Lawmakers want to prohibit long-term care insurers from using genetic tests to determine coverage, but a compromise forged with insurance companies could allow limited use of previously taken tests.
“We think it strikes a balance between the needs of the insurers and the needs of all of us,” said David Conn of the Maryland Jewish Alliance.
Sen. Jennie Forehand, D-Montgomery introduced the legislation to build on her 1995 bill to prohibit genetic discrimination in health insurance, which is now law.
Genetic tests can predict risk for devastating diseases like Alzheimer’s and certain cancers, but concerns over higher insurance rates, rejection and cancellation can discourage patients from using them.
The tests, which analyze DNA, RNA and chromosomes, only indicate risk and cannot confirm whether or not somebody will actually get a disease.
In Maryland, health management organizations, health service plans and health insurers already are prohibited from using the tests to determine coverage and to increase rates, but long-term care, disability and life insurance providers are exempt from the ban, according to the Department of Legislative Services.
Long-term care insurance covers expenses related to disability or chronic illness, such as nursing home care or in-home health services, which can be costly and are often not covered by health insurance or government programs.
Jesse Slome, executive director of the American Association for Long-Term Care Insurance, said “a very small number” of Americans, about 8 million, have the insurance.
“It’s a very difficult situation [for insurers],” Slome said. While the tests are good for consumers, he said forcing insurers to take on greater risks can affect their rates and ability to pay for care.
Longer life spans are making the insurance more important, said Dr. Susan Panny, director of the Maryland Department of Health and Mental Hygiene‘s Office for Genetics and Children with Special Health Care Needs. “The responsible thing to do, if you can afford it, is to purchase long-term care insurance.”
The amended version of the bill gives long-term insurance companies limited use of previously taken genetic test results if they have exact actuarial data that shows how a particular result can justify charging higher rates or a rejection, Conn said.
