How Insurance Companies Can Discriminate Against Some Americans Simply Based On Their Genes

Underscoring the complexity of protecting consumers in an age of accelerating technological innovation, NPR reports that some insurance companies specializing in life insurance and long-term care can choose to discriminate against Americans based on their genetic makeup — and the companies could even subject prospective customers to genetic testing.

Thanks to the 2007 Genetic Information Nondiscrimination Act (GINA) successfully championed by Rep. Louise Slaughter (D-NY), health insurers cannot use a patient’s genetic information in order to hike their premium rates or curb benefits. “There were countless people in this country who were not eligible for insurance at all, simply by the way they were born,” Slaughter told NPR.

But GINA does not extend to the types of supplemental insurance that Americans predisposed to genetically-linked, degenerative diseases like Parkinson’s or Alzheimer’s are likely to purchase, leaving consumers’ premiums susceptible to their genome and pushing essential long-term care costs onto patients:

“GINA was a fabulous accomplishment,” says Robert Green, a researcher in the genetics department at Harvard Medical School. “It was long in coming and much needed. But I think that it was not perfect.”

Green oversaw a study that examined how people react after they learn they have ApoE4, a gene associated with Alzheimer’s. He found that people who discover they have the gene are five times more likely than the average person to go out and buy long-term-care insurance.[…]

Green says it’s especially ironic that GINA does not apply to long-term-care insurance policies, since they cover the costs of nursing homes, assisted living facilities, home health aides and other things that people with Alzheimer’s disease often need to use.

Long-term care insurers assert that not being able to incorporate information about consumers’ genetic dispositions into their premium rates would make their businesses unsustainable. It’s true that Americans who need long-term care are almost certain to be sicker and, therefore more costly to their insurance companies, than those with standard health coverage. But on the other hand, the services covered under such insurance plans — such as home assistance and health aides — are far more rudimentary than the complex and specialized medical treatments covered under standard insurance, so permanently charging Americans higher premiums because of their genetics ends up being excessive and discriminatory.

Other than extending GINA protections to long-term care and life insurance, lawmakers could also address the disparity by requiring health insurance plans to have more long-term care options, perhaps by making such care an “essential health benefit” under Obamacare.

And the issue of human genetics is likely to remain at the forefront of policy debates for the foreseeable future. The Supreme Court is already slated to hear a case on whether or not corporations can patent the detection of certain cancer-causing genes.