Insurance and Genetic Testing
I've discussed the possibility of genetic discrimination before. As a matter of fact, there’s even a federal law prohibiting health insurers from denying coverage based on an applicant’s genetic code -- the Genetic Information Nondiscrimination Act (GINA), as NPR noted in a recent story -- but apparently genetic discrimination might be more possible than we thought.
“GINA was a fabulous accomplishment,” commented Robert Green, a Harvard Medical School genetics researcher. “It was long in coming and much needed. But I think that it was not perfect.”
According to the article, there is a loophole in GINA that only specifies health insurers – leaving out life, disability and long-term-care insurers. During a study in which researchers noted the reactions of potential Alzheimer’s Patients after being informed that have ApoE4 – “a gene associated with Alzheimer's” – Green’s team noticed 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.”
As GINA does not apply to insurers apart from health insurance providers, however, other insurers could request genetic test results before considering an applicant. The NPR story notes the irony “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.” This doesn't only apply to Alzheimer’s, but rather any disease that could be predicted in your genetic code.
On the other hand, Insurance companies are founded on a business model that allows them to collect more than they distribute in a client’s lifetime – it’s how they make money. According to a story in the Washington Post, it’s called “medical-loss ratio, or medical-benefit ratio.” The idea of people with foresight into the future of their health could potentially jeopardize insurance companies.
After discussing his findings with a group of insurance executives a few years ago, Green noted the tone of the meeting in the NPR article, saying “these mild-mannered people in the audience got very, very heated. They were standing up and saying, ‘this kind of situation is going to put us out of business.’” If GINA isn't amended, insurers could potentially be able to capitalize as genetic testing becomes more standardized. Regardless of which side of the fence you are on when it comes to insurance coverage, genetic research is poised to make a substantial impact.