Congress Passes Bill to Ban
Genetic Discrimination
after Adding Pro-Life Language
WASHINGTON (May 8,
2008)--Congress gave final approval in early May to landmark legislation
to ban genetic discrimination by employers and health insurance
providers.
President Bush is expected to soon
sign the legislation, the Genetic Information Non-discrimination Act
(GINA) (H.R. 493).
The legislation has been under
consideration in Congress for more than a decade. Until recently, it
contained certain defects that made it impossible for the National Right
to Life Committee and other pro-life groups to support it. But those
defects were corrected in the current Congress due in large part to the
work of Congressman Bart Stupak (D-Mi.), the co-chair of the House
Pro-Life Caucus, resulting in a final bill that substantially advances
pro-life interests.
The main thrust of the GINA is to
ban discrimination in employment or health insurance on the basis of
tests that show a person's genetic makeup. Advocates for the bill argued
that as genetic information and testing becomes more prevalent,
employers and health insurance providers would be increasingly likely to
use that information to discriminate against persons with genetic
predispositions to costly and debilitating diseases.
However, for years the legislation
contained a fatal flaw--it defined "family member" to exclude unborn
children.
Specifically, the original bill
said that "the term 'family member' means with respect to an individual
... a dependent child of the individual, including a child who is
born to or placed for adoption with the individual" [emphasis
added]. This definition left unborn children, their mothers, and their
entire families at risk of discrimination if the mother refused to
undergo an abortion at the request of her employer or health insurance
provider.
The risk of such discrimination is
very real. In 1998, Jeremy Gruber, legal director for the American Civil
Liberties Union, raised this concern in testimony before the Senate
Labor and Human Resources Committee. For example, he said, "Consider
further the pregnant woman whose fetus tested positive for cystic
fibrosis and whose managed-care health plan limited coverage for her
pregnancy and future child while offering full coverage should she
choose an abortion.
Prenatal genetic testing is
becoming increasingly common. In fact, in January 2007 the American
College of Obstetricians and Gynecologists (ACOG) issued guidelines
recommending prenatal screening for Down Syndrome for all pregnant
women, and some studies show that when women receive a prenatal
diagnosis of Down Syndrome, as many as nine out of ten abort. Already
women who receive test results showing a possible disability are
pressured to abort. The pressure to abort would become even more
powerful if a decision not to abort places a job in jeopardy or a health
insurance company threatens to withdraw health benefits.
Similar concerns arise in the
context of in vitro fertilization (IVF). Some IVF practitioners already
employ "preimplantation genetic diagnosis" (PGD) to eliminate embryos
who carry genes that will produce future disorders--a practice that
would become more widespread if insurance companies could demand such
tests as a condition to funding the IVF process.
Recognizing these serious defects
in the original GINA bill, Congressman Stupak last year announced his
intention to offer a pro-life amendment in the House Energy and Commerce
Committee. This led to an extended negotiation between Congressman John
Dingell (D-Mi.), who is the powerful chairman of the committee, GINA
prime sponsor Rep. Louise Slaughter (D-NY), and Stupak.
Eventually an agreement was
reached that addressed the full scope of the pro-life concerns. The
agreed-on language was inserted into the bill, and was retained
throughout the rest of the legislative process.
Under the negotiated language, the
final bill prohibits employers and insurers from discriminating against
a woman or her family on the basis of genetic information about "any
fetus carried by such pregnant woman." For example, it would be unlawful
for an insurer to exert financial pressure on a mother to abort an
unborn child who prenatal testing revealed to have a serious genetic
disorder.
Likewise, the negotiated language
prohibits discrimination on the basis of genetic information about "any
embryo legally held by the individual or family member."
In addition, the final bill
provides full protection for any child who has been placed for adoption,
even if the adoption has not been finalized.
Deirdre McQuade, an official with
the U.S. Conference of Catholic Bishops, praised the legislation for
extending protection against discrimination to "some of the most
vulnerable members of the human family, whether born, yet to be born, or
placed for adoption."
"No one should be discriminated
against on the basis of genetic testing," McQuade said.
NRLC Legislative Director Douglas
Johnson explained that NRLC had resisted earlier versions of the GINA,
but was pleased to support the legislation after the addition of the
changes negotiated by Congressman Stupak. The final bill, he said,
"provides some very important protections for all Americans who believe
that the 'pick of the litter' approach should not be applied to human
beings."