuer offering 
     health insurance coverage in connection with a group health 
     plan, that provides health care items and services to an 
     individual may request genetic information concerning such 
     individual or dependent for purposes of treatment, payment, 
     or health care operations in accordance with the standards 
     for protected health information described in subsection (d) 
     to the extent that the use of such information is otherwise 
     consistent with this section.
       [``(3) Failure to provide necessary information.--If an 
     individual or dependent refuses to provide the information 
     requested under paragraph (2), and such information is for 
     treatment, payment, or health care operations relating to the 
     individual, the group health plan or health insurance issuer 
     requesting such information shall not be required to provide 
     coverage for the items, services, or treatments with respect 
     to which the requested information relates in any action 
     under part 5.''.
       [(c) 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) the spouse of the individual;
       [``(B) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; and
       [``(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       [``(6) Genetic information.--
       [``(A) In general.--Except as provided in subparagraph (B), 
     the term `genetic information' means information--
       [``(i) concerning--

       [``(I) the genetic tests of an individual;
       [``(II) the genetic tests of family members of the 
     individual; or
       [``(III) the occurrence of a disease or disorder in family 
     members of the individual; and

       [``(ii) that is used to predict risk of disease in 
     asymptomatic or undiagnosed individuals.
       [``(B) Exceptions.--The term `genetic information' shall 
     not include--
       [``(i) information about the sex or age of the individual;
       [``(ii) information derived from clinical and laboratory 
     tests, such as the chemical, blood, or urine analyses of the 
     individual including cholesterol tests, used to determine 
     health status or detect illness or diagnose disease; and
       [``(iii) information about physical exams of the 
     individual.
       [``(7) Genetic services.--The term `genetic services' means 
     health services provided for genetic education and 
     counseling.
       [``(8) Genetic test.--The term `genetic test' means the 
     analysis of human DNA, RNA, chromosomes, proteins, and 
     metabolites, that detect genotypes, mutations, or chromosomal 
     changes. Such term does not include information described in 
     paragraph (6)(B).''.
       [(d) Regulations and Effective Date.--
       [(1) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of Labor shall issue 
     final regulations in an accessible format 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 18 months after the date of 
     enactment of this title.

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

       [(a) Amendments Relating to the Group Market.--
       [(1) Prohibition of health discrimination on the basis of 
     genetic information or genetic services.--
       [(A) No enrollment restriction for genetic services.--
     Section 2702(a)(1)(F) of the Public Health Service Act (42 
     U.S.C. 300gg-1(a)(1)(F)) is amended by inserting before the 
     period the following: ``(including information about a 
     request for or receipt of genetic services)''.
       [(B) 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 by adding at the end 
     the following:
       [``(3) No discrimination in group premiums based on genetic 
     information.--For purposes of this section, a group health 
     plan, or a health insurance issuer offering group health 
     insurance coverage in connection with a group health plan, 
     shall not adjust premium or contribution amounts for a group 
     on the basis of genetic information concerning an individual 
     in the group or a family member of the individual (including 
     information about a request for or receipt of genetic 
     services).''.
       [(2) Limitations on genetic testing and the collection of 
     genetic information.--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, or 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.--Nothing in this part shall be 
     construed to limit the authority of a health care 
     professional, who is providing health care services with 
     respect to an individual or who is acting on behalf of a 
     group health plan or a health insurance issuer, to request 
     that such individual or a family member of such individual 
     undergo a genetic test. Such a health care professional shall 
     not require that such individual or family member undergo a 
     genetic test.
       [``(d) Compliance With Certain Confidentiality Standards 
     With Respect to Genetic Information.--With respect to the use 
     or disclosure of genetic information by a group health plan, 
     or a health insurance issuer offering health insurance 
     coverage in connection with a group health plan, such 
     information shall be deemed to be protected health 
     information for purposes of, and shall be subject to, the 
     standards promulgated by the Secretary of Health and Human 
     Services under--
       [``(1) part C of title XI of the Social Security Act (42 
     U.S.C. 1320d et seq.); or
       [``(2) section 264(c) of the Health Insurance Portability 
     and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 
     2033).
       [``(e) Collection of Genetic Information.--
       [``(1) Limitation on requesting or requiring genetic 
     information.--Except as provided in paragraph (2), a group 
     health plan, or a health insurance issuer offering health 
     insurance coverage in connection with a group health plan, 
     shall not request or require genetic information concerning 
     an individual or a family member of the individual (including 
     information about a request for or receipt of genetic 
     services).
       [``(2) Information needed for treatment, payment, and 
     health care operations.--Notwithstanding paragraph (1), a 
     group health plan, or a health insurance issuer offering 
     health insurance coverage in connection with a group health 
     plan, that provides health care items and services to an 
     individual may request genetic information concerning such 
     individual or dependent for purposes of treatment, payment, 
     or health care operations in accordance with the standards 
     for protected health information described in subsection (d) 
     to the extent that the use of such information is otherwise 
     consistent with this section.
       [``(3) Failure to provide necessary information.--If an 
     individual or dependent refuses to provide the information 
     requested under paragraph (2), and such information is for 
     treatment, payment, or health care operations relating to the 
     individual, the group health plan or health insurance issuer 
     requesting such information shall not be required to provide 
     coverage for the items, services, or treatments with respect 
     to which the requested information relates.''.
       [(3) 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 an individual--
       [``(A) the spouse of the individual;
       [``(B) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; and
       [``(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       [``(16) Genetic information.--
       [``(A) In general.--Except as provided in subparagraph (B), 
     the term `genetic information' means information--
       [``(i) concerning--

       [``(I) the genetic tests of an individual;
       [``(II) the genetic tests of family members of the 
     individual; or
       [``(III) the occurrence of a disease or disorder in family 
     members of the individual; and

       [``(ii) that is used to predict risk of disease in 
     asymptomatic or undiagnosed individuals.

[[Page 24113]]

       [``(B) Exceptions.--The term `genetic information' shall 
     not include--
       [``(i) information about the sex or age of the individual;
       [``(ii) information derived from clinical and laboratory 
     tests, such as the chemical, blood, or urine analyses of the 
     individual including cholesterol tests, used to determine 
     health status or detect illness or diagnose disease; and
       [``(iii) information about physical exams of the 
     individual.
       [``(17) Genetic services.--The term `genetic services' 
     means health services provided for genetic education and 
     counseling.
       [``(18) Genetic test.--The term `genetic test' means the 
     analysis of human DNA, RNA, chromosomes, proteins, and 
     metabolites, that detect genotypes, mutations, or chromosomal 
     changes. Such term does not include information described in 
     paragraph (16)(B).''.
       [(b) Amendment Relating to the Individual Market.--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--
       [(1) by redesignating such subpart as subpart 2; and
       [(2) 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.--A health insurance issuer offering health 
     insurance coverage in the individual market may not use 
     genetic information as a condition of eligibility of an 
     individual to enroll in individual health insurance coverage 
     (including information about a request for or receipt of 
     genetic services).
       [``(b) Prohibition on Genetic Information in Setting 
     Premium Rates.--For purposes of this section, 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 (including information about a request for or 
     receipt of genetic services).
       [``(c) 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.--Nothing in this part shall be 
     construed to limit the authority of a health care 
     professional, who is providing health care services with 
     respect to an individual or who is acting on behalf of a 
     health insurance issuer, to request that such individual or a 
     family member of such individual undergo a genetic test. Such 
     a health care professional shall not require that such 
     individual or family member undergo a genetic test.
       [``(d) Compliance With Certain Confidentiality Standards 
     With Respect to Genetic Information.--With respect to the use 
     or disclosure of genetic information by a health insurance 
     issuer offering health insurance coverage in the individual 
     market, such information shall be deemed to be protected 
     health information for purposes of, and shall be subject to, 
     the standards promulgated by the Secretary of Health and 
     Human Services under--
       [``(1) part C of title XI of the Social Security Act (42 
     U.S.C. 1320d et seq.); or
       [``(2) section 264(c) of the Health Insurance Portability 
     and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 
     2033).
       [``(e) Collection of Genetic Information.--
       [``(1) Limitation on requesting or requiring genetic 
     information.--Except as provided in paragraph (2), a health 
     insurance issuer offering health insurance coverage in the 
     individual market shall not request or require genetic 
     information concerning an individual or a family member of 
     the individual (including information about a request for or 
     receipt of genetic services).
       [``(2) Information needed for treatment, payment, and 
     health care operations.--Notwithstanding paragraph (1), a 
     health insurance issuer offering health insurance coverage in 
     the individual market that provides health care items and 
     services to an individual may request genetic information 
     concerning such individual or dependent for purposes of 
     treatment, payment, or health care operations in accordance 
     with the standards for protected health information described 
     in subsection (d) to the extent that the use of such 
     information is otherwise consistent with this section.
       [``(3) Failure to provide necessary information.--If an 
     individual or dependent refuses to provide the information 
     requested under paragraph (2), and such information is for 
     treatment, payment, or health care operations relating to the 
     individual, the health insurance issuer requesting such 
     information shall not be required to provide coverage for the 
     items, services, or treatments with respect to which the 
     requested information relates.''.
       [(c) Regulations and Effective Date.--
       [(1) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of Labor and the 
     Secretary of Health and Human Services (as the case may be) 
     shall issue final regulations in an accessible format 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 18 
     months after the date of enactment of this title; 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 18 months after the 
     date of enactment of this title.

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

       [(a) Prohibition of Health Discrimination on the Basis of 
     Genetic Information or Genetic Services.--
       [(1) No enrollment restriction for genetic services.--
     Section 9802(a)(1)(F) of the Internal Revenue Code of 1986 is 
     amended by inserting before the period the following: 
     ``(including information about a request for or receipt of 
     genetic services)''.
       [(2) No discrimination in group premiums based on genetic 
     information.--Section 9802(b) of the Internal Revenue Code of 
     1986 is amended by adding at the end the following:
       [``(3) No discrimination in group premiums based on genetic 
     information.--For purposes of this section, a group health 
     plan shall not adjust premium or contribution amounts for a 
     group on the basis of genetic information concerning an 
     individual in the group or a family member of the individual 
     (including information about a request for or receipt of 
     genetic services).''.
       [(b) Limitations on Genetic Testing and the Collection of 
     Genetic Information.--Section 9802 of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following:
       [``(d) Genetic Testing and Genetic Services.--
       [``(1) Limitation on requesting or requiring genetic 
     testing.--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.--Nothing in this part shall be 
     construed to limit the authority of a health care 
     professional, who is providing health care services with 
     respect to an individual or who is acting on behalf of a 
     group health plan, to request that such individual or a 
     family member of such individual undergo a genetic test. Such 
     a health care professional shall not require that such 
     individual or family member undergo a genetic test.
       [``(e) Compliance With Certain Confidentiality Standards 
     With Respect to Genetic Information.--With respect to the use 
     or disclosure of genetic information by a group health plan, 
     such information shall be deemed to be protected health 
     information for purposes of, and shall be subject to, the 
     standards promulgated by the Secretary of Health and Human 
     Services under--
       [``(1) part C of title XI of the Social Security Act (42 
     U.S.C. 1320d et seq.); or
       [``(2) section 264(c) of the Health Insurance Portability 
     and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 
     2033).
       [``(f) Collection of Genetic Information.--
       [``(1) Limitation on requesting or requiring genetic 
     information.--Except as provided in paragraph (2), a group 
     health plan shall not request or require genetic information 
     concerning an individual or a family member of the individual 
     (including information about a request for or receipt of 
     genetic services).
       [``(2) Information needed for treatment, payment, and 
     health care operations.--Notwithstanding paragraph (1), a 
     group health plan that provides health care items and 
     services to an individual may request genetic information 
     concerning such individual or dependent for purposes of 
     treatment, payment, or health care operations in accordance 
     with the standards for protected health information described 
     in subsection (e) to the extent that the use of such 
     information is otherwise consistent with this section.
       [``(3) Failure to provide necessary information.--If an 
     individual or dependent refuses to provide the information 
     requested under paragraph (2), and such information is for 
     treatment, payment, or health care operations relating to the 
     individual, the group health plan requesting such information 
     shall not be required to provide coverage for the items, 
     services, or treatments with respect to which the requested 
     information relates.''.
       [(c) Definitions.--Section 9832(d) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following:
       [``(6) Family member.--The term `family member' means with 
     respect to an individual--
       [``(A) the spouse of the individual;
       [``(B) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; and
       [``(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       [``(7) Genetic information.--

[[Page 24114]]

       [``(A) In general.--Except as provided in subparagraph (B), 
     the term `genetic information' means information--
       [``(i) concerning--

       [``(I) the genetic tests of an individual;
       [``(II) the genetic tests of family members of the 
     individual; or
       [``(III) the occurrence of a disease or disorder in family 
     members of the individual; and

       [``(ii) that is used to predict risk of disease in 
     asymptomatic or undiagnosed individuals.
       [``(B) Exceptions.--The term `genetic information' shall 
     not include--
       [``(i) information about the sex or age of the individual;
       [``(ii) information derived from clinical and laboratory 
     tests, such as the chemical, blood, or urine analyses of the 
     individual including cholesterol tests, used to determine 
     health status or detect illness or diagnose disease; and
       [``(iii) information about physical exams of the 
     individual.
       [``(8) Genetic services.--The term `genetic services' means 
     health services provided for genetic education and 
     counseling.
       [``(9) Genetic test.--The term `genetic test' means the 
     analysis of human DNA, RNA, chromosomes, proteins, and 
     metabolites, that detect genotypes, mutations, or chromosomal 
     changes. Such term does not include information described in 
     paragraph (7)(B).''.
       [(d) Regulations and Effective Date.--
       [(1) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of the Treasury shall 
     issue final regulations in an accessible format 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 18 months after the date of 
     enactment of this title.

     [SEC. 104. ASSURING COORDINATION.

       [The Secretary of the Treasury, the Secretary of Health and 
     Human Services, and the Secretary of Labor 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; and member.--The terms--
       [(A) ``employee'', ``employer'', ``employment agency'', and 
     ``labor organization'' have the meanings given such terms in 
     section 701 of the Civil Rights Act of 1964 (42 U.S.C. 
     2000e); and
       [(B) ``employee'' and ``member'', as used with respect to a 
     labor organization, include an applicant for employment and 
     an applicant for membership in a labor organization, 
     respectively.
       [(3) Family member.--The term ``family member'' means with 
     respect to an individual--
       [(A) the spouse of the individual;
       [(B) a dependent child of the individual, including a child 
     who is born to or placed for adoption with the individual; 
     and
       [(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       [(4) Genetic information.--
       [(A) In general.--Except as provided in subparagraph (B), 
     the term ``genetic information'' means information--
       [(i) concerning--

       [(I) the genetic tests of an individual;
       [(II) the genetic tests of family members of the 
     individual; or
       [(III) the occurrence of a disease or disorder in family 
     members of the individual; and

       [(ii) that is used to predict risk of disease in 
     asymptomatic or undiagnosed individuals.
       [(B) Exceptions.--The term ``genetic information'' shall 
     not include--
       [(i) information about the sex or age of the individual;
       [(ii) information derived from clinical and laboratory 
     tests, such as the chemical, blood, or urine analyses of the 
     individual including cholesterol tests, used to determine 
     health status or detect illness or diagnose disease; and
       [(iii) information about physical exams of the 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 
     health services provided for genetic education and 
     counseling.
       [(7) Genetic test.--The term ``genetic test'' means the 
     analysis of human DNA, RNA, chromosomes, proteins, and 
     metabolites, that detect genotypes, mutations, or chromosomal 
     changes. Such term does not include information described in 
     paragraph (4)(B).

     [SEC. 202. EMPLOYER PRACTICES.

       [(a) Use of Genetic Information.--It shall be an unlawful 
     employment practice for an employer--
       [(1) to fail or refuse to hire or to discharge any 
     individual, or otherwise to discriminate against any 
     individual with respect to the compensation, terms, 
     conditions, or privileges of employment of the individual, 
     because of genetic information with respect to the individual 
     (or information about a request for or the receipt of genetic 
     services by such individual or family member of such 
     individual); or
       [(2) to limit, segregate, or classify the employees of the 
     employer 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 
     information about a request for or the receipt of genetic 
     services by such individual or family member of such 
     individual).
       [(b) Limitation on Collection of Genetic Information.--It 
     shall be an unlawful employment practice for an employer to 
     intentionally request, require, or purchase genetic 
     information with respect to an employee or a family member of 
     the employee (or information about a request for the receipt 
     of genetic services by such employee or a family of such 
     employee) except--
       [(1) 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, State, 
     or local law;
       [(C) the employee is informed of individual monitoring 
     results;
       [(D) the monitoring conforms to any Federal or State 
     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.) or the Federal Mine Safety and Health 
     Act of 1977 (30 U.S.C. 801 et seq.); and
       [(E) the employer, excluding any licensed or certified 
     health care professional 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;
       [(2) where--
       [(A) health or genetic services are offered by the 
     employer;
       [(B) the employee provides prior, knowing, voluntary, and 
     written authorization; and
       [(C) only the employee (or family member if the family 
     member is receiving genetic services) and the licensed or 
     certified health care professionals involved in providing 
     such services receive individually identifiable information 
     concerning the results of such services; or
       [(3) where the request or requirement is necessary to 
     comply with Federal, State, or local law.
       [(c) Limitation.--In the case of genetic information to 
     which paragraph (1), (2), or (3) of subsection (b) applies, 
     such information may not be used in violation of paragraph 
     (1) or (2) of subsection (a).
       [(d) Exception.--
       [(1) In general.--An employer shall not be considered to 
     engage in an employment practice that is unlawful under this 
     title because of its disparate impact, on the basis that the 
     employer applies a qualification standard, test, or other 
     selection criterion that screens out or tends to screen out, 
     or otherwise denies a job benefit to, an individual, if the 
     standard, test, or other selection criterion is shown to be 
     job-related with respect to the employment position involved 
     and consistent with business necessity.
       [(2) Qualification standard.--In this subsection, the term 
     ``qualification standard'' may include a requirement that an 
     individual shall not pose a direct threat to the health or 
     safety of other individuals in the workplace.
       [(e) Rule of Construction Relating to Group Health Plans.--
     Nothing in this section shall be construed to prohibit a 
     group health plan (as such term is defined in section 733(a) 
     of the Employee Retirement Income Security Act of 1974 (29 
     U.S.C. 1191b(a))), or a health insurance issuer offering 
     group health insurance coverage in connection with a group 
     health plan, from making a request described in subsection 
     (b) if such request is consistent with the provisions of part 
     7 of subtitle B of title I of the

[[Page 24115]]

     Employee Retirement Income Security Act of 1974 (29 U.S.C. 
     1181 et seq.), title XXVII of the Public Health Service (42 
     U.S.C. 300gg et seq.), and chapter 100 of the Internal 
     Revenue Code of 1986.

     [SEC. 203. EMPLOYMENT AGENCY PRACTICES.

       [(a) Use of 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 (or 
     information about a request for or the receipt of genetic 
     services by such individual or family member of such 
     individual); or
       [(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 information 
     about a request for or the receipt of genetic services by 
     such individual or family member of such individual).
       [(b) Limitation on Collection of Genetic Information.--It 
     shall be an unlawful employment practice for an employment 
     agency--
       [(1) to intentionally request, require, or purchase genetic 
     information with respect to an employee or family member of 
     the employee (or information about a request for or the 
     receipt of genetic services by such employee or family member 
     of such employee), except that the provisions of section 
     202(b) shall apply with respect to employment agencies and 
     employees (and the family members of the employees) under 
     this paragraph in the same manner and to the same extent as 
     such provisions apply to employers and employees (and the 
     family members of the employees) under section 202(b); or
       [(2) to cause or attempt to cause an employer to 
     discriminate against an individual in violation of this 
     title.
       [(c) Limitation and Exception.--Subsections (c) and (d) of 
     section 202 shall apply with respect to employment agencies 
     and employees (and the family members of the employees) under 
     this section in the same manner and to the same extent as 
     such provisions apply to employers and employees (and the 
     family members of the employees) under section 202.

     [SEC. 204. LABOR ORGANIZATION PRACTICES.

       [(a) Use of 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 
     individual because of genetic information with respect to the 
     individual (or information about a request for or the receipt 
     of genetic services by such individual or family member of 
     such individual); or
       [(2) to limit, segregate, or classify the members of the 
     organization, 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 information about a request for or the receipt of genetic 
     services by such individual or family member of such 
     individual).
       [(b) Limitation on Collection of Genetic Information.--It 
     shall be an unlawful employment practice for a labor 
     organization--
       [(1) to intentionally request, require, or purchase genetic 
     information with respect to an individual who is a member of 
     a labor organization or a family member of the individual (or 
     information about a request for or the receipt of genetic 
     services by such individual or family member of such 
     individual) except that the provisions of section 202(b) 
     shall apply with respect to labor organizations and such 
     individuals (and their family members) under this paragraph 
     in the same manner and to the same extent as such provisions 
     apply to employers and employees (and the family members of 
     the employees) under section 202(b); or
       [(2) to cause or attempt to cause an employer to 
     discriminate against an individual in violation of this 
     title.
       [(c) Limitation and Exception.--Subsections (c) and (d) of 
     section 202 shall apply with respect to labor organizations 
     and individuals who are members of labor organizations (and 
     the family members of the individuals) under this section in 
     the same manner and to the same extent as such provisions 
     apply to employers and employees (and the family members of 
     the employees) under section 202.

     [SEC. 205. TRAINING PROGRAMS.

       [(a) Use of 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 (or 
     information about a request for or the receipt of genetic 
     services by such individual or a family member of such 
     individual) in admission to, or employment in, any program 
     established to provide apprenticeship or other training or 
     retraining; or
       [(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 information about a request for or receipt of genetic 
     services by such individual or family member of such 
     individual).
       [(b) Limitation on Collection of Genetic Information.--It 
     shall be an unlawful employment practice for an employer, 
     labor organization, or joint labor-management committee 
     described in subsection (a)--
       [(1) to intentionally request, require, or purchase genetic 
     information with respect to an individual who is an applicant 
     for or a participant in such apprenticeship or other training 
     or retraining (or information about a request for or the 
     receipt of genetic services by such individual or family 
     member of such individual) except that the provisions of 
     section 202(b) shall apply with respect to such employers, 
     labor organizations, and joint labor-management committees 
     and to such individuals (and their family members) under this 
     paragraph in the same manner and to the same extent as such 
     provisions apply to employers and employees (and their family 
     members) under section 202(b); or
       [(2) 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.
       [(c) Limitation and Exception.--Subsections (c) and (d) of 
     section 202 shall apply with respect to employers, labor 
     organizations, and joint labor-management committees 
     described in subsection (a) and to individuals who are 
     applicants for or participants in apprenticeship or other 
     training or retraining (and the family members of the 
     individuals) under this section in the same manner and to the 
     same extent as the provisions apply to employers and to 
     employees (and the family members of the employees) under 
     section 202.

     [SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION.

       [(a) Treatment of Information as Part of Confidential 
     Medical Record.--
       [(1) In general.--If an employer, employment agency, labor 
     organization, or joint labor-management committee possesses 
     genetic information about an employee or member (or 
     information about a request for or receipt of genetic 
     services by such employee or member or family member of such 
     employee or member), such information shall be treated and 
     maintained as part of the employee's or member's confidential 
     medical records.
       [(2) Limitation on disclosure.--An employer, employment 
     agency, labor organization, or joint labor-management 
     committee shall not disclose genetic information concerning 
     an employee or member (or information about a request for or 
     receipt of genetic services by such employee or member or 
     family member of such employee or member) except--
       [(A) to the employee (or family member if the family member 
     is receiving the genetic services) or member at the request 
     of the employee or member;
       [(B) 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 (or any corresponding similar regulation 
     or rule);
       [(C) under legal compulsion of a Federal or State court 
     order, except that if the court order was secured without the 
     knowledge of the individual to whom the information refers, 
     the employer shall provide the individual with adequate 
     notice to challenge the court order;
       [(D) to government officials who are investigating 
     compliance with this title if the information is relevant to 
     the investigation;
       [(E) to the extent that such disclosure is necessary to 
     comply with Federal, State, or local law; or
       [(F) as otherwise provided for in this title.
       [(b) Rule of Construction Relating to Group Health Plans.--
     Nothing in this section shall be construed to prohibit a 
     group health plan (as such term is defined in section 733(a) 
     of the Employee Retirement Income Security Act of 1974 (29 
     U.S.C. 1191b(a))), or a health insurance issuer offering 
     group health insurance coverage in connection with a group 
     health plan, from using or disclosing information described 
     in subsection (a) if such use of disclosure is consistent 
     with the provisions of part 7 of subtitle B of title I of the 
     Employee Retirement Income Security Act of 1974 (29 U.S.C. 
     1181 et seq.), title XXVII of the Public Health Service (42 
     U.S.C. 300gg et seq.), and chapter 100 of the Internal 
     Revenue Code of 1986.

     [SEC. 207. ENFORCEMENT.

       [The powers, remedies, and procedures set forth in sections 
     705, 706, 707, 709, and 710 of the Civil Rights Act of 1964 
     (42 U.S.C. 2000e-4, 2000e-5, 2000e-6, 2000e-8, and 2000e-9) 
     shall be the powers, remedies, and procedures that this title 
     provides to the Commission, to the Attorney General, or to 
     any person alleging

[[Page 24116]]

     an unlawful employment practice in violation of section 202 
     (other than subsection (e) of such section), 203, 204, 205, 
     or 206(a) or the regulations promulgated under section 210, 
     concerning employment.

     [SEC. 208. AMENDMENT TO THE REVISED STATUTES.

       [(a) Right of Recovery.--Section 1977A(a) of the Revised 
     Statutes (42 U.S.C. 1981a(a)) is amended by adding at the end 
     the following:
       [``(4) Genetic information.--In an action brought by a 
     complaining party under the powers, remedies, and procedures 
     set forth in section 706 of the Civil Rights Act of 1964 (42 
     U.S.C. 2000e-5), as authorized under section 207 of the 
     Genetic Information Nondiscrimination Act of 2003, against a 
     respondent who is engaging (or has engaged) in an intentional 
     unlawful employment practice prohibited by section 202 (other 
     than subsection (e) of such section), 203, 204, 205 or 206(a) 
     of such Genetic Information Nondiscrimination Act of 2003 
     against an individual (other than an action involving an 
     employment practice that is allegedly unlawful because of its 
     disparate impact), the complaining party may recover 
     compensatory and punitive damages as permitted under 
     subsection (b), in addition to any relief otherwise provided 
     for under section 706(g) of the Civil Rights Act of 1964 (42 
     U.S.C. 2000e-5(g)), from the respondent.''.
       [(b) Conforming Amendments.--Section 1977A(d) of the 
     Revised Statutes (42 U.S.C. 1981a(d)) is amended--
       [(1) in paragraph (1)--
       [(A) in subparagraph (A), by striking ``or'' at the end;
       [(B) in subparagraph (B), by striking the period and 
     inserting ``; or''; and
       [(C) by adding at the end the following:
       [``(C) in the case of a person seeking to bring an action 
     under subsection (a)(4), the Equal Employment Opportunity 
     Commission, the Attorney General, or a person who may bring 
     an action or proceeding under title II of the Genetic 
     Information Nondiscrimination Act of 2003.''; and
       [(2) in paragraph (2), by striking ``or the discrimination 
     or the violation described in paragraph (2),'' and inserting 
     ``the discrimination or the violation described in paragraph 
     (2), or the intentional unlawful employment practice 
     described in paragraph (4),''.

     [SEC. 209. CONSTRUCTION.

       [Nothing in this title shall be construed to--
       [(1) limit the rights or 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.), except 
     that an individual may not bring an action against an 
     employer, employment agency, labor organization, or joint 
     labor-management committee pursuant to this title and also 
     pursuant to the Americans with Disabilities Act of 1990 or 
     the Rehabilitation Act of 1973, if the actions are predicated 
     on the same facts or a common occurrence;
       [(2) 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, except 
     that an individual may not bring an action against such an 
     employer, employment agency, labor organization, or joint 
     labor-management committee, with respect to a group health 
     plan or a health insurance issuer offering health insurance 
     coverage in connection with a group health plan, under this 
     title if the action is based on a violation of a provision of 
     the amendments made by title I;
       [(3) 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;
       [(4) apply to the Armed Forces Repository of Specimen 
     Samples for the Identification of Remains;
       [(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); and
       [(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.

     [SEC. 210. REGULATIONS.

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

     [SEC. 211. SEVERABILITY.

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

     [SEC. 212. AUTHORIZATION OF APPROPRIATIONS.

       [There are authorized to be appropriated such sums as may 
     be necessary to carry out this title.

     [SEC. 213. EFFECTIVE DATE.

       [(a) In General.--This title takes effect on the date that 
     is 18 months after the date of enactment of this Act.
       [(b) Enforcement.--Notwithstanding subsection (a), no 
     enforcement action shall be commenced under section 207 until 
     the date on which the Commission issues final regulations 
     under section 210.]

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Genetic Information 
     Nondiscrimination Act of 2003''.

         TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

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

       (a) Prohibition of Health Discrimination on the Basis of 
     Genetic Information or Genetic Services.--
       (1) No enrollment restriction for genetic services.--
     Section 702(a)(1)(F) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1182(a)(1)(F)) is amended by 
     inserting before the period the following: ``(including 
     information about a request for or receipt of genetic 
     services by an individual or family member of such 
     individual)''.
       (2) 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--
       (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 discrimination in group premiums based on genetic 
     information.--For purposes of this section, a group health 
     plan, or a health insurance issuer offering group health 
     insurance coverage in connection with a group health plan, 
     shall not adjust premium or contribution amounts for a group 
     on the basis of genetic information concerning an individual 
     in the group or a family member of the individual (including 
     information about a request for or receipt of genetic 
     services by an individual or family member of such 
     individual).''.
       (b) Limitations on Genetic Testing.--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, or 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.--Nothing in this part shall be 
     construed to--
       ``(A) limit the authority of a health care professional who 
     is providing health care services with respect to an 
     individual to request that such individual or a family member 
     of such individual undergo a genetic test;
       ``(B) limit the authority of a health care professional who 
     is employed by or affiliated with a group health plan or a 
     health insurance issuer and who is providing health care 
     services to an individual as part of a bona fide wellness 
     program to notify such individual of the availability of a 
     genetic test or to provide information to such individual 
     regarding such genetic test; or
       ``(C) authorize or permit a health care professional to 
     require that an individual undergo a genetic test.
       ``(d) Application to All Plans.--The provisions of 
     subsections (a)(1)(F), (b)(3), and (c) shall apply to group 
     health plans and health insurance issuers without regard to 
     section 732(a).''.
       (c) Remedies and Enforcement.--Section 502 of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 1132) is 
     amended by adding at the end the following:
       ``(n) Enforcement of Genetic Nondiscrimination 
     Requirements.--
       ``(1) Injunctive relief for irreparable harm.--With respect 
     to any violation of subsection (a)(1)(F), (b)(3), or (c) of 
     section 702, a participant or beneficiary may seek relief 
     under subsection 502(a)(1)(B) prior to the exhaustion of 
     available administrative remedies under section 503 if it is 
     demonstrated to the court, by a preponderance of the 
     evidence, that the exhaustion of such remedies would cause 
     irreparable harm to the health of the participant or 
     beneficiary. Any determinations that already have been made 
     under section 503 in such case, or that are made in such case 
     while an action under this paragraph is pending, shall be 
     given due consideration by the court in any action under this 
     subsection in such case.
       ``(2) Equitable relief for genetic nondiscrimination.--
       ``(A) Reinstatement of benefits where equitable relief has 
     been awarded.--The recovery of benefits by a participant or 
     beneficiary under a civil action under this section may 
     include an administrative penalty under subparagraph (B) and 
     the retroactive reinstatement of coverage under the plan 
     involved to the date on which the participant or beneficiary 
     was denied eligibility for coverage if--
       ``(i) the civil action was commenced under subsection 
     (a)(1)(B); and
       ``(ii) the denial of coverage on which such civil action 
     was based constitutes a violation of subsection (a)(1)(F), 
     (b)(3), or (c) of section 702.
       ``(B) Administrative penalty.--
       ``(i) In general.--An administrator who fails to comply 
     with the requirements of subsection

[[Page 24117]]

     (a)(1)(F), (b)(3), or (c) of section 702 with respect to a 
     participant or beneficiary may, in an action commenced under 
     subsection (a)(1)(B), be personally liable in the discretion 
     of the court, for a penalty in the amount not more than $100 
     for each day in the noncompliance period.
       ``(ii) Noncompliance period.--For purposes of clause (i), 
     the term `noncompliance period' means the period--

       ``(I) beginning on the date that a failure described in 
     clause (i) occurs; and
       ``(II) ending on the date that such failure is corrected.

       ``(iii) Payment to participant or beneficiary.--A penalty 
     collected under this subparagraph shall be paid to the 
     participant or beneficiary involved.
       ``(3) Secretarial enforcement authority.--
       ``(A) General rule.--The Secretary has the authority to 
     impose a penalty on any failure of a group health plan to 
     meet the requirements of subsection (a)(1)(F), (b)(3), or (c) 
     of section 702.
       ``(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 individual 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 such 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) 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 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.''.
       (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) the spouse of the individual;
       ``(B) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; and
       ``(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       ``(6) Genetic information.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     the term `genetic information' means information about--
       ``(i) an individual's genetic tests;
       ``(ii) the genetic tests of family members of the 
     individual; or
       ``(iii) the occurrence of a disease or disorder in family 
     members of the individual.
       ``(B) Exclusions.--The term `genetic information' shall not 
     include information about the sex or age of an 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 (such as obtaining, interpreting, 
     or assessing genetic information); or
       ``(C) genetic education.''.
       (e) Regulations and Effective Date.--
       (1) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of Labor shall issue 
     final regulations in an accessible format 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 18 months after the date of 
     enactment of this title.

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

       (a) Amendments Relating to the Group Market.--
       (1) Prohibition of health discrimination on the basis of 
     genetic information or genetic services.--
       (A) No enrollment restriction for genetic services.--
     Section 2702(a)(1)(F) of the Public Health Service Act (42 
     U.S.C. 300gg-1(a)(1)(F)) is amended by inserting before the 
     period the following: ``(including information about a 
     request for or receipt of genetic services by an individual 
     or family member of such individual)''.
       (B) 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--
       (i) in paragraph (2)(A), by inserting before the semicolon 
     the following: ``, except as provided in paragraph (3)''; and
       (ii) by adding at the end the following:
       ``(3) No discrimination in group premiums based on genetic 
     information.--For purposes of this section, a group health 
     plan, or a health insurance issuer offering group health 
     insurance coverage in connection with a group health plan, 
     shall not adjust premium or contribution amounts for a group 
     on the basis of genetic information concerning an individual 
     in the group or a family member of the individual (including 
     information about a request for or receipt of genetic 
     services by an individual or family member of such 
     individual).''.
       (2) Limitations on genetic testing.--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, or 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.--Nothing in this part shall be 
     construed to--
       ``(A) limit the authority of a health care professional who 
     is providing health care services with respect to an 
     individual to request that such individual or a family member 
     of such individual undergo a genetic test;
       ``(B) limit the authority of a health care professional who 
     is employed by or affiliated with a group health plan or a 
     health insurance issuer and who is providing health care 
     services to an individual as part of a bona fide wellness 
     program to notify such individual of the availability of a 
     genetic test or to provide information to such individual 
     regarding such genetic test; or
       ``(C) authorize or permit a health care professional to 
     require that an individual undergo a genetic test.
       ``(d) Application to All Plans.--The provisions of 
     subsections (a)(1)(F), (b)(3), and (c) shall apply to group 
     health plans and health insurance issuers without regard to 
     section 2721(a).''.
       (3) 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 
     following provisions 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), or (c) of section 2702.
       ``(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 individual 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 such failure is corrected.

       ``(C) Minimum penalties where failure discovered.--
     Notwithstanding clauses (i) and (ii) of subparagraph (D):

[[Page 24118]]

       ``(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) 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 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.''.
       (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 an individual--
       ``(A) the spouse of the individual;
       ``(B) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; and
       ``(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       ``(16) Genetic information.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     the term `genetic information' means information about--
       ``(i) an individual's genetic tests;
       ``(ii) the genetic tests of family members of the 
     individual; or
       ``(iii) the occurrence of a disease or disorder in family 
     members of the individual.
       ``(B) Exclusions.--The term `genetic information' shall not 
     include information about the sex or age of an 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 (such as obtaining, interpreting, 
     or assessing genetic information); or
       ``(C) genetic education.''.
       (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.--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 (including information 
     about a request for or receipt of genetic services by an 
     individual or family member of such individual).
       ``(b) Prohibition on Genetic Information in Setting Premium 
     Rates.--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 (including information about a 
     request for or receipt of genetic services by an individual 
     or family member of such individual).
       ``(c) 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.--Nothing in this part shall be 
     construed to--
       ``(A) limit the authority of a health care professional who 
     is providing health care services with respect to an 
     individual to request that such individual or a family member 
     of such individual undergo a genetic test;
       ``(B) limit the authority of a health care professional who 
     is employed by or affiliated with a health insurance issuer 
     and who is providing health care services to an individual as 
     part of a bona fide wellness program to notify such 
     individual of the availability of a genetic test or to 
     provide information to such individual regarding such genetic 
     test; or
       ``(C) authorize or permit a health care professional to 
     require that an individual undergo a genetic test.''.
       (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) and (c) of section 2702 and the 
     provisions of section 2702(b) to the extent that such 
     provisions apply to genetic information (or information about 
     a request for or the receipt of genetic services by an 
     individual or a family member of such individual).''.
       (d) Regulations and Effective Date.--
       (1) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of Labor and the 
     Secretary of Health and Human Services (as the case may be) 
     shall issue final regulations in an accessible format 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 18 
     months after the date of enactment of this title; 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 18 months after the 
     date of enactment of this title.

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

       (a) Prohibition of Health Discrimination on the Basis of 
     Genetic Information or Genetic Services.--
       (1) No enrollment restriction for genetic services.--
     Section 9802(a)(1)(F) of the Internal Revenue Code of 1986 is 
     amended by inserting before the period the following: 
     ``(including information about a request for or receipt of 
     genetic services by an individual or family member of such 
     individual)''.
       (2) No discrimination in group premiums based on genetic 
     information.--Section 9802(b) of the Internal Revenue Code of 
     1986 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 discrimination in group premiums based on genetic 
     information.--For purposes of this section, a group health 
     plan shall not adjust premium or contribution amounts for a 
     group on the basis of genetic information concerning an 
     individual in the group or a family member of the individual 
     (including information about a request for or receipt of 
     genetic services by an individual or family member of such 
     individual).''.
       (b) Limitations on Genetic Testing.--Section 9802 of the 
     Internal Revenue Code of 1986 is amended by adding at the end 
     the following:
       ``(d) Genetic Testing and Genetic Services.--
       ``(1) Limitation on requesting or requiring genetic 
     testing.--A group health plan shall

[[Page 24119]]

     not request or require an individual or a family member of 
     such individual to undergo a genetic test.
       ``(2) Rule of construction.--Nothing in this part shall be 
     construed to--
       ``(A) limit the authority of a health care professional who 
     is providing health care services with respect to an 
     individual to request that such individual or a family member 
     of such individual undergo a genetic test;
       ``(B) limit the authority of a health care professional who 
     is employed by or affiliated with a group health plan and who 
     is providing health care services to an individual as part of 
     a bona fide wellness program to notify such individual of the 
     availability of a genetic test or to provide information to 
     such individual regarding such genetic test; or
       ``(C) authorize or permit a health care professional to 
     require that an individual undergo a genetic test.
       ``(e) Application to All Plans.--The provisions of 
     subsections (a)(1)(F), (b)(3), and (d) shall apply to group 
     health plans and health insurance issuers without regard to 
     section 9831(a)(2).''.
       (c) Definitions.--Section 9832(d) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following:
       ``(6) Family member.--The term `family member' means with 
     respect to an individual--
       ``(A) the spouse of the individual;
       ``(B) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; and
       ``(C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).
       ``(7) Genetic services.--The term `genetic services' 
     means--
       ``(A) a genetic test;
       ``(B) genetic counseling (such as obtaining, interpreting, 
     or assessing genetic information); or
       ``(C) genetic education.
       ``(8) Genetic information.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     the term `genetic information' means information about--
       ``(i) an individual's genetic tests;
       ``(ii) the genetic tests of family members of the 
     individual; or
       ``(iii) the occurrence of a disease or disorder in family 
     members of the individual.
       ``(B) Exclusions.--The term `genetic information' shall not 
     include information about the sex or age of an individual.
       ``(9) 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.''.
       (d) Regulations and Effective Date.--
       (1) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of the Treasury shall 
     issue final regulations in an accessible format 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 18 months after the date of 
     enactment of this title.

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

       (a) Nondiscrimination.--
       (1) In general.--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)(i) An issuer of a medicare supplemental policy shall 
     not deny or condition the issuance or effectiveness of the 
     policy, and shall not discriminate in the pricing of the 
     policy (including the adjustment of premium rates) of an 
     eligible individual on the basis of genetic information 
     concerning the individual (or information about a request 
     for, or the receipt of, genetic services by such individual 
     or family member of such individual).
       ``(ii) For purposes of clause (i), the terms `family 
     member', `genetic services', and `genetic information' shall 
     have the meanings given such terms in subsection (v).''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall apply with respect to a policy for policy years 
     beginning after the date that is 18 months after the date of 
     enactment of this Act.
       (b) Limitations on Genetic Testing.--
       (1) In general.--Section 1882 of the Social Security Act 
     (42 U.S.C. 1395ss) is amended by adding at the end the 
     following:
       ``(v) Limitations on Genetic Testing.--
       ``(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.--Nothing in this title shall be 
     construed to--
       ``(i) limit the authority of a health care professional who 
     is providing health care services with respect to an 
     individual to request that such individual or a family member 
     of such individual undergo a genetic test;
       ``(ii) limit the authority of a health care professional 
     who is employed by or affiliated with an issuer of a medicare 
     supplemental policy and who is providing health care services 
     to an individual as part of a bona fide wellness program to 
     notify such individual of the availability of a genetic test 
     or to provide information to such individual regarding such 
     genetic test; or
       ``(iii) authorize or permit a health care professional to 
     require that an individual undergo a genetic test.
       ``(2) Definitions.--In this subsection:
       ``(A) Family member.--The term `family member' means with 
     respect to an individual--
       ``(i) the spouse of the individual;
       ``(ii) a dependent child of the individual, including a 
     child who is born to or placed for adoption with the 
     individual; or
       ``(iii) any other individuals related by blood to the 
     individual or to the spouse or child described in clause (i) 
     or (ii).
       ``(B) Genetic information.--
       ``(i) In general.--Except as provided in clause (ii), the 
     term `genetic information' means information about--

       ``(I) an individual's genetic tests;
       ``(II) the genetic tests of family members of the 
     individual; or
       ``(III) the occurrence of a disease or disorder in family 
     members of the individual.

       ``(ii) Exclusions.--The term `genetic information' shall 
     not include information about the sex or age of an 
     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 (such as obtaining, interpreting, 
     or assessing genetic information); or
       ``(iii) genetic education.
       ``(E) 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) 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 (v).''.
       (3) Effective date.--The amendments made by this subsection 
     shall apply with respect to an issuer of a medicare 
     supplemental policy for policy years beginning on or after 
     the date that is 18 months after the date of enactment of 
     this Act.
       (c) 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, 2004, 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, 2004, 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, 2004.
       (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 
     2004 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

[[Page 24120]]

     the close of the first legislative session of the State 
     legislature that begins on or after July 1, 2004. 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) Applicability.--Except as provided in subsection (d), 
     the provisions of this section shall apply to group health 
     plans, health insurance issuers (including issuers in 
     connection with group health plans or individual health 
     coverage), and issuers of medicare supplemental policies, 
     without regard to--
       (1) section 732(a) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1191a(a));
       (2) section 2721(a) of the Public Health Service Act (42 
     U.S.C. 300gg-21(a)); and
       (3) section 9831(a)(2) of the Internal Revenue Code of 
     1986.
       (b) Compliance With Certain Confidentiality Standards With 
     Respect to Genetic Information.--
       (1) In general.--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) shall 
     apply to the use or disclosure of genetic information.
       (2) Prohibition on underwriting and premium rating.--
     Notwithstanding paragraph (1), a group health plan, a health 
     insurance issuer, or issuer of a medicare supplemental policy 
     shall not use or disclose genetic information (including 
     information about a request for or a receipt of genetic 
     services by an individual or family member of such 
     individual) for purposes of underwriting, determinations of 
     eligibility to enroll, premium rating, or the creation, 
     renewal or replacement of a plan, contract or coverage for 
     health insurance or health benefits.
       (c) Prohibition on Collection of Genetic Information.--
       (1) In general.--A group health plan, health insurance 
     issuer, or issuer of a medicare supplemental policy shall not 
     request, require, or purchase genetic information (including 
     information about a request for or a receipt of genetic 
     services by an individual or family member of such 
     individual) for purposes of underwriting, determinations of 
     eligibility to enroll, premium rating, or the creation, 
     renewal or replacement of a plan, contract or coverage for 
     health insurance or health benefits.
       (2) Limitation relating to the collection of genetic 
     information prior to enrollment.--A group health plan, health 
     insurance issuer, or issuer of a medicare supplemental policy 
     shall not request, require, or purchase genetic information 
     (including information about a request for or a receipt of 
     genetic services by an individual or family member of such 
     individual) concerning a participant, beneficiary, or 
     enrollee prior to the enrollment, and in connection with such 
     enrollment, of such individual under the plan, coverage, or 
     policy.
       (3) Incidental collection.--Where a group health plan, 
     health insurance issuer, or issuer of a medicare supplemental 
     policy obtains genetic information incidental to the 
     requesting, requiring, or purchasing of other information 
     concerning a participant, beneficiary, or enrollee, such 
     request, requirement, or purchase shall not be considered a 
     violation of this subsection if--
       (A) such request, requirement, or purchase is not in 
     violation of paragraph (1); and
       (B) any genetic information (including information about a 
     request for or receipt of genetic services) requested, 
     required, or purchased is not used or disclosed in violation 
     of subsection (b).
       (d) Application of Confidentiality Standards.--The 
     provisions of subsections (b) and (c) shall not apply--
       (1) to group health plans, health insurance issuers, or 
     issuers of medicare supplemental policies that are not 
     otherwise covered under 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); and
       (2) to genetic information that is not considered to be 
     individually-identifiable health information under 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).
       (e) Enforcement.--A group health plan, health insurance 
     issuer, or issuer of a medicare supplemental policy that 
     violates a provision of this section shall be subject to the 
     penalties described in sections 1176 and 1177 of the Social 
     Security Act (42 U.S.C. 1320d-5 and 1320d-6) in the same 
     manner and to the same extent that such penalties apply to 
     violations of part C of title XI of such Act.
       (f) Preemption.--
       (1) In general.--A provision or requirement under this 
     section or a regulation promulgated under this section shall 
     supersede any contrary provision of State law unless such 
     provision of State law imposes requirements, standards, or 
     implementation specifications that are more stringent than 
     the requirements, standards, or implementation specifications 
     imposed under this section or such regulations. No penalty, 
     remedy, or cause of action to enforce such a State law that 
     is more stringent shall be preempted by this section.
       (2) Rule of construction.--Nothing in paragraph (1) shall 
     be construed to establish a penalty, remedy, or cause of 
     action under State law if such penalty, remedy, or cause of 
     action is not otherwise available under such State law.
       (g) Coordination With Privacy Regulations.--The Secretary 
     shall implement and administer this section in a manner that 
     is consistent with the implementation and administration by 
     the Secretary of 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).
       (h) Definitions.--In this section:
       (1) Genetic information; genetic services.--The terms 
     ``family member'', ``genetic information'', ``genetic 
     services'', and ``genetic test'' have the meanings given such 
     terms in section 2791 of the Public Health Service Act (42 
     U.S.C. 300gg-91), as amended by this Act.
       (2) Group health plan; health insurance issuer.--The terms 
     ``group health plan'' and ``health insurance issuer'' include 
     only those plans and issuers that are covered under the 
     regulations described in subsection (d)(1).
       (3) Issuer of a medicare supplemental policy.--The term 
     ``issuer of a medicare supplemental policy'' means an issuer 
     described in section 1882 of the Social Security Act (42 
     insert 1395ss).
       (4) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.

     SEC. 106. ASSURING COORDINATION.

       (a) In General.--Except as provided in subsection (b), the 
     Secretary of the Treasury, the Secretary of Health and Human 
     Services, and the Secretary of Labor 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.
       (b) Authority of the Secretary.--The Secretary of Health 
     and Human Services has the sole authority to promulgate 
     regulations to implement section 105.

     SEC. 107. REGULATIONS; EFFECTIVE DATE.

       (a) Regulations.--Not later than 1 year after the date of 
     enactment of this title, the Secretary of Labor, the 
     Secretary of Health and Human Services, and the Secretary of 
     the Treasury shall issue final regulations in an accessible 
     format to carry out this title.
       (b) Effective Date.--Except as provided in section 104, the 
     amendments made by this title shall take effect on the date 
     that is 18 months after the date of enactment of this Act.

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 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) the spouse of the individual;
       (B) a dependent child of the individual, including a child 
     who is born to or placed for adoption with the individual; 
     and
       (C) all other individuals related by blood to the 
     individual or the spouse or child described in subparagraph 
     (A) or (B).

[[Page 24121]]

       (4) Genetic information.--
       (A) In general.--Except as provided in subparagraph (B), 
     the term ``genetic information'' means information about--
       (i) an individual's genetic tests;
       (ii) the genetic tests of family members of the individual; 
     or
       (iii) the occurrence of a disease or disorder in family 
     members of the individual.
       (B) Exceptions.--The term ``genetic information'' shall not 
     include information about the sex or age of an 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 (such as obtaining, interpreting or 
     assessing genetic information); or
       (C) genetic education.
       (7) Genetic test.--
       (A) In general.--The term ``genetic test'' means the 
     analysis of human DNA, RNA, chromosomes, proteins, or 
     metabolites, that detects genotypes, mutations, or 
     chromosomal changes.
       (B) Exception.--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) Use of 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 information about a request 
     for or the receipt of genetic services by such employee or 
     family member of such 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 (or 
     information about a request for or the receipt of genetic 
     services by such employee or family member of such 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 (or information 
     about a request for the receipt of genetic services by such 
     employee or a family member of such 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 bona fide 
     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; 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 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;
       (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) or (2) of subsection (a) or 
     treated or disclosed in a manner that violates section 206.

     SEC. 203. EMPLOYMENT AGENCY PRACTICES.

       (a) Use of 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 (or information 
     about a request for or the receipt of genetic services by 
     such individual or family member of such 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 information about a 
     request for or the receipt of genetic services by such 
     individual or family member of such 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 
     (or information about a request for the receipt of genetic 
     services by such individual or a family member of such 
     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 bona fide 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 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) or (2) of subsection (a) or 
     treated or disclosed in a manner that violates section 206.

[[Page 24122]]



     SEC. 204. LABOR ORGANIZATION PRACTICES.

       (a) Use of 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 (or information about a request for or the receipt of 
     genetic services by such member or family member of such 
     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 
     information about a request for or the receipt of genetic 
     services by such member or family member of such 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 (or 
     information about a request for the receipt of genetic 
     services by such member or a family member of such 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 
     bona fide 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) or (2) of subsection (a) or 
     treated or disclosed in a manner that violates section 206.

     SEC. 205. TRAINING PROGRAMS.

       (a) Use of 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 (or 
     information about a request for or the receipt of genetic 
     services by such individual or a family member of such 
     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 information about a request for or receipt of genetic 
     services by such individual or family member of such 
     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 (or information about a request for the 
     receipt of genetic services by such individual or a family 
     member of such 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 bona fide 
     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;
       (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; 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 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;
       (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) or (2) 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 (or 
     information about a request for or receipt of genetic 
     services by such employee or member or family member of such 
     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.
       (b) Limitation on Disclosure.--An employer, employment 
     agency, labor organization, or joint labor-management 
     committee shall not

[[Page 24123]]

     disclose genetic information concerning an employee or member 
     (or information about a request for or receipt of genetic 
     services by such employee or member or family member of such 
     employee or member) except--
       (1) to the employee (or family member if the family member 
     is receiving the genetic services) or member of a labor 
     organization at the 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 provide the employee or 
     member with adequate notice to challenge the court order;
       (4) to government officials who are investigating 
     compliance with this title if the information is relevant to 
     the investigation; or
       (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.

     SEC. 207. REMEDIES AND ENFORCEMENT.

       (a) Employees Covered by Title VII of the Civil Rights Act 
     of 1964.--
       (1) In general.--The powers, remedies, and procedures 
     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, remedies, and procedures 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 (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 (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).
       (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 (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 (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).
       (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 (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 (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).
       (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 (42 U.S.C. 1988), shall be powers, remedies, 
     and procedures this title provides to the 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 (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).
       (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 (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 (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).
       (f) 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-d(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.
       (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 Representative;
       (F) 1 member shall be appointed by the Minority Leader of 
     the House of Representative;
       (G) 1 member shall be appointed by the Chairman of the 
     Committee on Education and the Workforce of the House of 
     Representatives; and
       (H) 1 member shall be appointed by the ranking minority 
     member of the Committee on Education and the Workforce 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,

[[Page 24124]]

     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.

       Nothing in this title shall be construed to--
       (1) limit the rights or 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) establish a violation under this title for an employer, 
     employment agency, labor organization, or joint labor-
     management committee of a provision of the amendments made by 
     title I;
       (3) 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;
       (4) apply to the Armed Forces Repository of Specimen 
     Samples for the Identification of Remains;
       (5) limit or expand the protections, rights, or obligations 
     of employees or employers under applicable workers' 
     compensation laws;
       (6) 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); and
       (7) 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.

     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 in an 
     accessible format 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 PROVISION

     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.
  The committee amendment in the nature of a substitute was agreed to.
  The amendment (No. 1824) was agreed to.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  Mr. FRIST. Mr. President, this legislation and the unanimous consent 
that was just obtained signifies an important accomplishment of this 
body but an accomplishment that resulted after about 6 years of work. 
As with so much important legislation, I think we sometimes take for 
granted how much work it takes to get to a certain point. Then when we 
present the bill, debate the bill, and then pass the bill, we move very 
quickly on to other issues.
  What the unanimous consent just said was that we will be voting on 
this Tuesday when we get back from recess; that all time for debate and 
discussion on this particular issue, which I should add over the last 6 
years has been debated a lot on this floor, will have been exhausted.
  For more than 6 years, Members of this body have worked on this 
issue. I have worked with Senator Olympia Snowe for about 5\3/4\ years, 
along with Senators Jeffords, Enzi, Gregg, Hagel, Collins, and DeWine 
on this issue of genetic nondiscrimination. Today, with the invaluable 
contributions of Senators Daschle and Kennedy, we bring to the Senate 
floor this solid, important, significant legislation that, if I had to 
summarize, I would say provides individuals, citizens, patients, with 
strong protections against the potential of genetic discrimination in 
health insurance.
  I especially want to take this opportunity to commend the chairman of 
the Health, Education, Labor and Pensions Committee, Chairman Judd 
Gregg, for his leadership on this issue. In large part, it is due to 
his passion and commitment to this issue, to the principle of fairness 
and of equity, which has driven this process forward.
  I also commend President Bush for his dedication in ensuring strong 
protections against genetic discrimination and for bringing attention 
to this critical matter.
  When we began work on this issue many years ago, we were looking 
ahead at what we anticipated, which was the anticipation of the 
decoding of the human genome. At that time, we looked to the future. We 
wanted to preempt potential problems. Yes, it has taken 6 years, but 
finally with passage a week from next Tuesday we can be satisfied that 
we accomplished that goal set out 6 years ago.
  This decoding of the human genome, which is about 3 billion bits of 
information that we did not have 15 years ago that we have now, has 
been accomplished. In fact, it was this year that scientists, working 
in collaboration with the National Human Genome Research Institute at 
the National Institutes of Health, published a final draft documenting 
the sequence of the entire human genetic code.
  The publication of this final draft occurred more than 2 years ahead 
of schedule and almost 50 years to the day from the historic 
publication by Dr. James Watson and Dr. Francis Crick of DNAs double 
helix.
  This dazzling accomplishment has begun to usher in a whole new era of 
medical understanding. It has already begun to expand our understanding 
of human development and health, as well as disease. For example, the 
discovery of disease genes holds great promise. Based on this 
discovery, scientists may be able to design drugs to treat specific 
genes and genetic defects. Organs and tissues may be specifically 
engineered for use in transplantation. Preventive care will be based in 
part on genetic testing.
  This explosion of knowledge, these tremendous advances in science and 
technology, are also fraught with risk, which this legislation will 
minimize.
  When I first joined Senator Snowe in this effort several years ago, 
at that point in time almost a third, one out of three, of the women 
offered a test for breast cancer risk at the National Institutes of 
Health declined the test. The reason they gave at that time for 
declining the test was that the result might in some way be made 
available to an insurance company which would then use that data, that 
information, to discriminate against them in whether health insurance 
would be issued to them.
  I think it is a tremendous example of the danger of having a threat 
of discrimination, preventing one from getting a test that might be 
useful to

[[Page 24125]]

them. Thus, that example led me to strongly believe then, and I do now, 
that we must protect people from the threat of genetic information in 
any way being used against them. That is a practical responsibility. It 
is a moral responsibility and it is one with this legislation that this 
body speaks to directly.
  Simply stated, if unchecked, the fear of genetic discrimination would 
have the potential of keeping people from participating in very useful 
research studies. It had the potential for keeping people from taking 
advantage of new genetic technologies, and it had the potential of 
keeping an individual from having the opportunity to obtain information 
that demonstrated that they are not at risk for a potential genetically 
determined disease.
  The fear of genetic discrimination has the potential to prevent 
citizens from making informed health decisions for themselves or their 
loved ones.
  Congress, of course, has a rich history in battling against 
discrimination, most notably through the landmark 1964 Civil Rights 
Act. We think also of the 1990 Americans With Disabilities Act and the 
Health Insurance Portability and Accountability Act. The legislation 
before us now extends those very same protections to citizens who have 
genetic markers, a move that, ultimately, I believe, through this 
legislation, will allow us to save lives.
  Genetic research, this unraveling of the genetic code, genetic 
testing will undoubtedly unleash tremendous advances to the benefit of 
mankind--thrilling advances, possible cures to illnesses today that 
seem vexing, that we do not fully understand. The potential medical 
advances from our knowledge of the human genome will be more dramatic 
than any of the advances that I had the opportunity to directly 
participate in over 20 years in the practice of medicine--just from 
this single unraveling of the genetic code.
  As we greet the future, as we look at new technology, this is just 
one example of this body acting proactively, acting preemptively, so 
that such potential use in a discriminatory fashion of medical advances 
is kept from hurting the American people. We must take care to protect 
our body politic, and this legislation does just that. I am pleased by 
the progress we have made thus far, and I do congratulate each of my 
colleagues on their dedication to this issue over the last several 
years.
  This legislation stands squarely on our time-tested civil rights laws 
establishing comprehensive, equitable, fair, consistent, and reasonable 
protections. I strongly support this bill, and I look forward to its 
swift passage when we vote on Tuesday, following our recess.
  Mr. GREGG. Mr. President, this year we celebrated the 50 year 
anniversary of the now fabled discovery by Watson and Crick of the 
double helix. And this year the scientists at the NIH Human Genome 
Project completed the sequencing of human DNA.
  These are major historical developments that will permanently change 
the course of biological science. The color of our eyes and the 
treatment of disease are now understood through the lens of genetics. 
As the science has progressed, so too have reservations with what we 
will do with this new information we are uncovering. Unlocking our 
genetic code unleashes new power. And power produces new 
responsibilities in protecting the privacy of our genetic information 
and protecting it from misuse.
  Scientific advances in field of genetics hold great promise for 
medical prevention of new treatments and therapies. However, because 
our public policies lag behind the science, the promise of the Human 
Genome Project is going unfulfilled. Individuals are afraid to get 
genetic tests or seek genetic counseling out of fear that they will 
lose their health insurance or face discrimination in their employment.
  After 6 years, numerous hearings, and hours of deliberation, I am 
pleased the Senate is finally taking up this important legislation, 
which was unanimously reported out of the Health, Education, Labor, and 
Pensions Committee on May 21, 2003. I am also pleased that the first 
civil rights legislation adopted under my chairmanship deals with an 
issue of truly 21st century concerns. This is the first civil rights 
act of the 21st century.
  Genetic discrimination is an issue that affect all Americans. 
Everyone has genes. Everyone has hereditary medical traits. It's a non-
partisan issue. This is reflected in the fact that this legislation is 
truly a bipartisan product. For more than a year, the HELP Committee 
has worked hard to marry together two major pieces of legislation--one 
sponsored by Senators Snowe/Frist/Jeffords and the other sponsored 
Senators Daschle and Kennedy.
  This legislation established in Federal law basic legal protections 
that prohibit discrimination in health insurance or employment based on 
genetic information.
  A key component of the legislation is its privacy provisions. 
Although current law already contains medical privacy rules covering 
genetic information, this legislation addresses some additional 
concerns and closes loopholes that are unique to genetics. For 
instance, it protects the privacy of genetic information at work and 
prohibits the use of genetic information in health insurance 
underwriting.
  This bill prohibits an employer from making employment decisions--
hiring, firing, etc.--based on genetic information, or even that fact 
than an individual or family member requested or received genetic 
services.
  This bill prohibits health insurance plans from denying eligibility 
or enrollment in the health plan based on genetic information. And it 
prohibits health insurance plans from charging higher premiums based on 
an individual's--or his or her family member's--genetic information.
  Most importantly, the legislation recognizes that all individuals, 
whether they are healthy or sick, and all medical information, whether 
genetic or otherwise, should be afforded the same protections under 
law.
  While genetic discrimination may not be widespread at this point in 
time, this legislation ensures that discriminatory practices will never 
become common practice. From the past we have learned that employees, 
employers, insurers and others all work best together when the rules 
are clear and opportunities for personal achievement and health are 
available. This legislation tells everyone what is expected of them and 
avoids the trip wires and uncertainty of some of our existing laws.
  Any concerns about new regulations on employers or health plans are 
far outweighed by the benefits of scientific advances that will further 
revolutionize the medical field. With no silver bullet solution in 
sight to cure what ails our expensive and troubled health care system, 
I believe all stakeholders will welcome reasonable legislation that 
fosters medical advances that can lead to prevention and cure disease.
  It is my hope that the bipartisan spirit that brought the parties 
together to craft this historic legislation will continue as we seek to 
realize the full potential of the human genome project.
  The PRESIDING OFFICER. Without objection, S. 1053 is considered read 
a third time.
  Mr. FRIST. Mr. President, I yield back all time on both sides, and I 
ask the bill be set aside.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________