Privacy Bills May Drive Up Insurance Costs

WASHINGTON (Reuters Health) Aug 29 - Congressional proposals to restrict health insurance companies' access to genetic test results could damage the industry's ability to underwrite affordable insurance, actuarial experts said Wednesday at a Capitol Hill briefing sponsored by the American Academy of Actuaries.

Experts warned that privacy bills currently under consideration in Washington define genetic testing so broadly that health insurers will not have enough information to set appropriate prices for coverage. They also warned that restricting their access to such information could drive up insurance premiums and price some consumers out of the market.

Genetic testing has been close to the center of recent medical records privacy debates in Washington, DC, and in state legislatures. Consumer groups fear that disclosure of genetic information to insurers would result in discrimination, since companies would probably drop members who showed a genetic predisposition to a disease.

But insurers caution that if they are not privy to genetic test results, patients who are prone to disease will seek out the companies with the best benefits. Such "adverse selection" would force the companies with the best benefits to spend more money caring for sicker patients.

Congress is currently considering a number of proposals to restrict access to genetic information, including a bill sponsored by Senate Majority Leader Thomas A. Daschle (D-SD). That proposal seeks to protect consumers from having to share the results of genetic tests with employers or potential insurers.

The problem for insurers comes in how genetic tests are defined. Daschle's bill defines a genetic test as the analysis of human DNA, RNA, chromosomes, proteins, and metabolites that detect genotypes, mutations, or chromosomal changes.

"The concern that we have, or might have, with this definition is that you've just described everything about your body," said Cecil D. Bykerk, the chief actuary for corporate actuarial and strategic planning operations with the Mutual of Omaha Companies.

Another Senate proposal, sponsored by Sen. Olympia Snowe (R-ME), protects "predictive genetic information" that is obtained from patients without symptoms of disease. The bill allows insurers to use information derived from physical tests such as blood or urine analyses.