[Congressional Record (Bound Edition), Volume 153 (2007), Part 7]
[House]
[Pages 10310-10330]
[From the U.S. Government Publishing Office, www.gpo.gov]




           GENETIC INFORMATION NONDISCRIMINATION ACT OF 2007

  Mr. GEORGE MILLER of California. Mr. Speaker, I move to suspend the 
rules and pass the bill (H.R. 493) to prohibit discrimination on the 
basis of genetic information with respect to health insurance and 
employment, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 493

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Genetic 
     Information Nondiscrimination Act of 2007''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

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

         TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

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

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

Sec. 201. Definitions.
Sec. 202. Employer practices.
Sec. 203. Employment agency practices.
Sec. 204. Labor organization practices.
Sec. 205. Training programs.
Sec. 206. Confidentiality of genetic information.
Sec. 207. Remedies and enforcement.

[[Page 10311]]

Sec. 208. Disparate impact.
Sec. 209. Construction.
Sec. 210. Medical information that is not genetic information.
Sec. 211. Regulations.
Sec. 212. Authorization of appropriations.
Sec. 213. Effective date.

                  TITLE III--MISCELLANEOUS PROVISIONS

Sec. 301. Guarantee agency collection retention.
Sec. 302. Severability.

     SEC. 2. FINDINGS.

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

         TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

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

       (a) No Discrimination in Group Premiums Based on Genetic 
     Information.--Section 702(b) of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1182(b)) is amended--
       (1) in paragraph (2)(A), by inserting before the semicolon 
     the following: ``except as provided in paragraph (3)''; and
       (2) by adding at the end the following:
       ``(3) No group-based discrimination on basis of genetic 
     information.--For purposes of this section, a group health 
     plan, and a health insurance issuer offering group health 
     insurance coverage in connection with a group health plan, 
     may not adjust premium or contribution amounts for the group 
     covered under such plan on the basis of genetic 
     information.''.
       (b) Limitations on Genetic Testing; Prohibition on 
     Collection of Genetic Information; Application to All 
     Plans.--Section 702 of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1182) is amended by adding at 
     the end the following:
       ``(c) Genetic Testing.--
       ``(1) Limitation on requesting or requiring genetic 
     testing.--A group health plan, and a health insurance issuer 
     offering health insurance coverage in connection with a group 
     health plan, shall not request or require an individual or a 
     family member of such individual to undergo a genetic test.
       ``(2) Rule of construction.--Paragraph (1) shall not be 
     construed to limit the authority of a health care 
     professional who is providing health care services to an 
     individual to request that such individual undergo a genetic 
     test.
       ``(3) Rule of construction regarding payment.--
       ``(A) In general.--Nothing in paragraph (1) shall be 
     construed to preclude a group health plan, or a health 
     insurance issuer offering health insurance coverage in 
     connection with a group health plan, from obtaining and using 
     the results of a genetic test in making a determination 
     regarding payment (as such term is defined for the purposes 
     of applying the regulations promulgated by the Secretary of 
     Health and Human Services under part C of title XI of the 
     Social Security Act and section 264 of the Health Insurance 
     Portability and Accountability Act of 1996, as may be revised 
     from time to time) consistent with subsection (a).
       ``(B) Limitation.--For purposes of subparagraph (A), a 
     group health plan, or a health insurance issuer offering 
     health insurance coverage in connection with a group health 
     plan, may request only the minimum amount of information 
     necessary to accomplish the intended purpose.
       ``(4) Research exception.--Notwithstanding paragraph (1), a 
     group health plan, or a health insurance issuer offering 
     health insurance coverage in connection with a group health 
     plan, may request, but not require, that a participant or 
     beneficiary undergo a genetic test if each of the following 
     conditions is met:
       ``(A) The request is made, in writing, pursuant to research 
     that complies with part 46 of title 45, Code of Federal 
     Regulations, or equivalent Federal regulations, and any 
     applicable State or local law or regulations for the 
     protection of human subjects in research.
       ``(B) The plan or issuer clearly indicates to each 
     participant or beneficiary, or in the case of a minor child, 
     to the legal guardian of such beneficiary, to whom the 
     request is made that--
       ``(i) compliance with the request is voluntary; and
       ``(ii) non-compliance will have no effect on enrollment 
     status or premium or contribution amounts.
       ``(C) No genetic information collected or acquired under 
     this paragraph shall be used for underwriting purposes.
       ``(D) The plan or issuer notifies the Secretary in writing 
     that the plan or issuer is conducting activities pursuant to 
     the exception provided for under this paragraph, including a 
     description of the activities conducted.
       ``(E) The plan or issuer complies with such other 
     conditions as the Secretary may by regulation require for 
     activities conducted under this paragraph.
       ``(d) Prohibition on Collection of Genetic Information.--
       ``(1) In general.--A group health plan, and a health 
     insurance issuer offering health insurance coverage in 
     connection with a group health plan, shall not request, 
     require, or purchase genetic information for underwriting 
     purposes (as defined in section 733).
       ``(2) Prohibition on collection of genetic information 
     prior to enrollment.--A group health plan, and a health 
     insurance issuer offering health insurance coverage in 
     connection with a group health plan, shall not request, 
     require, or purchase genetic information with respect to any 
     individual prior to such individual's enrollment under the 
     plan or coverage in connection with such enrollment.
       ``(3) Incidental collection.--If a group health plan, or a 
     health insurance issuer offering health insurance coverage in 
     connection with a group health plan, obtains genetic 
     information incidental to the requesting, requiring, or 
     purchasing of other information concerning any individual, 
     such request, requirement, or purchase shall not be 
     considered a violation of paragraph (2) if such request, 
     requirement, or purchase is not in violation of paragraph 
     (1).
       ``(e) Application to All Plans.--The provisions of 
     subsections (a)(1)(F), (b)(3), (c), and (d), and subsection 
     (b)(1) and section 701 with respect to genetic information, 
     shall apply to group health plans and health insurance 
     issuers without regard to section 732(a).''.
       (c) Application to Genetic Information of a Fetus or 
     Embryo.--Such section is further amended by adding at the end 
     the following:
       ``(f) Genetic Information of a Fetus or Embryo.--Any 
     reference in this part to genetic information concerning an 
     individual or family member of an individual shall--
       ``(1) with respect to such an individual or family member 
     of an individual who is a

[[Page 10312]]

     pregnant woman, include genetic information of any fetus 
     carried by such pregnant woman; and
       ``(2) with respect to an individual or family member 
     utilizing an assisted reproductive technology, include 
     genetic information of any embryo legally held by the 
     individual or family member.''.
       (d) Definitions.--Section 733(d) of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1191b(d)) is amended 
     by adding at the end the following:
       ``(5) Family member.--The term `family member' means, with 
     respect to an individual--
       ``(A) a dependent (as such term is used for purposes of 
     section 701(f)(2)) of such individual, and
       ``(B) any other individual who is a first-degree, second-
     degree, third-degree, or fourth-degree relative of such 
     individual or of an individual described in subparagraph (A).
       ``(6) Genetic information.--
       ``(A) In general.--The term `genetic information' means, 
     with respect to any individual, information about--
       ``(i) such individual's genetic tests,
       ``(ii) the genetic tests of family members of such 
     individual, and
       ``(iii) subject to subparagraph (D), the manifestation of a 
     disease or disorder in family members of such individual.
       ``(B) Inclusion of genetic services.--Such term includes, 
     with respect to any individual, any request for, or receipt 
     of, genetic services (including genetic services received 
     pursuant to participation in clinical research) by such 
     individual or any family member of such individual.
       ``(C) Exclusions.--The term `genetic information' shall not 
     include information about the sex or age of any individual.
       ``(D) Application to family members covered under same 
     plan.--Information described in clause (iii) of subparagraph 
     (A) shall not be treated as genetic information to the extent 
     that such information is taken into account only with respect 
     to the individual in which such disease or disorder is 
     manifested and not as genetic information with respect to any 
     other individual.
       ``(7) Genetic test.--
       ``(A) In general.--The term `genetic test' means an 
     analysis of human DNA, RNA, chromosomes, proteins, or 
     metabolites, that detects genotypes, mutations, or 
     chromosomal changes.
       ``(B) Exceptions.--The term `genetic test' does not mean--
       ``(i) an analysis of proteins or metabolites that does not 
     detect genotypes, mutations, or chromosomal changes; or
       ``(ii) an analysis of proteins or metabolites that is 
     directly related to a manifested disease, disorder, or 
     pathological condition that could reasonably be detected by a 
     health care professional with appropriate training and 
     expertise in the field of medicine involved.
       ``(8) Genetic services.--The term `genetic services' 
     means--
       ``(A) a genetic test;
       ``(B) genetic counseling (including obtaining, 
     interpreting, or assessing genetic information); or
       ``(C) genetic education.
       ``(9) Underwriting purposes.--The term `underwriting 
     purposes' means, with respect to any group health plan, or 
     health insurance coverage offered in connection with a group 
     health plan--
       ``(A) rules for, or determination of, eligibility 
     (including enrollment and continued eligibility) for benefits 
     under the plan or coverage;
       ``(B) the computation of premium or contribution amounts 
     under the plan or coverage;
       ``(C) the application of any pre-existing condition 
     exclusion under the plan or coverage; and
       ``(D) other activities related to the creation, renewal, or 
     replacement of a contract of health insurance or health 
     benefits.''.
       (e) ERISA Enforcement.--Section 502 of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 1132) is 
     amended--
       (1) in subsection (a)(6), by striking ``(7), or (8)'' and 
     inserting ``(7), (8), or (9)''; and
       (2) in subsection (c), by redesignating paragraph (9) as 
     paragraph (10), and by inserting after paragraph (8) the 
     following new paragraph:
       ``(9) Secretarial enforcement authority relating to use of 
     genetic information.--
       ``(A) General rule.--The Secretary may impose a penalty 
     against any plan sponsor of a group health plan, or any 
     health insurance issuer offering health insurance coverage in 
     connection with the plan, for any failure by such sponsor or 
     issuer to meet the requirements of subsection (a)(1)(F), 
     (b)(3), (c), or (d) of section 702 or section 701 or 
     702(b)(1) with respect to genetic information, in connection 
     with the plan.
       ``(B) Amount.--
       ``(i) In general.--The amount of the penalty imposed by 
     subparagraph (A) shall be $100 for each day in the 
     noncompliance period with respect to each participant or 
     beneficiary to whom such failure relates.
       ``(ii) Noncompliance period.--For purposes of this 
     paragraph, the term `noncompliance period' means, with 
     respect to any failure, the period--

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

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

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

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

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

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

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

       ``(E) Waiver by secretary.--In the case of a failure which 
     is due to reasonable cause and not to willful neglect, the 
     Secretary may waive part or all of the penalty imposed by 
     subparagraph (A) to the extent that the payment of such 
     penalty would be excessive relative to the failure involved.
       ``(F) Definitions.--Terms used in this paragraph which are 
     defined in section 733 shall have the meanings provided such 
     terms in such section.''.
       (f) Regulations and Effective Date.--
       (1) Regulations.--The Secretary of Labor shall issue final 
     regulations not later than 1 year after the date of enactment 
     of this Act to carry out the amendments made by this section.
       (2) Effective date.--The amendments made by this section 
     shall apply with respect to group health plans for plan years 
     beginning after the date that is 18 months after the date of 
     enactment of this Act.

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

       (a) Amendments Relating to the Group Market.--
       (1) No discrimination in group premiums based on genetic 
     information.--Section 2702(b) of the Public Health Service 
     Act (42 U.S.C. 300gg-1(b)) is amended--
       (A) in paragraph (2)(A), by inserting before the semicolon 
     the following: ``except as provided in paragraph (3)''; and
       (B) by adding at the end the following:
       ``(3) No group-based discrimination on basis of genetic 
     information.--For purposes of this section, a group health 
     plan, and health insurance issuer offering group health 
     insurance coverage in connection with a group health plan, 
     may not adjust premium or contribution amounts for the group 
     covered under such plan on the basis of genetic 
     information.''.
       (2) Limitations on genetic testing; prohibition on 
     collection of genetic information; application to all 
     plans.--Section 2702 of the Public Health Service Act (42 
     U.S.C. 300gg-1) is amended by adding at the end the 
     following:
       ``(c) Genetic Testing.--
       ``(1) Limitation on requesting or requiring genetic 
     testing.--A group health plan, and a health insurance issuer 
     offering health insurance coverage in connection with a group 
     health plan, shall not request or require an individual or a 
     family member of such individual to undergo a genetic test.
       ``(2) Rule of construction.--Paragraph (1) shall not be 
     construed to limit the authority of a health care 
     professional who is providing health care services to an 
     individual to request that such individual undergo a genetic 
     test.
       ``(3) Rule of construction regarding payment.--
       ``(A) In general.--Nothing in paragraph (1) shall be 
     construed to preclude a group health plan, or a health 
     insurance issuer offering health insurance coverage in 
     connection with a group health plan, from obtaining and

[[Page 10313]]

     using the results of a genetic test in making a determination 
     regarding payment (as such term is defined for the purposes 
     of applying the regulations promulgated by the Secretary 
     under part C of title XI of the Social Security Act and 
     section 264 of the Health Insurance Portability and 
     Accountability Act of 1996, as may be revised from time to 
     time) consistent with subsection (a).
       ``(B) Limitation.--For purposes of subparagraph (A), a 
     group health plan, or a health insurance issuer offering 
     health insurance coverage in connection with a group health 
     plan, may request only the minimum amount of information 
     necessary to accomplish the intended purpose.
       ``(4) Research exception.--Notwithstanding paragraph (1), a 
     group health plan, or a health insurance issuer offering 
     health insurance coverage in connection with a group health 
     plan, may request, but not require, that a participant or 
     beneficiary undergo a genetic test if each of the following 
     conditions is met:
       ``(A) The request is made pursuant to research that 
     complies with part 46 of title 45, Code of Federal 
     Regulations, or equivalent Federal regulations, and any 
     applicable State or local law or regulations for the 
     protection of human subjects in research.
       ``(B) The plan or issuer clearly indicates to each 
     participant or beneficiary, or in the case of a minor child, 
     to the legal guardian of such beneficiary, to whom the 
     request is made that--
       ``(i) compliance with the request is voluntary; and
       ``(ii) non-compliance will have no effect on enrollment 
     status or premium or contribution amounts.
       ``(C) No genetic information collected or acquired under 
     this paragraph shall be used for underwriting purposes.
       ``(D) The plan or issuer notifies the Secretary in writing 
     that the plan or issuer is conducting activities pursuant to 
     the exception provided for under this paragraph, including a 
     description of the activities conducted.
       ``(E) The plan or issuer complies with such other 
     conditions as the Secretary may by regulation require for 
     activities conducted under this paragraph.
       ``(d) Prohibition on Collection of Genetic Information.--
       ``(1) In general.--A group health plan, and a health 
     insurance issuer offering health insurance coverage in 
     connection with a group health plan, shall not request, 
     require, or purchase genetic information for underwriting 
     purposes (as defined in section 2791).
       ``(2) Prohibition on collection of genetic information 
     prior to enrollment.--A group health plan, and a health 
     insurance issuer offering health insurance coverage in 
     connection with a group health plan, shall not request, 
     require, or purchase genetic information with respect to any 
     individual prior to such individual's enrollment under the 
     plan or coverage in connection with such enrollment.
       ``(3) Incidental collection.--If a group health plan, or a 
     health insurance issuer offering health insurance coverage in 
     connection with a group health plan, obtains genetic 
     information incidental to the requesting, requiring, or 
     purchasing of other information concerning any individual, 
     such request, requirement, or purchase shall not be 
     considered a violation of paragraph (2) if such request, 
     requirement, or purchase is not in violation of paragraph 
     (1).
       ``(e) Application to All Plans.--The provisions of 
     subsections (a)(1)(F), (b)(3), (c), and (d) and subsection 
     (b)(1) and section 2701 with respect to genetic information, 
     shall apply to group health plans and health insurance 
     issuers without regard to section 2721(a).''.
       (3) Application to genetic information of a fetus or 
     embryo.--Such section is further amended by adding at the end 
     the following:
       ``(f) Genetic Information of a Fetus or Embryo.--Any 
     reference in this part to genetic information concerning an 
     individual or family member of an individual shall--
       ``(1) with respect to such an individual or family member 
     of an individual who is a pregnant woman, include genetic 
     information of any fetus carried by such pregnant woman; and
       ``(2) with respect to an individual or family member 
     utilizing an assisted reproductive technology, include 
     genetic information of any embryo legally held by the 
     individual or family member.''.
       (4) Definitions.--Section 2791(d) of the Public Health 
     Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at 
     the end the following:
       ``(15) Family member.--The term `family member' means, with 
     respect to any individual--
       ``(A) a dependent (as such term is used for purposes of 
     section 2701(f)(2)) of such individual; and
       ``(B) any other individual who is a first-degree, second-
     degree, third-degree, or fourth-degree relative of such 
     individual or of an individual described in subparagraph (A).
       ``(16) Genetic information.--
       ``(A) In general.--The term `genetic information' means, 
     with respect to any individual, information about--
       ``(i) such individual's genetic tests,
       ``(ii) the genetic tests of family members of such 
     individual, and
       ``(iii) subject to subparagraph (D), the manifestation of a 
     disease or disorder in family members of such individual.
       ``(B) Inclusion of genetic services.--Such term includes, 
     with respect to any individual, any request for, or receipt 
     of, genetic services (including genetic services received 
     pursuant to participation in clinical research) by such 
     individual or any family member of such individual.
       ``(C) Exclusions.--The term `genetic information' shall not 
     include information about the sex or age of any individual.
       ``(D) Application to family members covered under same 
     plan.--Information described in clause (iii) of subparagraph 
     (A) shall not be treated as genetic information to the extent 
     that such information is taken into account only with respect 
     to the individual in which such disease or disorder is 
     manifested and not as genetic information with respect to any 
     other individual.
       ``(17) Genetic test.--
       ``(A) In general.--The term `genetic test' means an 
     analysis of human DNA, RNA, chromosomes, proteins, or 
     metabolites, that detects genotypes, mutations, or 
     chromosomal changes.
       ``(B) Exceptions.--The term `genetic test' does not mean--
       ``(i) an analysis of proteins or metabolites that does not 
     detect genotypes, mutations, or chromosomal changes; or
       ``(ii) an analysis of proteins or metabolites that is 
     directly related to a manifested disease, disorder, or 
     pathological condition that could reasonably be detected by a 
     health care professional with appropriate training and 
     expertise in the field of medicine involved.
       ``(18) Genetic services.--The term `genetic services' 
     means--
       ``(A) a genetic test;
       ``(B) genetic counseling (including obtaining, 
     interpreting, or assessing genetic information); or
       ``(C) genetic education.
       ``(19) Underwriting purposes.--The term `underwriting 
     purposes' means, with respect to any group health plan, or 
     health insurance coverage offered in connection with a group 
     health plan--
       ``(A) rules for, or determination of, eligibility 
     (including enrollment and continued eligibility) for benefits 
     under the plan or coverage;
       ``(B) the computation of premium or contribution amounts 
     under the plan or coverage;
       ``(C) the application of any pre-existing condition 
     exclusion under the plan or coverage; and
       ``(D) other activities related to the creation, renewal, or 
     replacement of a contract of health insurance or health 
     benefits.''.
       (5) Remedies and enforcement.--Section 2722(b) of the 
     Public Health Service Act (42 U.S.C. 300gg-22(b)) is amended 
     by adding at the end the following:
       ``(3) Enforcement authority relating to genetic 
     discrimination.--
       ``(A) General rule.--In the cases described in paragraph 
     (1), notwithstanding the provisions of paragraph (2)(C), the 
     succeeding subparagraphs of this paragraph shall apply with 
     respect to an action under this subsection by the Secretary 
     with respect to any failure of a health insurance issuer in 
     connection with a group health plan, to meet the requirements 
     of subsection (a)(1)(F), (b)(3), (c), or (d) of section 2702 
     or section 2701 or 2702(b)(1) with respect to genetic 
     information in connection with the plan.
       ``(B) Amount.--
       ``(i) In general.--The amount of the penalty imposed under 
     this paragraph shall be $100 for each day in the 
     noncompliance period with respect to each participant or 
     beneficiary to whom such failure relates.
       ``(ii) Noncompliance period.--For purposes of this 
     paragraph, the term `noncompliance period' means, with 
     respect to any failure, the period--

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

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

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

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

[[Page 10314]]

     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.''.
       (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.
       ``(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.
       ``(c) Prohibition on Genetic Information as Preexisting 
     Condition.--A health insurance issuer offering health 
     insurance coverage in the individual market may not, on the 
     basis of genetic information, impose any preexisting 
     condition exclusion (as defined in section 2701(b)(1)(A)) 
     with respect to such coverage.
       ``(d) Genetic Testing.--
       ``(1) Limitation on requesting or requiring genetic 
     testing.--A health insurance issuer offering health insurance 
     coverage in the individual market shall not request or 
     require an individual or a family member of such individual 
     to undergo a genetic test.
       ``(2) Rule of construction.--Paragraph (1) shall not be 
     construed to limit the authority of a health care 
     professional who is providing health care services to an 
     individual to request that such individual undergo a genetic 
     test.
       ``(3) Rule of construction regarding payment.--
       ``(A) In general.--Nothing in paragraph (1) shall be 
     construed to preclude a health insurance issuer offering 
     health insurance coverage in the individual market from 
     obtaining and using the results of a genetic test in making a 
     determination regarding payment (as such term is defined for 
     the purposes of applying the regulations promulgated by the 
     Secretary under part C of title XI of the Social Security Act 
     and section 264 of the Health Insurance Portability and 
     Accountability Act of 1996, as may be revised from time to 
     time) consistent with subsection (a) and (c).
       ``(B) Limitation.--For purposes of subparagraph (A), a 
     health insurance issuer offering health insurance coverage in 
     the individual market may request only the minimum amount of 
     information necessary to accomplish the intended purpose.
       ``(4) Research exception.--Notwithstanding paragraph (1), a 
     health insurance issuer offering health insurance coverage in 
     the individual market may request, but not require, that an 
     individual or a family member of such individual undergo a 
     genetic test if each of the following conditions is met:
       ``(A) The request is made pursuant to research that 
     complies with part 46 of title 45, Code of Federal 
     Regulations, or equivalent Federal regulations, and any 
     applicable State or local law or regulations for the 
     protection of human subjects in research.
       ``(B) The issuer clearly indicates to each individual, or 
     in the case of a minor child, to the legal guardian of such 
     child, to whom the request is made that--
       ``(i) compliance with the request is voluntary; and
       ``(ii) non-compliance will have no effect on enrollment 
     status or premium or contribution amounts.
       ``(C) No genetic information collected or acquired under 
     this paragraph shall be used for underwriting purposes.
       ``(D) The issuer notifies the Secretary in writing that the 
     issuer is conducting activities pursuant to the exception 
     provided for under this paragraph, including a description of 
     the activities conducted.
       ``(E) The issuer complies with such other conditions as the 
     Secretary may by regulation require for activities conducted 
     under this paragraph.
       ``(e) Prohibition on Collection of Genetic Information.--
       ``(1) In general.--A health insurance issuer offering 
     health insurance coverage in the individual market shall not 
     request, require, or purchase genetic information for 
     underwriting purposes (as defined in section 2791).
       ``(2) Prohibition on collection of genetic information 
     prior to enrollment.--A health insurance issuer offering 
     health insurance coverage in the individual market shall not 
     request, require, or purchase genetic information with 
     respect to any individual prior to such individual's 
     enrollment under the plan in connection with such enrollment.
       ``(3) Incidental collection.--If a health insurance issuer 
     offering health insurance coverage in the individual market 
     obtains genetic information incidental to the requesting, 
     requiring, or purchasing of other information concerning any 
     individual, such request, requirement, or purchase shall not 
     be considered a violation of paragraph (2) if such request, 
     requirement, or purchase is not in violation of paragraph 
     (1).
       ``(f) Genetic Information of a Fetus or Embryo.--Any 
     reference in this part to genetic information concerning an 
     individual or family member of an individual shall--
       ``(1) with respect to such an individual or family member 
     of an individual who is a pregnant woman, include genetic 
     information of any fetus carried by such pregnant woman; and
       ``(2) with respect to an individual or family member 
     utilizing an assisted reproductive technology, include 
     genetic information of any embryo legally held by the 
     individual or family member.''.
       (2) Remedies and enforcement.--Section 2761(b) of the 
     Public Health Service Act (42 U.S.C. 300gg-61(b)) is amended 
     to read as follows:
       ``(b) Secretarial Enforcement Authority.--The Secretary 
     shall have the same authority in relation to enforcement of 
     the provisions of this part with respect to issuers of health 
     insurance coverage in the individual market in a State as the 
     Secretary has under section 2722(b)(2), and section 
     2722(b)(3) with respect to violations of genetic 
     nondiscrimination provisions, in relation to the enforcement 
     of the provisions of part A with respect to issuers of health 
     insurance coverage in the small group market in the State.''.
       (c) Elimination of Option of Non-Federal Governmental Plans 
     To Be Excepted From Requirements Concerning Genetic 
     Information.--Section 2721(b)(2) of the Public Health Service 
     Act (42 U.S.C. 300gg-21(b)(2)) is amended--
       (1) in subparagraph (A), by striking ``If the plan 
     sponsor'' and inserting ``Except as provided in subparagraph 
     (D), if the plan sponsor''; and
       (2) by adding at the end the following:
       ``(D) Election not applicable to requirements concerning 
     genetic information.--The election described in subparagraph 
     (A) shall not be available with respect to the provisions of 
     subsections (a)(1)(F), (b)(3), (c), and (d) of section 2702 
     and the provisions of sections 2701 and 2702(b) to the extent 
     that such provisions apply to genetic information.''.
       (d) Regulations and Effective Date.--
       (1) Regulations.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall issue final regulations to carry out the 
     amendments made by this section.
       (2) Effective date.--The amendments made by this section 
     shall apply--
       (A) with respect to group health plans, and health 
     insurance coverage offered in connection with group health 
     plans, for plan years beginning after the date that is 18 
     months after the date of enactment of this Act; and
       (B) with respect to health insurance coverage offered, 
     sold, issued, renewed, in effect, or operated in the 
     individual market after the date that is 18 months after the 
     date of enactment of this Act.

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

       (a) No Discrimination in Group Premiums Based on Genetic 
     Information.--Subsection (b) of section 9802 of the Internal 
     Revenue Code of 1986 is amended--
       (1) in paragraph (2)(A), by inserting before the semicolon 
     the following: ``except as provided in paragraph (3)''; and
       (2) by adding at the end the following:
       ``(3) No group-based discrimination on basis of genetic 
     information.--For purposes of this section, a group health 
     plan may not adjust premium or contribution amounts for the 
     group covered under such plan on the basis of genetic 
     information.''.
       (b) Limitations on Genetic Testing; Prohibition on 
     Collection of Genetic Information; Application to All 
     Plans.--Section 9802 of such Code is amended by redesignating 
     subsection (c) as subsection (f) and by

[[Page 10315]]

     inserting after subsection (b) the following new subsections:
       ``(c) Genetic Testing.--
       ``(1) Limitation on requesting or requiring genetic 
     testing.--A group health plan may not request or require an 
     individual or a family member of such individual to undergo a 
     genetic test.
       ``(2) Rule of construction.--Paragraph (1) shall not be 
     construed to limit the authority of a health care 
     professional who is providing health care services to an 
     individual to request that such individual undergo a genetic 
     test.
       ``(3) Rule of construction regarding payment.--
       ``(A) In general.--Nothing in paragraph (1) shall be 
     construed to preclude a group health plan from obtaining and 
     using the results of a genetic test in making a determination 
     regarding payment (as such term is defined for the purposes 
     of applying the regulations promulgated by the Secretary of 
     Health and Human Services under part C of title XI of the 
     Social Security Act and section 264 of the Health Insurance 
     Portability and Accountability Act of 1996, as may be revised 
     from time to time) consistent with subsection (a).
       ``(B) Limitation.--For purposes of subparagraph (A), a 
     group health plan may request only the minimum amount of 
     information necessary to accomplish the intended purpose.
       ``(4) Research exception.--Notwithstanding paragraph (1), a 
     group health plan may request, but not require, that a 
     participant or beneficiary undergo a genetic test if each of 
     the following conditions is met:
       ``(A) The request is made pursuant to research that 
     complies with part 46 of title 45, Code of Federal 
     Regulations, or equivalent Federal regulations, and any 
     applicable State or local law or regulations for the 
     protection of human subjects in research.
       ``(B) The plan clearly indicates to each participant or 
     beneficiary, or in the case of a minor child, to the legal 
     guardian of such beneficiary, to whom the request is made 
     that--
       ``(i) compliance with the request is voluntary; and
       ``(ii) non-compliance will have no effect on enrollment 
     status or premium or contribution amounts.
       ``(C) No genetic information collected or acquired under 
     this paragraph shall be used for underwriting purposes.
       ``(D) The plan notifies the Secretary in writing that the 
     plan is conducting activities pursuant to the exception 
     provided for under this paragraph, including a description of 
     the activities conducted.
       ``(E) The plan complies with such other conditions as the 
     Secretary may by regulation require for activities conducted 
     under this paragraph.
       ``(d) Prohibition on Collection of Genetic Information.--
       ``(1) In general.--A group health plan shall not request, 
     require, or purchase genetic information for underwriting 
     purposes (as defined in section 9832).
       ``(2) Prohibition on collection of genetic information 
     prior to enrollment.--A group health plan shall not request, 
     require, or purchase genetic information with respect to any 
     individual prior to such individual's enrollment under the 
     plan or in connection with such enrollment.
       ``(3) Incidental collection.--If a group health plan 
     obtains genetic information incidental to the requesting, 
     requiring, or purchasing of other information concerning any 
     individual, such request, requirement, or purchase shall not 
     be considered a violation of paragraph (2) if such request, 
     requirement, or purchase is not in violation of paragraph 
     (1).
       ``(e) Application to All Plans.--The provisions of 
     subsections (a)(1)(F), (b)(3), (c), and (d) and subsection 
     (b)(1) and section 9801 with respect to genetic information, 
     shall apply to group health plans without regard to section 
     9831(a)(2).''.
       (c) Application to Genetic Information of a Fetus or 
     Embryo.--Such section is further amended by adding at the end 
     the following:
       ``(f) Genetic Information of a Fetus or Embryo.--Any 
     reference in this chapter to genetic information concerning 
     an individual or family member of an individual shall--
       ``(1) with respect to such an individual or family member 
     of an individual who is a pregnant woman, include genetic 
     information of any fetus carried by such pregnant woman; and
       ``(2) with respect to an individual or family member 
     utilizing an assisted reproductive technology, include 
     genetic information of any embryo legally held by the 
     individual or family member.''.
       (d) Definitions.--Subsection (d) of section 9832 of such 
     Code is amended by adding at the end the following:
       ``(6) Family member.--The term `family member' means, with 
     respect to any individual--
       ``(A) a dependent (as such term is used for purposes of 
     section 9801(f)(2)) of such individual, and
       ``(B) any other individual who is a first-degree, second-
     degree, third-degree, or fourth-degree relative of such 
     individual or of an individual described in subparagraph (A).
       ``(7) Genetic information.--
       ``(A) In general.--The term `genetic information' means, 
     with respect to any individual, information about--
       ``(i) such individual's genetic tests,
       ``(ii) the genetic tests of family members of such 
     individual, and
       ``(iii) subject to subparagraph (D), the manifestation of a 
     disease or disorder in family members of such individual.
       ``(B) Inclusion of genetic services.--Such term includes, 
     with respect to any individual, any request for, or receipt 
     of, genetic services (including genetic services received 
     pursuant to participation in clinical research) by such 
     individual or any family member of such individual.
       ``(C) Exclusions.--The term `genetic information' shall not 
     include information about the sex or age of any individual.
       ``(D) Application to family members covered under same 
     plan.--Information described in clause (iii) of subparagraph 
     (A) shall not be treated as genetic information to the extent 
     that such information is taken into account only with respect 
     to the individual in which such disease or disorder is 
     manifested and not as genetic information with respect to any 
     other individual.
       ``(8) Genetic test.--
       ``(A) In general.--The term `genetic test' means an 
     analysis of human DNA, RNA, chromosomes, proteins, or 
     metabolites, that detects genotypes, mutations, or 
     chromosomal changes.
       ``(B) Exceptions.--The term `genetic test' does not mean--
       ``(i) an analysis of proteins or metabolites that does not 
     detect genotypes, mutations, or chromosomal changes, or
       ``(ii) an analysis of proteins or metabolites that is 
     directly related to a manifested disease, disorder, or 
     pathological condition that could reasonably be detected by a 
     health care professional with appropriate training and 
     expertise in the field of medicine involved.
       ``(9) Genetic services.--The term `genetic services' 
     means--
       ``(A) a genetic test;
       ``(B) genetic counseling (including obtaining, 
     interpreting, or assessing genetic information); or
       ``(C) genetic education.
       ``(10) Underwriting purposes.--The term `underwriting 
     purposes' means, with respect to any group health plan ,or 
     health insurance coverage offered in connection with a group 
     health plan--
       ``(A) rules for, or determination of, eligibility 
     (including enrollment and continued eligibility) for benefits 
     under the plan or coverage;
       ``(B) the computation of premium or contribution amounts 
     under the plan or coverage;
       ``(C) the application of any pre-existing condition 
     exclusion under the plan or coverage; and
       ``(D) other activities related to the creation, renewal, or 
     replacement of a contract of health insurance or health 
     benefits.''.
       (e) Enforcement.--
       (1) In general.--Subchapter C of chapter 100 of the 
     Internal Revenue Code of 1986 (relating to general 
     provisions) is amended by adding at the end the following new 
     section:

     ``SEC. 9834. ENFORCEMENT.

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

``Sec. 9834. Enforcement.''.
       (f) Regulations and Effective Date.--
       (1) Regulations.--The Secretary of the Treasury shall issue 
     final regulations or other guidance not later than 1 year 
     after the date of the enactment of this Act to carry out the 
     amendments made by this section.
       (2) Effective date.--The amendments made by this section 
     shall apply with respect to group health plans for plan years 
     beginning after the date that is 18 months after the date of 
     the enactment of this Act.

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

       (a) Nondiscrimination.--Section 1882(s)(2) of the Social 
     Security Act (42 U.S.C. 1395ss(s)(2)) is amended by adding at 
     the end the following:
       ``(E) An issuer of a medicare supplemental policy shall not 
     deny or condition the issuance or effectiveness of the policy 
     (including the imposition of any exclusion of benefits under 
     the policy based on a pre-existing condition) and shall not 
     discriminate in the pricing of the policy (including the 
     adjustment of premium rates) of an individual on the basis of 
     the genetic information with respect to such individual.''.
       (b) Limitations on Genetic Testing and Genetic 
     Information.--
       (1) In general.--Section 1882 of the Social Security Act 
     (42 U.S.C. 1395ss) is amended by adding at the end the 
     following:
       ``(x) Limitations on Genetic Testing and Information.--
       ``(1) Genetic testing.--
       ``(A) Limitation on requesting or requiring genetic 
     testing.--An issuer of a medicare supplemental policy shall 
     not request or

[[Page 10316]]

     require an individual or a family member of such individual 
     to undergo a genetic test.
       ``(B) Rule of construction.--Subparagraph (A) shall not be 
     construed to limit the authority of a health care 
     professional who is providing health care services to an 
     individual to request that such individual undergo a genetic 
     test.
       ``(C) Rule of construction regarding payment.--
       ``(i) In general.--Nothing in subparagraph (A) shall be 
     construed to preclude an issuer of a medicare supplemental 
     policy from obtaining and using the results of a genetic test 
     in making a determination regarding payment (as such term is 
     defined for the purposes of applying the regulations 
     promulgated by the Secretary under part C of title XI and 
     section 264 of the Health Insurance Portability and 
     Accountability Act of 1996, as may be revised from time to 
     time) consistent with subsection (s)(2)(E).
       ``(ii) Limitation.--For purposes of clause (i), an issuer 
     of a medicare supplemental policy may request only the 
     minimum amount of information necessary to accomplish the 
     intended purpose.
       ``(D) Research exception.--Notwithstanding subparagraph 
     (A), an issuer of a medicare supplemental policy may request, 
     but not require, that an individual or a family member of 
     such individual undergo a genetic test if each of the 
     following conditions is met:
       ``(i) The request is made pursuant to research that 
     complies with part 46 of title 45, Code of Federal 
     Regulations, or equivalent Federal regulations, and any 
     applicable State or local law or regulations for the 
     protection of human subjects in research.
       ``(ii) The issuer clearly indicates to each individual, or 
     in the case of a minor child, to the legal guardian of such 
     child, to whom the request is made that--

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

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

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

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

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

       ``(D) Genetic services.--The term `genetic services' 
     means--
       ``(i) a genetic test;
       ``(ii) genetic counseling (including obtaining, 
     interpreting, or assessing genetic information); or
       ``(iii) genetic education.
       ``(E) Underwriting purposes.--The term `underwriting 
     purposes' means, with respect to a medicare supplemental 
     policy--
       ``(i) rules for, or determination of, eligibility 
     (including enrollment and continued eligibility) for benefits 
     under the policy;
       ``(ii) the computation of premium or contribution amounts 
     under the policy;
       ``(iii) the application of any pre-existing condition 
     exclusion under the policy; and
       ``(iv) other activities related to the creation, renewal, 
     or replacement of a contract of health insurance or health 
     benefits.
       ``(F) Issuer of a medicare supplemental policy.--The term 
     `issuer of a medicare supplemental policy' includes a third-
     party administrator or other person acting for or on behalf 
     of such issuer.''.
       (2) Application to genetic information of a fetus or 
     embryo.--Section 1882(x) of such Act, as added by paragraph 
     (1), is further amended by adding at the end the following:
       ``(4) Genetic information of a fetus or embryo.--Any 
     reference in this section to genetic information concerning 
     an individual or family member of an individual shall--
       ``(A) with respect to such an individual or family member 
     of an individual who is a pregnant woman, include genetic 
     information of any fetus carried by such pregnant woman; and
       ``(B) with respect to an individual or family member 
     utilizing an assisted reproductive technology, include 
     genetic information of any embryo legally held by the 
     individual or family member.''.
       (3) Conforming amendment.--Section 1882(o) of the Social 
     Security Act (42 U.S.C. 1395ss(o)) is amended by adding at 
     the end the following:
       ``(4) The issuer of the medicare supplemental policy 
     complies with subsection (s)(2)(E) and subsection (x).''.
       (c) Effective Date.--The amendments made by this section 
     shall apply with respect to an issuer of a medicare 
     supplemental policy for policy years beginning on or after 
     the date that is 18 months after the date of enactment of 
     this Act.
       (d) Transition Provisions.--
       (1) In general.--If the Secretary of Health and Human 
     Services identifies a State as requiring a change to its 
     statutes or regulations to conform its regulatory program to 
     the changes made by this section, the State regulatory 
     program shall not be considered to be out of compliance with 
     the requirements of section 1882 of the Social Security Act 
     due solely to failure to make such change until the date 
     specified in paragraph (4).
       (2) NAIC standards.--If, not later than June 30, 2008, the 
     National Association of Insurance Commissioners (in this 
     subsection referred to as the ``NAIC'') modifies its NAIC 
     Model Regulation relating to section 1882 of the Social 
     Security Act (referred to in such section as the 1991 NAIC 
     Model Regulation, as subsequently modified) to conform to the 
     amendments made by this section, such revised regulation 
     incorporating the modifications shall be considered to be the 
     applicable NAIC model regulation (including the revised NAIC 
     model regulation and the 1991 NAIC Model Regulation) for the 
     purposes of such section.
       (3) Secretary standards.--If the NAIC does not make the 
     modifications described in paragraph (2) within the period 
     specified in such paragraph, the Secretary of Health and 
     Human Services shall, not later than October 1, 2008, make 
     the modifications described in such paragraph and such 
     revised regulation incorporating the modifications shall be 
     considered to be the appropriate regulation for the purposes 
     of such section.
       (4) Date specified.--
       (A) In general.--Subject to subparagraph (B), the date 
     specified in this paragraph for a State is the earlier of--
       (i) the date the State changes its statutes or regulations 
     to conform its regulatory program to the changes made by this 
     section, or
       (ii) October 1, 2008.
       (B) Additional legislative action required.--In the case of 
     a State which the Secretary identifies as--
       (i) requiring State legislation (other than legislation 
     appropriating funds) to conform its regulatory program to the 
     changes made in this section, but
       (ii) having a legislature which is not scheduled to meet in 
     2008 in a legislative session in which such legislation may 
     be considered, the date specified in this paragraph is the 
     first day of the first calendar quarter beginning after the 
     close of the first legislative session of the State 
     legislature that begins on or after July 1, 2008. For 
     purposes of the previous sentence, in the case of a State 
     that has a 2-year legislative session, each year of such 
     session shall be deemed to be a separate regular session of 
     the State legislature.

[[Page 10317]]



     SEC. 105. PRIVACY AND CONFIDENTIALITY.

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


       ``APPLICATION OF HIPAA REGULATIONS TO GENETIC INFORMATION

       ``Sec. 1180.  (a) In General.--The Secretary shall revise 
     the HIPAA privacy regulation (as defined in subsection (b)) 
     so it is consistent with the following:
       ``(1) Genetic information shall be treated as health 
     information described in section 1171(4)(B).
       ``(2) The use or disclosure by a covered entity that is a 
     group health plan, health insurance issuer that issues health 
     insurance coverage, or issuer of a medicare supplemental 
     policy of protected health information that is genetic 
     information about an individual for underwriting purposes 
     under the group health plan, health insurance coverage, or 
     medicare supplemental policy shall not be a permitted use or 
     disclosure.
       ``(b) Definitions.--For purposes of this section:
       ``(1) Genetic information; genetic test; family member.--
     The terms `genetic information', `genetic test', and `family 
     member' have the meanings given such terms in section 2791 of 
     the Public Health Service Act (42 U.S.C. 300gg-91), as 
     amended by the Genetic Information Nondiscrimination Act of 
     2007.
       ``(2) Group health plan; health insurance coverage; 
     medicare supplemental policy.--The terms `group health plan' 
     and `health insurance coverage' have the meanings given such 
     terms under section 2791 of the Public Health Service Act (42 
     U.S.C. 300gg-91), and the term `medicare supplemental policy' 
     has the meaning given such term in section 1882(g).
       ``(3) HIPAA privacy regulation.--The term `HIPAA privacy 
     regulation' means the regulations promulgated by the 
     Secretary under this part and section 264 of the Health 
     Insurance Portability and Accountability Act of 1996 (42 
     U.S.C. 1320d-2 note).
       ``(4) Underwriting purposes.--The term `underwriting 
     purposes' means, with respect to a group health plan, health 
     insurance coverage, or a medicare supplemental policy--
       ``(A) rules for eligibility (including enrollment and 
     continued eligibility) for, or determination of, benefits 
     under the plan, coverage, or policy;
       ``(B) the computation of premium or contribution amounts 
     under the plan, coverage, or policy;
       ``(C) the application of any pre-existing condition 
     exclusion under the plan, coverage, or policy; and
       ``(D) other activities related to the creation, renewal, or 
     replacement of a contract of health insurance or health 
     benefits.
       ``(c) Procedure.--The revisions under subsection (a) shall 
     be made by notice in the Federal Register published not later 
     than 60 days after the date of the enactment of this section 
     and shall be effective upon publication, without opportunity 
     for any prior public comment, but may be revised, consistent 
     with this section, after opportunity for public comment.
       ``(d) Enforcement.--In addition to any other sanctions or 
     remedies that may be available under law, a covered entity 
     that is a group health plan, health insurance issuer, or 
     issuer of a medicare supplemental policy and that violates 
     the HIPAA privacy regulation (as revised under subsection (a) 
     or otherwise) with respect to the use or disclosure of 
     genetic information shall be subject to the penalties 
     described in sections 1176 and 1177 in the same manner and to 
     the same extent that such penalties apply to violations of 
     this part.''.
       (b) Regulations; Effective Date.--
       (1) Regulations.--Not later than 1 year after the date of 
     the enactment of this Act, the Secretary of Health and Human 
     Services shall issue final regulations to carry out the 
     revision required by section 1180(a) of the Social Security 
     Act, as added by subsection (a). The Secretary has the sole 
     authority to promulgate such regulations, but shall 
     promulgate such regulations in consultation with the 
     Secretaries of Labor and the Treasury.
       (2) Effective date.--The amendment made by subsection (a) 
     shall take effect on the date that is 18 months after the 
     date of the enactment of this Act.

     SEC. 106. ASSURING COORDINATION.

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

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

     SEC. 201. DEFINITIONS.

       In this title:
       (1) Commission.--The term ``Commission'' means the Equal 
     Employment Opportunity Commission as created by section 705 
     of the Civil Rights Act of 1964 (42 U.S.C. 2000e-4).
       (2) Employee; employer; employment agency; labor 
     organization; member.--
       (A) In general.--The term ``employee'' means--
       (i) an employee (including an applicant), as defined in 
     section 701(f) of the Civil Rights Act of 1964 (42 U.S.C. 
     2000e(f));
       (ii) a State employee (including an applicant) described in 
     section 304(a) of the Government Employee Rights Act of 1991 
     (42 U.S.C. 2000e-16c(a));
       (iii) a covered employee (including an applicant), as 
     defined in section 101 of the Congressional Accountability 
     Act of 1995 (2 U.S.C. 1301);
       (iv) a covered employee (including an applicant), as 
     defined in section 411(c) of title 3, United States Code; or
       (v) an employee or applicant to which section 717(a) of the 
     Civil Rights Act of 1964 (42 U.S.C. 2000e-16(a)) applies.
       (B) Employer.--The term ``employer'' means--
       (i) an employer (as defined in section 701(b) of the Civil 
     Rights Act of 1964 (42 U.S.C. 2000e(b)));
       (ii) an entity employing a State employee described in 
     section 304(a) of the Government Employee Rights Act of 1991;
       (iii) an employing office, as defined in section 101 of the 
     Congressional Accountability Act of 1995;
       (iv) an employing office, as defined in section 411(c) of 
     title 3, United States Code; or
       (v) an entity to which section 717(a) of the Civil Rights 
     Act of 1964 applies.
       (C) Employment agency; labor organization.--The terms 
     ``employment agency'' and ``labor organization'' have the 
     meanings given the terms in section 701 of the Civil Rights 
     Act of 1964 (42 U.S.C. 2000e).
       (D) Member.--The term ``member'', with respect to a labor 
     organization, includes an applicant for membership in a labor 
     organization.
       (3) Family member.--The term ``family member'' means, with 
     respect to an individual--
       (A) a dependent (as such term is used for purposes of 
     section 701(f)(2) of the Employee Retirement Income Security 
     Act of 1974) of such individual, and
       (B) any other individual who is a first-degree, second-
     degree, third-degree, or fourth-degree relative of such 
     individual or of an individual described in subparagraph (A).
       (4) Genetic information.--
       (A) In general.--The term ``genetic information'' means, 
     with respect to any individual, information about--
       (i) such individual's genetic tests,
       (ii) the genetic tests of family members of such 
     individual, and
       (iii) subject to subparagraph (D), the manifestation of a 
     disease or disorder in family members of such individual.
       (B) Inclusion of genetic services.--Such term includes, 
     with respect to any individual, any request for, or receipt 
     of, genetic services (including genetic services received 
     pursuant to participation in clinical research) by such 
     individual or any family member of such individual.
       (C) Exclusions.--The term ``genetic information'' shall not 
     include information about the sex or age of any individual.
       (5) Genetic monitoring.--The term ``genetic monitoring'' 
     means the periodic examination of employees to evaluate 
     acquired modifications to their genetic material, such as 
     chromosomal damage or evidence of increased occurrence of 
     mutations, that may have developed in the course of 
     employment due to exposure to toxic substances in the 
     workplace, in order to identify, evaluate, and respond to the 
     effects of or control adverse environmental exposures in the 
     workplace.
       (6) Genetic services.--The term ``genetic services'' 
     means--
       (A) a genetic test;
       (B) genetic counseling (including obtaining, interpreting, 
     or assessing genetic information); or
       (C) genetic education.
       (7) Genetic test.--
       (A) In general.--The term ``genetic test'' means an 
     analysis of human DNA, RNA, chromosomes, proteins, or 
     metabolites, that detects genotypes, mutations, or 
     chromosomal changes.
       (B) Exceptions.--The term ``genetic test'' does not mean an 
     analysis of proteins or metabolites that does not detect 
     genotypes, mutations, or chromosomal changes.

     SEC. 202. EMPLOYER PRACTICES.

       (a) Discrimination Based on Genetic Information.--It shall 
     be an unlawful employment practice for an employer--
       (1) to fail or refuse to hire, or to discharge, any 
     employee, or otherwise to discriminate against any employee 
     with respect to the compensation, terms, conditions, or 
     privileges of employment of the employee, because of genetic 
     information with respect to the employee; or
       (2) to limit, segregate, or classify the employees of the 
     employer in any way that would deprive or tend to deprive any 
     employee of employment opportunities or otherwise adversely 
     affect the status of the employee as an employee, because of 
     genetic information with respect to the employee.

[[Page 10318]]

       (b) Acquisition of Genetic Information.--It shall be an 
     unlawful employment practice for an employer to request, 
     require, or purchase genetic information with respect to an 
     employee or a family member of the employee except--
       (1) where an employer inadvertently requests or requires 
     family medical history of the employee or family member of 
     the employee;
       (2) where--
       (A) health or genetic services are offered by the employer, 
     including such services offered as part of a 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;
       (5) where the information involved is to be used for 
     genetic monitoring of the biological effects of toxic 
     substances in the workplace, but only if--
       (A) the employer provides written notice of the genetic 
     monitoring to the employee;
       (B)(i) the employee provides prior, knowing, voluntary, and 
     written authorization; or
       (ii) the genetic monitoring is required by Federal or State 
     law;
       (C) the employee is informed of individual monitoring 
     results;
       (D) the monitoring is in compliance with--
       (i) any Federal genetic monitoring regulations, including 
     any such regulations that may be promulgated by the Secretary 
     of Labor pursuant to the Occupational Safety and Health Act 
     of 1970 (29 U.S.C. 651 et seq.), the Federal Mine Safety and 
     Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic 
     Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
       (ii) State genetic monitoring regulations, in the case of a 
     State that is implementing genetic monitoring regulations 
     under the authority of the Occupational Safety and Health Act 
     of 1970 (29 U.S.C. 651 et seq.); and
       (E) the employer, excluding any licensed health care 
     professional or board certified genetic counselor that is 
     involved in the genetic monitoring program, receives the 
     results of the monitoring only in aggregate terms that do not 
     disclose the identity of specific employees; or
       (6) where the employer conducts DNA analysis for law 
     enforcement purposes as a forensic laboratory, includes such 
     analysis in the Combined DNA Index System pursuant to section 
     210304 of the Violent Crime Control and Law Enforcement Act 
     of 1994 (42 U.S.C. 14132), and requests or requires genetic 
     information of such employer's employees, but only to the 
     extent that such genetic information is used for analysis of 
     DNA identification markers for quality control to detect 
     sample contamination.
       (c) Preservation of Protections.--In the case of 
     information to which any of paragraphs (1) through (6) of 
     subsection (b) applies, such information may not be used in 
     violation of paragraph (1) or (2) of subsection (a) or 
     treated or disclosed in a manner that violates section 206.

     SEC. 203. EMPLOYMENT AGENCY PRACTICES.

       (a) Discrimination Based on Genetic Information.--It shall 
     be an unlawful employment practice for an employment agency--
       (1) to fail or refuse to refer for employment, or otherwise 
     to discriminate against, any individual because of genetic 
     information with respect to the individual;
       (2) to limit, segregate, or classify individuals or fail or 
     refuse to refer for employment any individual in any way that 
     would deprive or tend to deprive any individual of employment 
     opportunities, or otherwise adversely affect the status of 
     the individual as an employee, because of genetic information 
     with respect to the individual; or
       (3) to cause or attempt to cause an employer to 
     discriminate against an individual in violation of this 
     title.
       (b) Acquisition of Genetic Information.--It shall be an 
     unlawful employment practice for an employment agency to 
     request, require, or purchase genetic information with 
     respect to an individual or a family member of the individual 
     except--
       (1) where an employment agency inadvertently requests or 
     requires family medical history of the individual or family 
     member of the individual;
       (2) where--
       (A) health or genetic services are offered by the 
     employment agency, including such services offered as part of 
     a 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), (2), or (3) of subsection (a) or 
     treated or disclosed in a manner that violates section 206.

     SEC. 204. LABOR ORGANIZATION PRACTICES.

       (a) Discrimination Based on Genetic Information.--It shall 
     be an unlawful employment practice for a labor organization--
       (1) to exclude or to expel from the membership of the 
     organization, or otherwise to discriminate against, any 
     member because of genetic information with respect to the 
     member;
       (2) to limit, segregate, or classify the members of the 
     organization, or fail or refuse to refer for employment any 
     member, in any way that would deprive or tend to deprive any 
     member of employment opportunities, or otherwise adversely 
     affect the status of the member as an employee, because of 
     genetic information with respect to the member; or
       (3) to cause or attempt to cause an employer to 
     discriminate against a member in violation of this title.
       (b) Acquisition of Genetic Information.--It shall be an 
     unlawful employment practice for a labor organization to 
     request, require, or purchase genetic information with 
     respect to a member or a family member of the member except--
       (1) where a labor organization inadvertently requests or 
     requires family medical history of the member or family 
     member of the member;
       (2) where--
       (A) health or genetic services are offered by the labor 
     organization, including such services offered as part of a 
     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;

[[Page 10319]]

       (3) where a labor organization requests or requires family 
     medical history from the members to comply with the 
     certification provisions of section 103 of the Family and 
     Medical Leave Act of 1993 (29 U.S.C. 2613) or such 
     requirements under State family and medical leave laws;
       (4) where a labor organization purchases documents that are 
     commercially and publicly available (including newspapers, 
     magazines, periodicals, and books, but not including medical 
     databases or court records) that include family medical 
     history; or
       (5) where the information involved is to be used for 
     genetic monitoring of the biological effects of toxic 
     substances in the workplace, but only if--
       (A) the labor organization provides written notice of the 
     genetic monitoring to the member;
       (B)(i) the member provides prior, knowing, voluntary, and 
     written authorization; or
       (ii) the genetic monitoring is required by Federal or State 
     law;
       (C) the member is informed of individual monitoring 
     results;
       (D) the monitoring is in compliance with--
       (i) any Federal genetic monitoring regulations, including 
     any such regulations that may be promulgated by the Secretary 
     of Labor pursuant to the Occupational Safety and Health Act 
     of 1970 (29 U.S.C. 651 et seq.), the Federal Mine Safety and 
     Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic 
     Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
       (ii) State genetic monitoring regulations, in the case of a 
     State that is implementing genetic monitoring regulations 
     under the authority of the Occupational Safety and Health Act 
     of 1970 (29 U.S.C. 651 et seq.); and
       (E) the labor organization, excluding any licensed health 
     care professional or board certified genetic counselor that 
     is involved in the genetic monitoring program, receives the 
     results of the monitoring only in aggregate terms that do not 
     disclose the identity of specific members.
       (c) Preservation of Protections.--In the case of 
     information to which any of paragraphs (1) through (5) of 
     subsection (b) applies, such information may not be used in 
     violation of paragraph (1), (2), or (3) of subsection (a) or 
     treated or disclosed in a manner that violates section 206.

     SEC. 205. TRAINING PROGRAMS.

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

     SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION.

       (a) Treatment of Information as Part of Confidential 
     Medical Record.--If an employer, employment agency, labor 
     organization, or joint labor-management committee possesses 
     genetic information about an employee or member, such 
     information shall be maintained on separate forms and in 
     separate medical files and be treated as a confidential 
     medical record of the employee or member. An employer, 
     employment agency, labor organization, or joint labor-
     management committee shall be considered to be in compliance 
     with the maintenance of information requirements of this 
     subsection with respect to genetic information subject to 
     this subsection that is maintained with and treated as a 
     confidential medical record under section 102(d)(3)(B) of the 
     Americans With Disabilities Act (42 U.S.C. 12112(d)(3)(B)).
       (b) Limitation on Disclosure.--An employer, employment 
     agency, labor organization, or joint labor-management 
     committee shall not disclose genetic information concerning 
     an employee or member except--
       (1) to the employee or member of a labor organization (or 
     family member if the family member is receiving the genetic 
     services) at the written request of the employee or member of 
     such organization;
       (2) to an occupational or other health researcher if the 
     research is conducted in compliance with the regulations and 
     protections provided for under part 46 of title 45, Code of 
     Federal Regulations;
       (3) in response to an order of a court, except that--
       (A) the employer, employment agency, labor organization, or 
     joint labor-management committee may disclose only the 
     genetic information expressly authorized by such order; and
       (B) if the court order was secured without the knowledge of 
     the employee or member to whom the information refers, the 
     employer, employment agency, labor organization, or joint 
     labor-management committee shall inform the employee or 
     member of the court order and any genetic information that 
     was disclosed pursuant to such order;
       (4) to government officials who are investigating 
     compliance with this title if the information is relevant to 
     the investigation; 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.

[[Page 10320]]

       (c) Relationship to HIPAA Regulations.--With respect to the 
     regulations promulgated by the Secretary of Health and Human 
     Services under part C of title XI of the Social Security Act 
     (42 U.S.C. 1320d et seq.) and section 264 of the Health 
     Insurance Portability and Accountability Act of 1996 (42 
     U.S.C. 1320d-2 note), this title does not prohibit a covered 
     entity under such regulations from any use or disclosure of 
     health information that is authorized for the covered entity 
     under such regulations. The previous sentence does not affect 
     the authority of such Secretary to modify such regulations.

     SEC. 207. REMEDIES AND ENFORCEMENT.

       (a) Employees Covered by Title VII of the Civil Rights Act 
     of 1964.--
       (1) In general.--The powers, 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 of the United States (42 U.S.C. 1988), shall 
     be powers, remedies, and procedures this title provides to 
     the Commission, the Attorney General, or any person, alleging 
     such a practice.
       (3) Damages.--The powers, remedies, and procedures provided 
     in section 1977A of the Revised Statutes of the United States 
     (42 U.S.C. 1981a), including the limitations contained in 
     subsection (b)(3) of such section 1977A, shall be powers, 
     remedies, and procedures this title provides to the 
     Commission, the Attorney General, or any person, alleging 
     such a practice (not an employment practice specifically 
     excluded from coverage under section 1977A(a)(1) of the 
     Revised Statutes of the United States).
       (b) Employees Covered by Government Employee Rights Act of 
     1991.--
       (1) In general.--The powers, remedies, and procedures 
     provided in sections 302 and 304 of the Government Employee 
     Rights Act of 1991 (42 U.S.C. 2000e-16b, 2000e-16c) to the 
     Commission, or any person, alleging a violation of section 
     302(a)(1) of that Act (42 U.S.C. 2000e-16b(a)(1)) shall be 
     the powers, remedies, and procedures this title provides to 
     the Commission, or any person, respectively, alleging an 
     unlawful employment practice in violation of this title 
     against an employee described in section 201(2)(A)(ii), 
     except as provided in paragraphs (2) and (3).
       (2) Costs and fees.--The powers, remedies, and procedures 
     provided in subsections (b) and (c) of section 722 of the 
     Revised Statutes of the United States (42 U.S.C. 1988), shall 
     be powers, remedies, and procedures this title provides to 
     the Commission, or any person, alleging such a practice.
       (3) Damages.--The powers, remedies, and procedures provided 
     in section 1977A of the Revised Statutes of the United States 
     (42 U.S.C. 1981a), including the limitations contained in 
     subsection (b)(3) of such section 1977A, shall be powers, 
     remedies, and procedures this title provides to the 
     Commission, or any person, alleging such a practice (not an 
     employment practice specifically excluded from coverage under 
     section 1977A(a)(1) of the Revised Statutes of the United 
     States).
       (c) Employees Covered by Congressional Accountability Act 
     of 1995.--
       (1) In general.--The powers, remedies, and procedures 
     provided in the Congressional Accountability Act of 1995 (2 
     U.S.C. 1301 et seq.) to the Board (as defined in section 101 
     of that Act (2 U.S.C. 1301)), or any person, alleging a 
     violation of section 201(a)(1) of that Act (42 U.S.C. 
     1311(a)(1)) shall be the powers, remedies, and procedures 
     this title provides to that Board, or any person, alleging an 
     unlawful employment practice in violation of this title 
     against an employee described in section 201(2)(A)(iii), 
     except as provided in paragraphs (2) and (3).
       (2) Costs and fees.--The powers, remedies, and procedures 
     provided in subsections (b) and (c) of section 722 of the 
     Revised Statutes of the United States (42 U.S.C. 1988), shall 
     be powers, remedies, and procedures this title provides to 
     that Board, or any person, alleging such a practice.
       (3) Damages.--The powers, remedies, and procedures provided 
     in section 1977A of the Revised Statutes of the United States 
     (42 U.S.C. 1981a), including the limitations contained in 
     subsection (b)(3) of such section 1977A, shall be powers, 
     remedies, and procedures this title provides to that Board, 
     or any person, alleging such a practice (not an employment 
     practice specifically excluded from coverage under section 
     1977A(a)(1) of the Revised Statutes of the United States).
       (4) Other applicable provisions.--With respect to a claim 
     alleging a practice described in paragraph (1), title III of 
     the Congressional Accountability Act of 1995 (2 U.S.C. 1381 
     et seq.) shall apply in the same manner as such title applies 
     with respect to a claim alleging a violation of section 
     201(a)(1) of such Act (2 U.S.C. 1311(a)(1)).
       (d) Employees Covered by Chapter 5 of Title 3, United 
     States Code.--
       (1) In general.--The powers, remedies, and procedures 
     provided in chapter 5 of title 3, United States Code, to the 
     President, the Commission, the Merit Systems Protection 
     Board, or any person, alleging a violation of section 
     411(a)(1) of that title, shall be the powers, remedies, and 
     procedures this title provides to the President, the 
     Commission, such Board, or any person, respectively, alleging 
     an unlawful employment practice in violation of this title 
     against an employee described in section 201(2)(A)(iv), 
     except as provided in paragraphs (2) and (3).
       (2) Costs and fees.--The powers, remedies, and procedures 
     provided in subsections (b) and (c) of section 722 of the 
     Revised Statutes of the United States (42 U.S.C. 1988), shall 
     be powers, remedies, and procedures this title provides to 
     the President, the Commission, such Board, or any person, 
     alleging such a practice.
       (3) Damages.--The powers, remedies, and procedures provided 
     in section 1977A of the Revised Statutes of the United States 
     (42 U.S.C. 1981a), including the limitations contained in 
     subsection (b)(3) of such section 1977A, shall be powers, 
     remedies, and procedures this title provides to the 
     President, the Commission, such Board, or any person, 
     alleging such a practice (not an employment practice 
     specifically excluded from coverage under section 1977A(a)(1) 
     of the Revised Statutes of the United States).
       (e) Employees Covered by Section 717 of the Civil Rights 
     Act of 1964.--
       (1) In general.--The powers, remedies, and procedures 
     provided in section 717 of the Civil Rights Act of 1964 (42 
     U.S.C. 2000e-16) to the Commission, the Attorney General, the 
     Librarian of Congress, or any person, alleging a violation of 
     that section shall be the powers, remedies, and procedures 
     this title provides to the Commission, the Attorney General, 
     the Librarian of Congress, or any person, respectively, 
     alleging an unlawful employment practice in violation of this 
     title against an employee or applicant described in section 
     201(2)(A)(v), except as provided in paragraphs (2) and (3).
       (2) Costs and fees.--The powers, remedies, and procedures 
     provided in subsections (b) and (c) of section 722 of the 
     Revised Statutes of the United States (42 U.S.C. 1988), shall 
     be powers, remedies, and procedures this title provides to 
     the Commission, the Attorney General, the Librarian of 
     Congress, or any person, alleging such a practice.
       (3) Damages.--The powers, remedies, and procedures provided 
     in section 1977A of the Revised Statutes of the United States 
     (42 U.S.C. 1981a), including the limitations contained in 
     subsection (b)(3) of such section 1977A, shall be powers, 
     remedies, and procedures this title provides to the 
     Commission, the Attorney General, the Librarian of Congress, 
     or any person, alleging such a practice (not an employment 
     practice specifically excluded from coverage under section 
     1977A(a)(1) of the Revised Statutes of the United States).
       (f) Definition.--In this section, the term ``Commission'' 
     means the Equal Employment Opportunity Commission.

     SEC. 208. DISPARATE IMPACT.

       (a) General Rule.--Notwithstanding any other provision of 
     this Act, ``disparate impact'', as that term is used in 
     section 703(k) of the Civil Rights Act of 1964 (42 U.S.C. 
     2000e-2(k)), on the basis of genetic information does not 
     establish a cause of action under this Act.
       (b) Commission.--On the date that is 6 years after the date 
     of enactment of this Act, there shall be established a 
     commission, to be known as the Genetic Nondiscrimination 
     Study Commission (referred to in this section as the 
     ``Commission'') to review the developing science of genetics 
     and to make recommendations to Congress regarding whether to 
     provide a disparate impact cause of action under this Act.
       (c) Membership.--
       (1) In general.--The Commission shall be composed of 8 
     members, of which--
       (A) 1 member shall be appointed by the Majority Leader of 
     the Senate;
       (B) 1 member shall be appointed by the Minority Leader of 
     the Senate;
       (C) 1 member shall be appointed by the Chairman of the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate;
       (D) 1 member shall be appointed by the ranking minority 
     member of the Committee on Health, Education, Labor, and 
     Pensions of the Senate;
       (E) 1 member shall be appointed by the Speaker of the House 
     of Representatives;
       (F) 1 member shall be appointed by the Minority Leader of 
     the House of Representatives;
       (G) 1 member shall be appointed by the Chairman of the 
     Committee on Education and Labor of the House of 
     Representatives; and
       (H) 1 member shall be appointed by the ranking minority 
     member of the Committee on Education and Labor of the House 
     of Representatives.
       (2) Compensation and expenses.--The members of the 
     Commission shall not receive compensation for the performance 
     of services for the Commission, but shall be allowed travel 
     expenses, including per diem in lieu of subsistence, at rates 
     authorized for employees of agencies under subchapter I of

[[Page 10321]]

     chapter 57 of title 5, United States Code, while away from 
     their homes or regular places of business in the performance 
     of services for the Commission.
       (d) Administrative Provisions.--
       (1) Location.--The Commission shall be located in a 
     facility maintained by the Equal Employment Opportunity 
     Commission.
       (2) Detail of government employees.--Any Federal Government 
     employee may be detailed to the Commission without 
     reimbursement, and such detail shall be without interruption 
     or loss of civil service status or privilege.
       (3) Information from federal agencies.--The Commission may 
     secure directly from any Federal department or agency such 
     information as the Commission considers necessary to carry 
     out the provisions of this section. Upon request of the 
     Commission, the head of such department or agency shall 
     furnish such information to the Commission.
       (4) Hearings.--The Commission may hold such hearings, sit 
     and act at such times and places, take such testimony, and 
     receive such evidence as the Commission considers advisable 
     to carry out the objectives of this section, except that, to 
     the extent possible, the Commission shall use existing data 
     and research.
       (5) Postal services.--The Commission may use the United 
     States mails in the same manner and under the same conditions 
     as other departments and agencies of the Federal Government.
       (e) Report.--Not later than 1 year after all of the members 
     are appointed to the Commission under subsection (c)(1), the 
     Commission shall submit to Congress a report that summarizes 
     the findings of the Commission and makes such recommendations 
     for legislation as are consistent with this Act.
       (f) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Equal Employment Opportunity 
     Commission such sums as may be necessary to carry out this 
     section.

     SEC. 209. CONSTRUCTION.

       (a) In General.--Nothing in this title shall be construed 
     to--
       (1) limit the rights or protections of an individual under 
     any other Federal or State statute that provides equal or 
     greater protection to an individual than the rights or 
     protections provided for under this title, including the 
     protections of an individual under the Americans with 
     Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) (including 
     coverage afforded to individuals under section 102 of such 
     Act (42 U.S.C. 12112)), or under the Rehabilitation Act of 
     1973 (29 U.S.C. 701 et seq.);
       (2)(A) limit the rights or protections of an individual to 
     bring an action under this title against an employer, 
     employment agency, labor organization, or joint labor-
     management committee for a violation of this title; or
       (B) provide for enforcement of, or penalties for violation 
     of, any requirement or prohibition applicable to any 
     employer, employment agency, labor organization, or joint 
     labor-management committee the enforcement of which, or 
     penalties for which, are provided under the amendments made 
     by title I;
       (3) apply to the Armed Forces Repository of Specimen 
     Samples for the Identification of Remains;
       (4) limit or expand the protections, rights, or obligations 
     of employees or employers under applicable workers' 
     compensation laws;
       (5) limit the authority of a Federal department or agency 
     to conduct or sponsor occupational or other health research 
     that is conducted in compliance with the regulations 
     contained in part 46 of title 45, Code of Federal Regulations 
     (or any corresponding or similar regulation or rule);
       (6) limit the statutory or regulatory authority of the 
     Occupational Safety and Health Administration or the Mine 
     Safety and Health Administration to promulgate or enforce 
     workplace safety and health laws and regulations; or
       (7) require any specific benefit for an employee or member 
     or a family member of an employee or member under any group 
     health plan or health insurance issuer offering group health 
     insurance coverage in connection with a group health plan.
       (b) Genetic Information of a Fetus or Embryo.--Any 
     reference in this title to genetic information concerning an 
     individual or family member of an individual shall--
       (1) with respect to such an individual or family member of 
     an individual who is a pregnant woman, include genetic 
     information of any fetus carried by such pregnant woman; and
       (2) with respect to an individual or family member 
     utilizing an assisted reproductive technology, include 
     genetic information of any embryo legally held by the 
     individual or family member.

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

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

     SEC. 211. REGULATIONS.

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

     SEC. 212. AUTHORIZATION OF APPROPRIATIONS.

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

     SEC. 213. EFFECTIVE DATE.

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

                  TITLE III--MISCELLANEOUS PROVISIONS

     SEC. 301. GUARANTEE AGENCY COLLECTION RETENTION.

       Clause (ii) of section 428(c)(6)(A) of the Higher Education 
     Act of 1965 (20 U.S.C. 1078(c)(6)(A)) is amended to read as 
     follows:
       ``(ii) an amount equal to 23 percent of such payments for 
     use in accordance with section 422B, except that beginning 
     October 1, 2007, and ending September 30, 2008, this 
     subparagraph shall be applied by substituting `22 percent' 
     for `23 percent'.''.

     SEC. 302. 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 SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. George Miller) and the gentlewoman from Illinois (Mrs. 
Biggert) each will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. GEORGE MILLER of California. Mr. Speaker, I request 5 legislative 
days in which Members may insert material relevant to H.R. 493 in the 
Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. GEORGE MILLER of California. Mr. Speaker, I yield myself 2 
minutes.
  Mr. Speaker, I am pleased that the House will take up H.R. 493, the 
Genetic Information Nondiscrimination Act of 2007.
  This legislation is sponsored by two of my distinguished colleagues, 
Congresswoman Louise Slaughter, who has been waiting 10 years to debate 
this bill on the floor of the House of Representatives, and 
Congresswoman Judy Biggert, who has been a member of the committee 
which I chair, the Committee on Education and Labor, and I commend the 
sponsors for their hard work and for their perseverance.
  This bill is long overdue. The Human Genome Project started the 
revolution in science and medicine nearly 20 years ago by identifying 
the specific chromosomes within the genes that make up the human body. 
Once the scientists identified and understood these genetic building 
blocks, they developed tests that identified genetic markers for 
diseases that could, but may never, occur.
  We understand that this scientific revolution can and will save 
lives. It can save children from devastating illnesses, and once these 
tests and treatments become more widely available, they will help us 
live longer lives with less debilitating diseases.
  The key to unlocking this scientific revolution is to assure 
individuals of genetic privacy and nondiscrimination when they undergo 
genetic testing and counseling. Many Americans already forgo testing 
for fear of losing their jobs and their health insurance. In a 2003 
National Institutes of Health study, 39 percent of the individuals 
surveyed cited fear of losing their health insurance as the most 
distressing issues related to genetic testing.

                              {time}  1345

  There is a clear need for us to pass this law to protect genetic 
information from discriminatory uses. We all suffer if fears of lost 
jobs or health insurance stifle these scientific advances.
  That is why 41 States have passed laws to prohibit discrimination in 
the individual health insurance market.
  Mr. Speaker, I reserve the balance of my time.
  Mrs. BIGGERT. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Louisiana (Mr. Boustany), a member of the Education and 
Labor Committee.

[[Page 10322]]


  Mr. BOUSTANY. Mr. Speaker, I rise in support of this legislation, and 
while I do not by any means think it is a perfect bill, I do believe it 
contains a number of important improvements over prior versions of the 
legislation. More importantly, it marks a commitment by this Congress 
to ensure that the law of the United States protects American workers 
and health care consumers from discrimination on the basis of their 
genetic makeup. Because that goal is so critical, I will vote for this 
bill today, and I urge my colleagues to do likewise.
  I would like to commend my colleagues, and fellow member on the 
Committee on Education and Labor, Representative Judy Biggert, and 
Congresswoman Louise Slaughter for their tremendous work and years of 
dedication on this important issue. Both of you have been persistent 
and effective on so many issues that have come before this committee 
and this Congress. Both should be commended for adding this important 
bill to your list of legislative accomplishments.
  As was noted during our committee's consideration of this bill, I 
believe that the title of the legislation before us, the Genetic 
Information Nondiscrimination Act, embodies a proposition that all 
members of our committee and, indeed, all Members of this Congress 
should endorse. Simply put, no employee should face discrimination on 
the basis of genetic makeup or on any characteristic other than the 
ability to do the job. Similarly, no employee should risk his or her 
health insurance status simply because of the possibility that they may 
someday develop an illness.
  This bill was drafted with those fundamental principles in mind, and 
I believe that through the legislative process we have taken steps 
toward ensuring that the bill we pass fulfills those principles, while 
minimizing the potential for unintended consequences.
  I would like to point out a number of improvements in the bill that I 
think merit attention.
  I am pleased that the bill before us today embodies the same logic as 
a past executive order issued by President Clinton to ensure that this 
legislation would not inadvertently serve as a broad, new Federal 
mandate requiring all insurance plans and employers to cover all 
treatments related to genetic-related conditions. That is exactly the 
type of unintended consequence we were seeking to avoid, and I am 
pleased that we were able to work this out.
  Second, I would like to highlight a provision in the legislation that 
ensures that employers, who are currently subject to a number of 
confidentiality and recordkeeping requirements under law, are not 
burdened by yet another redundant set of paperwork requirements. The 
bill before us today provides that with respect to genetic information, 
if an employer maintains employee records and treats them as it does 
confidential medical records under the Americans with Disabilities Act, 
it is in compliance with this new genetics law.
  Third, I applaud a significant improvement in the bill, and namely, 
its extension of genetic nondiscrimination protection to all Americans. 
One of the issues raised during our committee's consideration of the 
bill was concern that the bill's protections did not adequately extend 
to cover children in utero or at early stages of development or in 
connection with in vitro fertilization and other technologies. I am 
very pleased that the final bill before us addresses these issues to 
the satisfaction of all Members on both sides of the aisle who have 
worked in good faith to ensure the broadest protection possible.
  The bill contains a number of other improvements over prior versions, 
representing issues we were able to work through over the past couple 
of months and which demonstrate how the committee process is truly 
meant to work. We were presented with well-intentioned legislation, 
heard meaningful testimony on it and its potential impact on employers 
and employees alike, raised and debated legitimate concerns, and worked 
together to bridge the gap between where we began and where we stand 
today. I thank the staff on both sides of the aisle for making this a 
reality.
  I would be remiss if I did not point out concerns I have with the 
bill and express my hope that as the legislative process continues, and 
if and when the provisions of this bill are administered, we give due 
weight to these concerns.
  I remain concerned that the bill's penalty provisions are overbroad 
and will potentially subject employers to punitive damages for simple 
paperwork violations. I am equally concerned that the bill we pass 
today will not set a single national standard, but still leave 
employers subject to a patchwork of varying requirements on a State-by-
State basis. And finally, I think the bill would be significantly 
improved if we made clear that employers would not be held liable for 
the acquisition and use of genetic information where such use was 
required or justified by business necessity.
  As we send this bill to the United States Senate for consideration, I 
would urge my colleagues in that body to take up and address these 
issues. Beyond that, as courts and administrative agencies interpret 
and enforce these laws, I would urge them to heed the intent of 
Congress; namely, that this bill's most egregious penalties must be 
reserved for the most egregious violations of the law, and that our 
intent is not to ensnare employers acting in good faith in a legal web 
of penalties and damages.
  As I noted at the outset of my remarks, our actions today will ensure 
that the law of the United States protects American workers and health 
care consumers from discrimination on the basis of their genetic 
makeup, a goal I think that is shared by every Member of this House. I 
urge my colleagues to support this legislation.
  Mr. GEORGE MILLER of California. Mr. Speaker, I yield 5\1/2\ minutes 
to the gentlewoman from New York (Ms. Slaughter), the Chair of the 
Rules Committee of the House, who has worked on this legislation for a 
very long time, without whose persistence with this bill we would not 
be here on the floor.
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman for yielding, and I 
thank my partner, Mrs. Biggert, also for the hard work she has done. It 
has taken us collectively 12 years to get to this point, and I want to 
say at the outset we are not talking about some population of people 
who might have bad genes. We are talking about us, because every one of 
us has bad genes, between 30 and 40. So this protection goes not just 
to some employee somewhere, but all of us and the people we love.
  It is with great pride that I rise today. As a matter of fact, I 
could not stop smiling all day. With the passage of this bill, we are 
going to stand up for the future health of our citizens and one of 
medicine's most promising fields, genetic research.
  It is almost heartbreaking to me to think that we are 10 years behind 
in genetic research and the people we could have helped up to now, but 
it is the culmination of a bipartisan effort to prevent the improper 
use of genetic information in the workforce and insurance decisions.
  It is no longer simply the work of science fiction writers.
  There have been many instances of genetic discrimination, from a 
woman who was fired after a genetic test revealed her risk for lung 
disorder, to a social worker who, despite outstanding performance 
reviews, was dismissed because some member of her family had 
Huntington's disease.
  Consider the case of Heidi Williams, an individual diagnosed with 
alpha-1 antitrypsin deficiency. In 2004, she testified that a large 
health insurance company had denied coverage for her two children 
because they were carriers for the disease.
  GINA will make these discriminatory practices illegal by prohibiting 
health insurers from denying coverage or charging higher premiums to a 
healthy individual because of a genetic predisposition, which means you 
may never get the disease, might happen.
  GINA also bars employers from using genetic information for hiring, 
firing, job placement or promotion decisions.
  In the 12 years since I first introduced this legislation, the need 
for it

[[Page 10323]]

has grown rapidly. Scientific research has advanced so quickly that we 
cannot possibly afford to wait any longer.
  It offers immense potential for early treatment and prevention of 
numerous diseases.
  Since the sequencing of the human genome was completed in 2003, 
researchers have identified genetic markers for a wide variety of 
health conditions, and new progress is being made every day.
  Fifteen percent of all cancers are found to have an inherited 
susceptibility. Ten percent of adult chronic diseases, heart disease 
and diabetes, America's top killers, have a genetic component.
  Already, over 15,500 recognized genetic disorders affect 13 million 
Americans, and each and every one of us, as I said before, and it is so 
important for you to know this, each and every one of us is in that 
category of carrying between 5 and 50 bad genes, or predicted genes. 
They may not be so bad.
  That is exactly why this bill is so important to all of us, not just 
those with recognized disorders. There is not a single person on the 
planet that has perfect genes. Every one of us, and let me make that 
clear again, are all vulnerable to genetic discrimination.
  To give you an idea of the potential that exists from this research, 
consider that a genetic test can tell a woman with a family history of 
breast cancer if she has the genetic mutation that can cause it, long 
before the cancer might develop.
  For these exciting scientific advances to continue, for the potential 
of this technology to be realized, we have to make genetic testing 
something commonplace rather than something that is feared and kept 
secret.
  But sadly, the threat of genetic discrimination and the fear of being 
passed over for promotion, forced to pay more for health insurance, or 
even denied coverage, men and women are much less likely to be tested 
and to take advantage of that potentially lifesaving information.
  Most importantly, if individuals do not participate in the clinical 
trials, we will never be able to reap the great benefits of this 
genetic technology.
  In a 2006 Cogent Research poll, 66 percent of respondents said they 
were concerned about how their genetic information would be stored and 
who would have access to it.
  I want to thank everybody, first Dr. Collins who sequenced the human 
genome and testified before Congress at least 12 times, and I cannot 
imagine anybody would be not be moved by his testimony. He is here with 
us today.
  I want to thank all the committee members, certainly Mrs. Biggert who 
has worked so hard, and her staff; and the three committees who have 
jurisdiction here who have done so much for us. Mr. Miller, the first 
thing I think in January he told me this bill was coming to the floor.
  I want to thank Congresswoman Eshoo for her untiring effort to help 
bring this, and certainly the member of my staff who has worked so 
hard.
  It is a great day. You may not realize it but it also just turns out 
to be DNA Day. What a wonderful way to celebrate it.
  Seventy-two percent agreed that the government should establish laws 
and regulations to protect the privacy of individuals' genetic 
information. And 85 percent said that without amending current law, 
employers would use this information to discriminate.
  Before I close, I want to reiterate the broad support that this bill 
enjoys. We have over 220 Democrat and Republican cosponsors behind this 
bill.
  In past Congresses, the Senate has passed this bill twice with 
unanimous support. And I would like to thank the President who today 
issued a statement of administration policy in support of the bill.
  I want to take a moment to thank the lead Republican cosponsor of 
this bill, Congresswoman Judy Biggert for her dedication to this bill, 
along with Congresswoman Anna Eshoo for being a strong advocate for 
this bill over the years.
  I also want to thank Dr. Francis Collins for his support. His 
testimonies over the years should have swayed even the firmest 
unbelievers that genetics has the potential to change our health care 
system as we know it.
  Lastly, I want to thank the advocates from the health and science 
community. Over 200 organizations including Hadassah support this bill.
  GINA will do more than stamp out a new form of discrimination--it 
will help our country be a leader in a field of scientific research 
that holds as much promise as any other in history.
  And it will allow us to realize the tremendous potential of genetic 
research without jeopardizing one of the most fundamental privacies 
that can be imagined.
  Mr. Speaker, today is a momentous day.
  And, I urge all my colleagues to support this bill.
  Mrs. BIGGERT. Mr. Speaker, I yield myself 3 minutes.
  Obviously I rise in strong support of H.R. 493. I think it has been 
an honor to work with the gentlewoman from New York (Ms. Slaughter) 
and, I might add, work we did.
  When the Human Genome Project was completed in 2003, the House of 
Representatives recognized it as ``one of the most significant 
scientific accomplishments of the past 100 years.''
  For the first time, individuals actually could know their genetic 
risk of developing disorders such as cancer, diabetes, heart disease, 
Parkinson's, Alzheimer's, and they could take preventative measures to 
decrease their risks. It spawned a personalized medicine movement, 
focusing on catching diseases earlier, when they are cheaper and easier 
to treat or, even better, preventing the onset of the disease in the 
first place.
  But after investing more than $3.7 billion in taxpayer money to 
achieve this breakthrough, Congress walked away and left the job 
unfinished.
  We left people without any assurance that their genetic information 
would not be used against them. So, understandably, they avoided this 
great technology, never realizing the untold health benefits and 
savings.
  This concern even spilled over into NIH, where a fear of genetic 
discrimination is currently the most commonly cited reason for not 
participating in research on potentially lifesaving genetic testing for 
breast cancer and colon cancer. Fully one-third of those eligible to 
participate declined to do so for this reason, undermining the 
development of new treatments and cures.
  Mr. Speaker, today Congress is here to settle some unfinished 
business and provide Americans the protections against genetic 
discrimination in health care insurance and employment that they need 
to utilize genetic testing without fear.
  Besides the more than 200 health advocacy and business organizations 
that support this bill, recent surveys show 93 percent of Americans 
believe that employers and insurers should not be able to use genetic 
information to discriminate.
  With numbers like this, it should come as no surprise that this 
legislation enjoys overwhelmingly bipartisan support. And I want to 
take a moment to thank my good friend Ms. Slaughter, Mr. Walden and Ms. 
Eshoo. It truly has been a pleasure working with all of them. I would 
also like to thank Mr. McKeon, Mr. Miller and all the other chairmen 
and ranking full committee and subcommittee members for working 
together to make this a better bill.
  I would be remiss if I did not mention the members of the Coalition 
for Genetic Fairness, without whom this bill would not be possible.
  Finally, I would like to thank Brian Petersen of my staff and 
Michelle Adams of Ms. Slaughter's staff and all the outstanding staff 
who worked tirelessly behind the scenes on our behalf and who have put 
in long hours on this legislation.
  Why must we pass this bill today? Because it dramatically reduces 
health care costs while saving or extending human lives.

                              {time}  1400

  Madam Speaker, I reserve the balance of my time.
  Mr. GEORGE MILLER of California. Madam Speaker, I yield 2 minutes to 
the gentleman from Michigan (Mr. Dingell), the chairman of the Energy 
and Commerce Committee.
  Mr. DINGELL. I thank the gentleman for yielding to me. I applaud the 
work of the three committees that have brought this legislation to us, 
and

[[Page 10324]]

the work of my good friend from California (Mr. George Miller) as well 
as that of the distinguished gentleman from New Jersey (Mr. Andrews). I 
want to say a word of praise for our colleagues from Ways and Means led 
by their distinguished chairman, Mr. Rangel.
  On our committee, a lot of people worked on it very hard: Mr. 
Pallone, the chairman of our subcommittee; Ms. Eshoo, who worked very 
hard on the matter; and our good friend Mr. Stupak and the 
distinguished gentlewoman from Colorado, who now occupies the Chair, 
Ms. DeGette, who both did a superb job in negotiating language to avoid 
the difficult questions associated with birth and issues relating to 
abortion.
  I want to say a word of praise for the distinguished gentlewoman from 
New York (Ms. Slaughter) who did so much.
  Madam Speaker, this is an extraordinary bill. It prevents individuals 
from employment discrimination. It would make it unlawful for 
employers, employment agencies, labor organizations or training 
programs to deny individuals the employment opportunities because of 
genetic information. It requires genetic information to be treated as a 
part of the individual's confidential medical record. In addition to 
that, it protects individuals from insurance discrimination by 
prohibiting insurers both in the group and individual markets from 
using genetic information to determine eligibility to establish 
individual premiums based on genetic information of individuals or 
their family members.
  The bill has been significantly amended since its introduction and 
has been refined through the work of the three able committees of 
jurisdiction. The version before us includes key elements that were 
reported by the Committee on Energy and Commerce, and includes a useful 
definition change of the word ``family member.'' It is a fine piece of 
legislation.
  I want to pay a tribute to my friend, Mr. Barton, the ranking member 
of the committee on Energy and Commerce, for his cooperation on this 
matter. This is an excellent bill. It should pass, it should become 
law. My private guess, my dear friends, is that it will exceed, in 
terms of votes, 350 or 400.
  I also want to express my respect and affection for the gentlewoman 
from California (Mrs. Capps), who worked hard on this bill.
  Mrs. BIGGERT. Madam Speaker, I yield 3\1/2\ minutes to the gentleman 
from Florida (Mr. Stearns).
  Mr. STEARNS. Let me also congratulate the authors of the bill and the 
fine work that they have done. We have had a hearing in Energy and 
Commerce, where I serve, but I thought I would just follow up a little 
bit on what the gentleman from Louisiana talked about, a little bit 
about the preemption.
  Madam Speaker, I think almost everybody in this House is for genetic 
protection from genetic discrimination. There have been many bills over 
the years that Ms. Slaughter has worked on. I think she indicated she 
has worked on it for 12 years. I compliment her on her perseverance. 
Sometimes it takes that kind of conscientiousness to get anything 
accomplished here. The fact we are able to get this today is a success 
story. In fact, the President has indicated, I think nationally, that 
he would like to sign this bill. So it is on a fast track, and I am 
sure that we won't have any trouble in the suspension passing it.
  But one significant concern that I bring to the attention of my 
colleagues is a Federal preemption. I mention this as perhaps, as the 
Senate and the House come together, they can solve this problem. So I 
will continue to talk about it.
  According to CBO, the bill would ``preempt some State laws that 
establish confidentiality standards for genetic information, and would 
restrict how State and local governments use such information in 
employment practices and in the provision of health care to 
employees.'' This bill will create, I think, a little bit of a problem, 
the confusion in about the 42 States that currently have laws 
prohibiting discrimination based upon genetic information.
  For example, my home State of Florida is very strong with clear 
definitions. If we superimpose this bill, it would create a lot of 
confusion, I think, in my State of Florida. Many exemptions occur, HIV 
testing, drug testing, forensic analysis, routine blood tests for 
current health would be negated. Even more frustrating for the 
regulated, the operative Federal-State relationship rule is whatever 
part of a State law is more stringent survives. The question is, who 
decides when that occurs? The courts? I think that is a question the 
Senate should look at.
  There are better approaches, but partial preemption is what we see 
here. I think it should be changed. Maybe the answer is across-the-
board preemption, and that is what I am recommending, or maybe allow 
States to apply for an exemption. I believe Florida and other States 
are substantially meeting this policy.
  In any event, some Federal agency should at least adjudicate so that 
the regulated community is not subject to uncertainty, fines, 
ultimately litigation. So I asked this same question when we had the 
markup in Energy and Commerce.
  So I asked during our Energy markup on March 23 about this to the 
staff. At that time, it was difficult to understand what their answer 
was. I followed up on March 27 with a letter to Chairman Dingell, 
signed along with a Health Subcommittee ranking member Nathan Deal. We 
have not at this point received a reply to this letter, and I just urge 
that somehow in the conference on this bill that we try to answer that 
question.
  Finally, 11 Energy and Commerce Republicans signed our views to the 
energy report, which, Madam Speaker, I make part of the Record, and I 
support the intention of this legislation. It's good. I congratulate 
everybody, but I would like to see a preemption and other clear issues 
worked out in conference.
  I support protection from genetic discrimination, so much so I have 
offered my own bills in prior Congresses. However, this bill has, some 
problems I would like resolved.
  (For the record: Many people have been remarking that we have been 
working for over a dozen years on legislation to safeguard individuals 
from discrimination against due to their genetic profile when they seek 
to purchase health insurance or employment.
  Well, I count myself among those waiting. For, in 1995, I was proud 
to be named the first Chair of the Congressional Task Force on Medical 
Records and Genetics, by then Commerce Committee Chairman Bliley. 
Congressman Gene Green (Committee Democrat) was my Co-chair, and 
together we held many meetings and hearings with witnesses from the 
genetics community, including insurance companies, the biotech and 
pharmaceutical industries, and patient advocates. Indeed, one of my 
proudest legislative achievements came in the Health Insurance 
Portability and Accountability Act of 1996 (HIPAA). In the Commerce 
Committee markup of HIPAA, I was successful in adding two words to the 
list of protections: ``genetic information.'' It survived and is in the 
HIPAA law today.
  And, I have continued my engagement, authoring bills in the last 
several Congresses to prohibit genetic nondiscrimination in health 
insurance.)
  One significant concern is the lack of clarity over federal pre-
emption. According to CBO, the bill would ``preempt some state laws 
that establish confidentiality standards for generic information, and 
would restrict how state and local governments use such information in 
employment practices and in the provision of health care to 
employees.'' GINA will create confusion for the 43 states that 
currently have laws prohibiting discrimination based on genetic 
information.
  Florida's law, for example, is very strong, with clear definitions. 
If we superimpose GINA it will create a lot of confusion. Many 
exemptions--HIV testing, drug testing, forensic analysis, routine blood 
tests for current health--would be negated. Even more frustrating for 
the regulated, the operative Federal-state relationship rule is 
whatever part of a state law is more stringent survives. And who will 
decide? The courts.
  There are better approaches, but partial preemption is 
unsatisfactory. Maybe the answer is across the board preemption. Or, 
maybe allow states to apply for an exemption. I believe Florida and 
other States are substantially meeting the policy. In any event, some 
Federal agency should at least adjudicate so that

[[Page 10325]]

the regulated community is not subject to uncertainty, fines, or 
litigation.
  I asked this in the Energy and Commerce markup March 23. And, I 
followed up on March 27 with a letter to Chairman Dingell, signed along 
with Health Subcommittee Ranking Member Nathan Deal--a response to 
which has not arrived. Finally, eleven Energy and Commerce Republicans 
signed Additional Views to our Committee Report, which I resubmit for 
the Record.
  Again, I support the intention of this legislation, but would like to 
see pre-emption and other unclear issues worked out in conference.

 Gina Will Create Confusion for the 43 States That Currently Have Laws 
        Prohibiting Discrimination Based on Genetic Information

       We have not done a complete survey but understand that 43 
     States already have programs and definitions. We would then 
     want to ask Members if they find the programs in their state 
     inadequate. If you were to superimpose the GINA requirements 
     on those states it will involve a lot of confusion. Many 
     exemptions and clear statements regarding HIV testing, drug 
     testing, and other issues would appear to be wiped out. Even 
     more frustrating for the regulatory community the operative 
     Federal-state relationship rule is whatever part of a state 
     law is more stringent survives. This means pieces of state 
     law will apply while other pieces will be preempted. This 
     would all have to be sorted out by the courts. We think there 
     are better approaches. The worst approach is this partial 
     preemption approach. For some programs there is across the 
     board preemption. In other cases, a state is allowed to 
     submit its program for evaluation as a whole. If such 
     programs are adequate or substantially promoting the policy, 
     they would stay intact. We believe our States are 
     substantially meeting the policy and do not see the need for 
     disruption. In any event, some Federal agency should at least 
     sort out what law applies in advance so that the regulated 
     community is not held hostage to more lawyers and 
     uncertainty. Joe Barton. Nathan Deal. Michael Burgess. Steve 
     Buyer. Barbara Cubin. Mike Rogers. John Shadegg. Cliff 
     Stearns. Lee Terry. Heather Wilson. Tim Murphy.

  Mr. GEORGE MILLER of California. Madam Speaker, I yield 2\1/2\ 
minutes to the gentlewoman from California (Ms. Eshoo) who, again, has 
worked so hard to bring this legislation to the floor and helped to 
resolve some of the differences that have existed between the 
committees, and I thank her for her work.
  Ms. ESHOO. I thank the distinguished chairman of the Education 
Committee.
  Madam Speaker, today is a very exciting day. I don't think there is 
any feeling that beats coming to the floor and knowing that success 
awaits us and the American people. I think that's the case today as we 
gather to support the Genetic Information Nondiscrimination Act, known 
as GINA.
  Many times over the course of American history in this Chamber, 
discrimination has been struck down. I believe that is what we are 
doing here today with this bill. When the sequencing of the Human 
Genome Project was completed in April of 2003, it was a great, great 
victory in the scientific community. So many of us understood what the 
implications were for our constituents, for the people of our Nation, 
and people in the world.
  Researchers identified genetic markers for a variety of chronic 
health conditions. When they did, they threw open the doors to increase 
the potential for early treatment and prevention of numerous diseases.
  But there was something that stepped in the way, and that was the 
threat of discrimination against anyone that subjected themselves to 
the test, found that they had a gene that wasn't perfect, which I think 
is the potential of every single one of us, and as a result of that, 
that their job would be threatened, and that their health care 
insurance could be dropped. What this bill does today is to throw the 
doors open with a guarantee by making it illegal for health plans and 
health insurers to deny coverage to a healthy individual or charge a 
higher premium based solely on genetic predisposition to a specific 
disease.
  I could go on and on about the bill, but the fact of the matter is, 
it has well over 200 cosponsors. It is a real bipartisan bill. Thank 
you to Congresswoman Louise Slaughter for her tenacity and her belief 
in the effort. Twelve years, that is a long time.
  I would also like to say what a difference a new majority makes, 
because this bill was really blocked from coming to the floor for full 
consideration. To Representative Biggert, she has been just as 
tenacious as Louise Slaughter, to all of my colleagues that have worked 
on this, to the chairman, Mr. George Miller of California, Mr. Dingell, 
Mr. Rangel, for making sure that they saw this through and, Ms. 
Slaughter, of course, she slaughtered us all, I tell you, on this, she 
made sure, and to the inspirational Dr. Francis Collins, who testified 
over and over again what the possibilities were that awaited the 
American people.
  I pay tribute to all of you. It's a great day here in the House of 
Representatives.
  Mrs. BIGGERT. Madam Speaker, may I inquire how much time remains on 
both sides?
  The SPEAKER pro tempore (Ms. DeGette). The gentlelady from Illinois 
has 8 minutes remaining. The gentleman from California has 9 minutes 
remaining.
  Mrs. BIGGERT. Madam Speaker, I yield 2 minutes to a member of the 
Energy and Commerce Committee, Dr. Burgess.
  Mr. BURGESS. Madam Speaker, it's my feeling that this bill should 
have been brought to the floor under a rule to perhaps allow additional 
improvement and amendment, as pointed out by Mr. Stearns. There is the 
opportunity, perhaps in conference, to further improve the bill. I 
don't think our work is quite done.
  One improvement that I was able to effect in our committee, the 
Committee on Energy and Commerce, is the exclusion of title II for 
covered entities already subject to regulation under HIPAA statutes, 
the Health Insurance Portability and Accountability Act statutes. Dual 
regulation of communications, uses, disclosures and other aspects and 
activities, subject to regulation, currently regulated by the 
Department of Health and Human Services, by GINA, would have had 
disastrous consequences for coordination of care.
  We need to make clear that providing health services is not the same 
as hiring, firing or job promotion. Genetic information is medical 
information and is not restricted under the House bill for employer-
sponsored services that are covered in entities under HIPAA. Also, 
nothing in this bill affects the practice of medicine. That is not the 
intention, and this is among the principles that I have sought to 
ensure.
  I would note that the current HIPAA regulations are extremely 
sophisticated. They are the result of over 5,000 communications and 
comments. We are not going to trump those regulations under title II, 
and that will prevent the possibility for enormous disruption and 
adverse consequences.
  Failure to address this issue would have been calamitous, for efforts 
of using health information, new efforts for using health information 
technology. Medical information systems cannot be burdened with legal 
requirements that would, in effect, force complicated segregation of 
genetic information from other medical information and health care, 
including those in employer-sponsored clinics.
  Still, with all of those caveats, I will be voting in favor of the 
bill today. I do look forward to making certain that these 
modifications survive in conference and perhaps there will be the 
opportunity to even make things a little bit better in that process.
  Mr. GEORGE MILLER of California. Madam Speaker, I yield 2 minutes to 
the gentleman from New Jersey (Mr. Andrews).
  Mr. ANDREWS. I thank my friend for yielding. I congratulate Chairman 
Miller and Mr. Rangel and Mr. Dingell for their work, and especially my 
friend, Congresswoman Slaughter, and Congresswoman Biggert for her 
great work. I think we should reflect on the great work they are 
achieving on this bill.
  Madam Speaker, if your grandmother had breast cancer, you shouldn't 
be denied a job or a promotion. That's what this bill says. If your dad 
is a diabetic, you shouldn't have to pay higher health insurance 
premiums. That's what this bill says.

[[Page 10326]]

  When the scientific community comes to you and asks you to 
participate in a genetic study that may hold the key to unlocking the 
mystery of AIDS or Alzheimer's or leukemia, you should be able to 
participate fully and freely without fear that your genetic information 
will be unlawfully and improperly shared with someone who wants to do 
the wrong thing with it.

                              {time}  1415

  This is a significant achievement, not only in protecting the working 
men and women of America from discrimination, but in empowering 
American scientists to achieve the maximum that we can from the promise 
of genetic medicine.
  The bipartisan effort to support this bill will be vindicated year 
after year and case after case as Americans can work freely, can avoid 
discrimination, and as scientists can take the next step and the next 
step and the next step to unlock the keys to genetic medicine.
  So I congratulate my friends, Madam Speaker, for their great work on 
this bill. I enthusiastically support it. I ask everyone to vote 
``yes.''
  I would like to note that the final version of H.R. 493 represents 
the input and compromises made by 3 committees of jurisdiction.
  In particular, I would like to mention 3 critical compromises 
reflected in the final bill:
  (1) the bill does not affect or limit the ability of health plans to 
provide information to their members about the availability and 
benefits of genetic tests,
  (2) the bill is intended to supplement the protections afforded under 
HIPAA and not intended to prohibit practices permitted under HIPAA 
unless explicitly stated, and
  (3) the bill is intended to provide 2 comparable but distinct causes 
of action for violations of the Act with respect to genetic 
information. Health plans and insurers generally are subject to the 
requirements of the title 1. Employers, including to the extent 
employers control or direct health benefit plans, are subject to the 
requirements of title II of the bill.
  I commend my colleagues on all 3 committees for their hard work to 
enable us to pass this important genetic information protection bill.
  Mrs. BIGGERT. Madam Speaker, I yield myself 1 minute.
  Madam Speaker, I think that by incorporating genetic testing, we can 
significantly reduce the cost of chronic disease, which currently 
accounts for 70 cents of every health care dollar. I think the 
President of the United States understands this, and I will include for 
the Record the statement of administrative policy from the White House 
in favor of this legislation.

         Executive Office of the President, Office of Management 
           and Budget,
                                   Washington, DC, April 25, 2007.

                   Statement of Administration Policy


   H.R. 493--Genetic Information Nondiscrimination Act of 2007 (Rep. 
                  Slaughter (D) NY and 224 cosponsors)

       The Administration favors enactment of legislation to 
     prohibit the improper use of genetic information in health 
     insurance and employment. The Administration supports House 
     passage of H.R. 493, which would prohibit group health plans 
     and health insurers from denying coverage to a healthy 
     individual or charging that person higher premiums based 
     solely on a genetic prediposition to developing a disease in 
     the future. The legislation also would bar employers from 
     using individuals' genetic information when making hiring, 
     firing, job placement, or promotion decisions. The 
     Administration appreciates that the House bill clarifies that 
     the bill's protections cover unborn children.
       The mapping of the human genome has led to more information 
     about diseases and a better understanding of our genetic 
     code. Scientists are pursuing new diagnostics, treatments, 
     and cures based on this information, but the potential misuse 
     of this information raises serious moral and legal issues. 
     Concern about unwarranted use of genetic information 
     threatens the utilization of existing genetic tests as well 
     as the ability to conduct further research. The 
     Administration wants to work with Congress to further perfect 
     this legislation and to make genetic discrimination illegal 
     and provide individuals with fair, reasonable protections 
     against improper use of their genetic information.

  Madam Speaker, I reserve the balance of my time.
  Mr. GEORGE MILLER of California. Madam Speaker, I yield 2 minutes to 
the gentleman from New Jersey (Mr. Pallone).
  Mr. PALLONE. Madam Speaker, I thank the chairman for yielding.
  Madam Speaker, I rise in strong support of H.R. 493, of which I am a 
cosponsor. As science continues to make rapid advancement in the area 
of genetics, I cannot stress how important this bill is to every 
American citizen.
  Genetic testing has increasingly become an integral part of the 
American health care system, providing the possibility to develop 
better therapies that are more effective against disease and allow 
individuals to take steps to reduce the likelihood that they will 
contract a particular disorder. However, as knowledge of the human 
genome expands, a greater proportion of the population will likely be 
identified as carriers of mutations associated with a greater risk of 
certain diseases, indicating that virtually all people are potentially 
victims of genetic discrimination in health insurance.
  Along with the increasing prevalence of genetic testing comes the 
growing fear of the potential misuse of this information by way of 
discrimination in health insurance and employment. Accordingly, we need 
to strengthen current laws at both the Federal and State level in order 
to protect against the possibility of genetic discrimination. This bill 
will go a long way in making sure that this highly private information 
cannot be misused or abused.
  In closing, I want to thank the primary sponsors of this legislation, 
particularly Ms. Slaughter, I know how long she has worked on this, 
along with Ms. Eshoo and others. We finally came together in a 
bipartisan fashion to bring up what I think is a bipartisan bill. They 
should all be commended, all of us should be commended for our efforts. 
I think that this could serve as a model for bipartisan cooperation on 
other bills.
  Mrs. BIGGERT. Madam Speaker, I reserve the balance of my time.
  Mr. GEORGE MILLER of California. Madam Speaker, I yield 2 minutes to 
the gentleman from Michigan (Mr. Stupak), a member of the Energy and 
Commerce Committee.
  Mr. STUPAK. Madam Speaker, I thank the gentleman for yielding.
  Madam Speaker, I rise in support of H.R. 493, the Genetic Information 
Nondiscrimination Act, or GINA. Congratulations to all who have worked 
for the last number of years on this legislation, especially Ms. 
Slaughter.
  In reviewing this bill, I was concerned that families may face 
genetic information discrimination from testing of embryos and fetuses, 
plus I was concerned about children who are in the process of being 
adopted. As genetic testing becomes increasingly common, GINA 
protections must be extended to genetic material gathered through pre-
implementation genetic diagnoses, amniocentesis or other future 
techniques.
  Together with Chairman Dingell, Ms. DeGette and Mr. Smith, we were 
able to close this loophole, which could have been exploited against 
families on the basis of genetic material of their fetuses or children 
in the process of being adopted.
  I am proud to have worked with so many Members to correct the 
concerns I had on this bill. I support the passage of this bill.
  Mr. GEORGE MILLER of California. Madam Speaker, I yield 2 minutes to 
the gentlewoman from California (Mrs. Capps), a member of the 
committee.
  Mrs. CAPPS. Madam Speaker, I thank my California colleague for 
yielding me time.
  Madam Speaker, I also rise in strong support of H.R. 493, and I 
commend my colleagues, the Congresswomen who have been acknowledged, 
Slaughter, Eshoo, Biggert and others who persisted over the years to 
bring this legislation to the floor, and acknowledge that the Caucus 
for Women's Studies of the 110th Congress has made the passage of this 
its highest priority.
  I am also struck by the importance of the partnership that is 
highlighted with this legislation, a partnership between this 
legislative body and our colleagues in the National Institutes of

[[Page 10327]]

Health and work that we should be doing together on behalf of the 
American people.
  As Dr. Francis Collins and his wonderful staff of the Genome Project 
have taught us, the identification of genetic markers for disease is 
one of the most remarkable accomplishments scientists have ever made. 
Being able to identify risks for certain conditions holds such great 
promise for our ability to identify and practice greater preventive 
health care in this country. The importance of preventive care to our 
well-being and our optimum health can never be overemphasized.
  However, as with almost all great scientific advancements, we have 
also opened the door to a whole slew of unintended consequences. 
Preventive health care can be put at risk if patients decline genetic 
testing for fear of insurance or employment discrimination. We need to 
work together, and we will, on ways to promote ethical genetic testing, 
coupled with appropriate privacy protections and with measures such as 
we are doing today to prevent discrimination.
  This bill accomplishes these goals, and I am extremely proud to 
support it. I urge all of my colleagues to vote ``yes'' on its passage
  Mrs. BIGGERT. Madam Speaker, I have no further speakers, so I will 
yield myself the balance of my time to close.
  Madam Speaker, this bill has been a bipartisan bill. It has got 95 
Republicans and 125 Democrats. GINA passed the Education and Labor 
Committee, Energy and Commerce Committee and the Ways and Means 
Committee by voice vote. I think that GINA is needed to maintain high-
quality genetic research and clinical trials at NIH. It passed the 
Senate last year 98-0, and the last Congress was a strong SAP for them, 
so when this goes to conference we will see what happens this year.
  Let me just say that Newt Gingrich said to not have this bill is to 
cripple our ability to save lives. I would like to enter into the 
Record a statement of his in the Washington Times, and just to quote a 
little bit from it.
  ``Without protection from genetic discrimination, we risk missing out 
on the promise of personalized medicine. But if we apply time-honored 
principles of fairness and justice to the genome era, we can grant the 
American public the gift of better informed patients, better equipped 
providers, an enhanced biotech industry, improved health and lives 
saved.
  ``Let's not withhold this gift any longer. Let's empower all 
Americans to embrace the possibilities of personalized medicine for 
better health, and let's commend the forward-thinking bipartisanship of 
the 110th Congress that has brought us to the threshold of a world 
where Americans can embrace personalized medicine without fear.
  ``Our health, and that of our children and grandchildren, depends on 
it.''
  Let me just say that this bill had to go through three committees, 
and that is not easy, Education and Labor, Ways and Means and the 
Energy and Commerce. That is no small feat. I really thank Chairman 
Slaughter for all that she did to make sure that this went through, and 
all the time she has spent on this. It has been a great honor to work 
with her.
  Again, let me thank the chairmen of these committees and the ranking 
members for the time that they put in, and all the Members that came 
down to speak today and all the Members that supported this as 
cosponsors.
  To go through the three committees, everybody knows something about 
this place, but everybody wants to put their stamp on it. To come out 
with a bill we can all agree on, and, as people said, they have some 
things they would still like to put in, but I think being able to 
manage all of the different committees, and what was their jurisdiction 
and what maybe they thought was their jurisdiction but really was the 
jurisdiction of another committee, makes it a very interesting process.
  And I think we all learned about how this type of bill works. It is a 
very technical bill, and that is why we thank all of the 200 groups, at 
least 200 groups that have worked on this bill and been able to give us 
the technical information that we needed to make this something that is 
going to save lives. It is going to lower costs and it also is going to 
find the cures for so many of these diseases and disorders, because 
people will be willing to go into clinical trials. So I congratulate 
all of the people that participated.
  Madam Speaker, I include the article by Newt Gingrich for the Record

                                Congress of the United States,

                                                   Washington, DC.
       Why does Newt Gingrich Support GINA?
       Dear Republican Colleague, We wanted to draw your attention 
     to this op-ed by Newt Gingrich supporting H.R. 493, the 
     Genetic Information Nondiscrimination Act. It appeared in the 
     Washington Times on April 11, 2007. We urge you to vote 
     ``yes'' when this legislation comes to the floor.
           Sincerely,
                                                     Judy Biggert,
     Member of Congress.
                                  ____

                                                      Greg Walden,
                                               Member of Congress.

                      [From the Washington Times]

       Health care re-gifting Legislation rightly avoids genetic 
                             discrimination

                   (By Newt Gingrich and Robert Egge)

       Protecting every American from genetic discrimination is a 
     long overdue gift to the nation. After 12 years of debate, 
     Congress is at last poised to deliver this gift.
       The sequencing of the human genome is leading to 
     revolutionary advances in our understanding of the causes of 
     disease. Four years after completing the Human Genome 
     Project, we are witnessing the dawn of the era of 
     personalized medicine.
       The discovery of genetic variants that contribute to risk 
     of common diseases will continue to grow rapidly during the 
     next few years, offering better opportunities for 
     individualized, preventive medicine. Already, health-care 
     providers can test for DNA patterns that predispose some of 
     us to cancer, and soon this will be possible for diabetes, 
     heart disease and other common diseases. Doctors will also 
     soon be able to prescribe medicines and treatments based on 
     our own individual genetics. Pharmacogenomics will better 
     equip doctors to give the right medicine to the right patient 
     at the right dose and, by avoiding giving treatments to 
     patients who would suffer a negative reaction, save both 
     lives and money.
       The arrival of this new era, however, is being delayed by 
     widespread public fear of genetic discrimination. Individuals 
     worry that genetic predisposition to a particular disease 
     will deny them access to health care of employment. These 
     fears are not unwarranted. This issue affects all of us; 
     there are no perfect specimens at the DNA level. Each of us 
     carries gene variants that increase risk of developing one 
     disease or another, each of us is at risk for genetic 
     discrimination.
       A recent independent survey conducted by the Genetics and 
     Public Policy Center showed that more than 90 percent of 
     Americans support the use of genetic testing by doctors to 
     identify a person's risk for future disease. But nearly all 
     Americans (93 percent) believe that health insurers should 
     not be able to use genetic test results about increased risk 
     of future disease to deny or limit insurance or charge higher 
     prices. Similarly, 93 percent felt that employers should not 
     be able to use genetic information to make hiring or 
     promotion decisions.
       Not only do these fears discourage Americans from using 
     genetic tests that could personally benefit them, but they 
     risk delaying the arrival of new medical breakthroughs. At 
     the National Institutes of Health, fear of genetic 
     discrimination is the most commonly cited reason for 
     declining to participate in research that includes 
     potentially lifesaving genetic tests for cancer; over one-
     third of eligible participants decline on this basis.
       In the past, lawmakers have come close to providing 
     Americans the protections they seek. Two years ago, with the 
     support of the Bush administration, the Senate passed the 
     Genetic Information Nondiscrimination Act of 2005 by a 98-0 
     vote. Progress in the House was slower. Despite 244 
     cosponsors, including 117 Republicans, the bill never came to 
     a House vote in the 109th Congress.
       In this Congress, the 110th, House and the Senate champions 
     have taken up genetic nondiscrimination with even greater 
     determination. All the House and Senate committees involved 
     have already held hearings on the bill, and the leadership 
     has signaled a commitment to moving S 358 and HR 493 to a 
     vote. President Bush has strongly restated his support. The 
     time is right to put the needed protections in place.
       Without protection from genetic discrimination, we risk 
     missing out on the promise of personalized medicine. But if 
     we apply time-honored principles of fairness and justice to 
     the genome era, we can grant the American public the gift of 
     better-informed patients, better-equipped providers, an 
     enhanced biotech industry, improved health and lives saved.
       Let's not withhold the gift any longer. Let's empower all 
     Americans to embrace the possibilities of personalized 
     medicine for better health. And let's commend the forward-
     thinking bipartisanship of the 110th Congress that has 
     brought us to the threshold of a world where Americans can 
     embrace personalized medicine without fear.

[[Page 10328]]

       Our health, and that of our children and grandchildren, 
     depends on it.

  Madam Speaker, I yield back the balance of my time.
  Mr. GEORGE MILLER of California. Madam Speaker, I yield myself the 
balance of my time.
  Madam Speaker, I would just want to join in thanking all of the 
Chairs and the ranking members of the three committees and the 
subcommittees, and clearly Louise Slaughter, our colleague from New 
York, who has worked so hard on this legislation so very long, and Judy 
Biggert also, and Anna Eshoo.
  Given the importance of this legislation, it is hard to believe it 
has been stuck in the Congress of the United States for 10 years, but 
it has been. Maybe our reporting it today off of the floor is a tribute 
to a fresh start.
  This is a very, very important piece of legislation to the health of 
the Nation and to the world. The advocacy of Louise Slaughter has 
reminded us almost every day in those 10 years what we were missing by 
not passing this legislation and making it available so that we could 
get on with the wonderful discovery and the wonderful help that could 
be provided to individuals, to their families and to our communities. 
And the National Institutes of Health is to be commended, with all of 
the assistance they provided and all of the information provided to 
this Congress.
  With that, I also want to thank the staffs of the three committees on 
both sides of the aisle for all of their work. They put in a lot of 
hours to get this resolved so that we could come to the floor and work 
over the differences that were there sometimes between the committees.
  Mr. GENE GREEN of Texas. Madam Speaker, I rise in support of H.R. 
493, the Genetic Information Non-Discrimination Act.
  The sequencing of the human genome was an amazing scientific 
advancement, and has contributed to the rise of genetic testing to 
inform patients of their proclivity for disease. Thanks to genetic 
testing, individuals with a risk of an illness can take precautionary 
steps ahead of time to ward off disease, which will contribute to lower 
health care costs over time.
  As we take advantage of this scientific progress, however, it is 
critical that we protect individuals from any discrimination that could 
result from the information these tests reveal. The results should not 
be used by health insurers to deny anyone coverage or increase their 
premiums because of a pre-disposition to a certain disease. Likewise, 
the results should not be used by employers to discriminate against 
employees based on their predisposition to disease.
  I am proud to be a co-sponsor of this legislation, which our 
colleagues Ms. Slaughter and Mrs. Biggert have been working on for over 
a decade now. The health care marketplace has changed significantly 
since the bill's original introduction, and important changes were made 
to the bill during the 108th Congress to refine the bill's definitions 
and scope.
  During the Energy and Commerce Committee's consideration of the bill, 
we learned about one segment of the health care marketplace that was 
excluded from the bill's protections--the long-term care insurance 
market. The bill sponsors and supporters all agreed that this bill was 
never intended to regulate the long-term care insurance market, and I 
understand that current statute treats long-term care insurance 
differently.
  Regardless of the bill's original intent, the fact remains that the 
long-term care exclusion in this bill would allow a long-term care 
insurer to discriminate against an individual on the basis of genetic 
information. If an individual determines that she is at high-risk for 
developing Alzheimer's disease, the next obvious step is to plan her 
future care for Alzheimer's, including the purchase of long-term care 
insurance. Despite all of the good intentions in this legislation, the 
bill would allow long-term care insurance underwriters to refuse to 
cover her or charge her higher premiums for a disease she has yet to 
develop and may never develop.
  As a Congress that continues to encourage Americans to plan for their 
future, we should ensure that future legislation extends the patient 
protections inherent in this bill to consumers who want to plan for 
their future and purchase long-term care. With that, Madam Speaker, I 
am pleased to support this important legislation and encourage my 
colleagues to vote for its passage.
  Mr. PAUL. Madam Speaker, the supporters of H.R. 493, the Genetic 
Information Nondiscrimination Act, are right to be concerned over the 
possibility that third parties, such as the government or potential 
employers, will access an individual's genetic information without 
consent, and use that information to deny an individual health 
insurance or other benefits. I have long advocated repealing government 
laws and polices that allow third parties to access personal 
information. For example, I have worked to repeal the provision of 
Federal law giving the Federal Government the power to assign every 
American a ``unique medical health identifier.'' I also support 
repealing the phony ``medical privacy'' regulations that give law 
enforcement officials and state-favored private interests the right to 
access medical records at will.
  Because of the Federal Government's poor record in protecting 
privacy, I do not believe the best way to address concerns about the 
misuse of genetic information is through intrusive Federal legislation. 
Uniform Federal mandates are a clumsy and ineffective way to deal with 
problems such as employers making hiring decisions on the basis of a 
potential employee's genetic profile. Imposing Federal mandates on 
private businesses merely raises the costs of doing business and thus 
reduces the employment opportunities for all citizens. A much better 
way to eliminate irrational discrimination is to rely on state and 
local regulation. Unlike the Federal Government, states and localities 
are able to tailor their regulations to fit the needs of their 
particular populaces. I would remind my colleagues that 34 states 
currently ban genetic discrimination in employment, while 46 states 
forbid health insurers from engaging in genetic discrimination. 
Clearly, the states are capable of addressing this issue without 
interference from Washington. My colleagues should also remember that 
Congress has no constitutional authority to forbid private sector 
employers from making hiring or other employment decisions on the basis 
of genetic information.
  The best way to address the sponsors of H.R. 493's legitimate 
concerns is to put individuals back in control of the health care 
dollar. When individuals control the health care dollar they, not their 
employers, insurance companies or Health Maintenance Organizations, can 
make all health care decisions, including whether or not to share 
individual genetic histories with a potential employer, insurer, or 
other third party. Therefore, instead of creating more Federal 
regulations and bureaucracies, my colleagues should increase individual 
control of health care by passing legislation expanding Health Savings 
Accounts and individual health care tax credits and deductions.
  Mr. HOLT. Madam Speaker, I rise today in strong support of H.R. 493, 
the Genetic Non-Discrimination Act (GINA). As a cosponsor of this 
important legislation since I first came to Congress, I am delighted 
that it is finally being considered by the House of Representatives.
  As humans, we have a genetic destiny that we cannot control. The 
genes we are born with are the genes we will die with, and it is wrong 
for any employer to fire, refuse to hire, or deny insurance to an 
employee based on that individual's genetic composition. It is 
unconscionable for employers to require their employees to submit to a 
genetic test or to secretly obtain genetic information, only to use the 
genetic information against the employees.
  The Human Genome Project was created to provide a genetic map of the 
human body to aid the scientific and medical communities in their fight 
against some of the most insidious diseases and afflictions suffered by 
humanity. It is a great irony and a tragedy that this research is now 
being used as justification to fire or refuse to hire employees who 
have no control over their genetic destinies.
  As a member of the Education and Labor Committee, I participated in 
hearings on GINA which highlighted the existing loopholes in federal 
and state laws protecting an individual's health information. Lacking a 
strong and clear national law prohibiting genetic discrimination, 
employees have been fired or denied insurance coverage based on this 
most personal of information.
  Today, the House will act to end genetic discrimination in hiring and 
firing decisions. GINA will protect prospective and current employees 
from discrimination based on a genetic predisposition regardless of 
what state they live in. It will provide strong protections to those 
individuals who may suffer from actual genetic discrimination now and 
in the future. This legislation would pose a nominal cost to employers, 
but provide priceless protections for American workers and peace of 
mind for their families.
  New Jersey, along with 32 other states, already prohibits genetic 
discrimination in decisions on hiring, firing, or benefits. However, 
only 25 states prohibit employers from requiring genetic information 
from their employees.

[[Page 10329]]

Worse yet, only 10 states prohibit employers from obtaining genetic 
information or genetic tests of employees through any means.
  This vital legislation is supported by more than 200 groups and 
associations including: the Hereditary Disease Foundation, the American 
Association for the Advancement of Science, the American Jewish 
Congress, the American Association of People with Disabilities, the 
American Society of Human Genetics, the March of Dimes, the NAACP, the 
National Fragile X Foundation, the National Hemophilia Foundation, the 
National Council of La Raza, Citizens for Quality Sickle Cell Care, the 
Coalition for Genetic Fairness, the Cornelia de Lange Syndrome 
Foundation, the Cystic Fibrosis Foundation, The National Workrights 
Institute, the Religious Action Center for Reform Judaism, Rett 
Syndrome Research Foundation, the Spina Bifida Association of America 
and many others.
  Madam Speaker, it is long past time for the Genetic Non-
Discrimination Act to become law. I urge my colleagues to vote for this 
important legislation, which will protect the rights of American 
workers and their families.
  Mr. STARK. Madame Speaker, I am pleased that we are finally passing 
the Genetic Information Nondiscrimination Act.
  This is a bill that has languished in Congress more than a decade. 
The Senate has twice passed earlier versions of this bill with 
unanimous votes, but the House has always blocked action.
  It's good to see that times have changed. Members from both sides of 
the aisle--as well as the President support the bill before us.
  As I hope most of you know, this bill does something very simple, but 
something very important as well. It protects people's genetic 
information and family history from being used by health plans or 
employers to discriminate against them. Enactment of this law is 
critical to protect patients and for genetic science to advance.
  Recent breakthroughs in medical science have made genetic testing 
available to more patients, but with these breakthroughs comes the fear 
that patients may be discriminated against by insurance companies and/
or employers if they are pre-disposed to suffer from a disease or other 
condition.
  We are here today to make sure that patients can undergo genetic 
tests which could help with treatments or cures without fear that the 
results will keep them from affordable, reliable health care.
  This legislation is an overdue and important step toward ensuring 
that our laws governing patient rights are as current as the latest 
medical technology.
  I urge strong support for this bill.
  Mr. SHAYS. Madam Speaker, as an original cosponsor of H.R. 493, I 
rise in strong support of this legislation and am grateful we are 
finally considering it. The objective of this bill is simple: 
preventing both health insurance companies and employers from using 
genetic information to discriminate against individuals.
  In the past decade, science has made remarkable advances on the human 
genome. Genetic tests are already available to measure an individual's 
likelihood of developing specific diseases. In fact, soon every 
individual will have a genetic profile available that predicts the 
diseases for which they are more at risk, and what side effects to 
which they are more susceptible. These genetic advances will make 
health care pre-emptive and ultimately save the health care system--and 
consumers--money.
  While these advances hold amazing potential, they also hold potential 
for abuse. For example, health insurance companies could charge higher 
rates--or even deny coverage--to individuals who are determined to be 
at higher risk for certain disease or illnesses. Similarly, employers 
could screen applicants for certain positions based on their genetic 
make-up to get the individuals least likely to develop diseases.
  Our laws need to keep pace with medical advancement. If Americans are 
afraid of retribution from their health insurance company or from their 
employer if they get genetic testing done, none of the medical advances 
that are possible will be achieved. We simply must move forward in this 
critical area of science, which is why I urge passage of this 
legislation.
  Mr. BARTON of Texas. Madam Speaker, I want to commend the work of the 
Energy and Commerce Committee in making certain improvements to H.R. 
493. In particular, I note the inclusion of information on embryos, 
fetuses, and adopted children. I further note a clear statement that 
nothing affects claims processing and quality improvement activities 
and related items. Finally, I am happy that there is a provision for 
covered entities already subject to regulations governing personally 
identifiable health information.
  The primary author of the House bill, Ms. Slaughter, has stated:

       ``GINA prohibits group health plans and health insurers 
     from denying coverage to a healthy individual or charging 
     that person higher premiums based solely on a genetic 
     predisposition to develop a disease in the future. 
     Furthermore, it bars employers from using an individual's 
     genetic information when making hiring, firing, job placement 
     or promotion decisions.''

  That is the focus of this legislation. I expect the relevant Federal 
agencies will interpret this bill in light of the primary focus. GINA 
is a very complicated bill with a number of definitions capable of 
counterproductive readings. We have tried to improve the bill to reduce 
these problems. In the spirit of these efforts to improve the 
legislation I support its passage from the House and look forward to 
work in Conference.
  Ms. McCOLLUM of Minnesota. Madam Speaker, I rise today in support of 
the Genetic Information Nondiscrimination Act.
  I am a cosponsor of this important legislation, which bans 
discrimination in the workplace and in health insurance on the basis of 
predictive genetic information. It prohibits insurance companies from 
denying coverage or increasing premiums because of genetic factors. 
Also, under this bill, employers cannot consider genetic factors in the 
process of hiring, firing, or promoting workers. H.R. 493 is much like 
a Minnesota law, which I voted for when I was a member of the Minnesota 
House of Representatives.
  Genetic discrimination has the potential to affect every person in 
the United States. Despite advances in modern medical technology, it is 
impossible to predict with certainty whether a given individual will 
actually develop a disease. Patients recognize that few laws exist to 
prevent health insurers or employers from using their predictive 
genetic information to deny them coverage or jobs. As a result, they 
may avoid taking an important genetic test or participating in genetic 
research.
  Federal employees are already protected from genetic discrimination 
by an executive order signed by President Clinton and retained by 
President Bush. It is time to extend this protection to the rest of our 
country.
  H.R. 493 will give Americans the security they need to take care of 
their health needs without worrying that they will face discrimination. 
I urge my colleagues to join me in supporting this bill.
  Ms. DeGETTE. Madam Speaker, I rise in strong support of H.R 493, the 
``Genetic Information Nondiscrimination Act of 2007.''
  This bill will protect people from discrimination in securing health 
insurance or employment based on their genetic make-up. Such 
discrimination is wrong and should not be tolerated. I am proud to 
support a bill that would outlaw it. I applaud Representative Slaughter 
and Representative Biggert for their hard work in bringing this bill to 
the floor today.
  During consideration of H.R 493 by the Committee on Energy and 
Commerce, of which I am a member, a concern was raised by 
Representative Stupak. The concern related to genetic discrimination 
dealing with embryos or fetuses, as well as adopted children and those 
in the process of being adopted. Like Representative Stupak, I do not 
want to allow insurance companies to use genetic information to 
discriminate. Period.
  I worked out language with Representative Stupak to amend H.R. 493, 
which addressed his concerns in a mutually acceptable way. This 
language says that individuals cannot be discriminated against as a 
result of genetic information gleaned prior to birth. It further says 
that women cannot be discriminated against as a result of the genetic 
information of a fetus, embryo, adopted child, or child they are in the 
process of adopting. At the same time, it does not create a new legal 
status or convey new legal rights to fetuses or embryos. Thus, I feel 
it provides the proper balance between providing protections from 
genetic discrimination while not addressing other non-germane issues.
  The compromise language was adopted by the full Committee on Energy 
and Commerce without objection during its consideration of H.R. 493. I 
am pleased that this language is included in the bill we are 
considering on the floor today.
  I encourage all Members to support H.R. 493 and I look forward to its 
soon becoming law.
  Mr. GEORGE MILLER of California. Madam Speaker, with that, I yield 
back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. George Miller) that the House suspend 
the rules and pass the bill, H.R. 493, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.

[[Page 10330]]


  Mr. GEORGE MILLER of California. Madam Speaker, on that I demand the 
yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this question will 
be postponed.

                          ____________________