The Genetic Information Nondiscrimination Act of

2008Thao T. Nguyen, Danielle N. Wade, Raven J.

Morgan, Naisha C. Renous, Deford L. Smith

Purpose of GINA• The purpose of the Genetic Information Nondiscrimination Act of

2008 is to provide protection from genetic discrimination in health insurance and employment (GINA, 2015). This act makes it illegal for the health insurance providers to require genetic information to make decisions on eligibility or coverage for patients. This part of the law was implemented in May of 2009. Title II of the Act makes it illegal for employers to use a person's genetic information when making decisions about hiring, promotion, and several other terms of employment. This part of the law went into effect on November 21, 2009 (GINA, 2015).

GINA Origins• Original bill was proposed in 1995• Was modified and retried to pass

multiple times from 1995-2007• Finally passed in 2008

• Sen. Olympia J. Snow• Rep. Louise McIntosh Slaughter

• Signed by George W. Bush On May 21 2008

Legislative Process

Identify the legislative process (committee/subcommittee) that determined the outcome of the legislation

Genetic Information Nondiscrimination Act of 2008Pub. L. No.110-233 would be the 233rd law adopted during the 110th Congress (2007 - 2008)

Statutes at Large: 122 Stat. 881

Chamber Standing Committees  Subcommittee

1. House of Representatives Measure Number: (H.R. 493)

House Education and Labor

  House Energy and Commerce  Subcommittee on Health

   House Ways and Means

2. SenateMeasure Number: (S.358)

Committee on Health, Education, Labor, and Pensions

 

Agency that determined the regulations/rules of the law promulgated due to the legislation

• Title I: Genetic Nondiscrimination in Health Insurance

Agencies: The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury have responsibility for issuing regulations for Title I of GINA.

HHS: Centers for Medicare & Medicaid Services (CMS) and the Office for Civil Rights

DOL: Department of the Treasury (the Internal Revenue Service)

• Title II: Prohibiting employment discrimination on the basis of genetic information

Agency: The Equal Employment Opportunity Commission (EEOC) administers Title II of GINA. The U.S. Equal Employment Opportunity Commission is responsible for administering and enforcing civil rights laws against workplace discrimination.

• Title III: Miscellaneous Provisions

 Date House of Representatives Measure Number: (H.R. 493)

Introduction January 16, 2007

By Rep. Louise M. Slaughter

Step 1: Referral to Committee

  Bills are referred to standing committees in the House

  January 16, 2007

Referred to Committee on Education and Labor, Committee on Energy and Commerce, & Ways and Means

  February, 02, 2007

Referred to Committee on House Energy and Commerce Subcommittee on Health

Step 2: Committee Action March 29, 2007

The bill reaches and is placed on the Union Calendar, Calendar No. 46. The Union Calendar is the list of bills available for consideration to the Committee of the Whole. Bills are referred to the Union Calendar if they directly or indirectly deal with money.

  January 18, 2007

A bill can be referred to a subcommittee [Subcommittee on Health] or considered by the committee as a whole

Step 3: Subcommittee Review

   

The Legislative Process at the Federal Level

Step 4: Mark Up Febuary 14, 2007

After hearings are completed, the subcommittee on Health will meet to mark- up the bill. Marking up the bill means to make changes and amendments prior to recommending the bill to the full committees.

  February 12, 2007

House Education and Labor

  March 23, 2007 House Energy and Commerce

  March 21, 2007 House Ways and Means

Step 5: Committee Action to Report a Bill

  March 21, 2007: House committee/subcommittee actions: Ordered to be Reported (Amended) by Voice Vote

  Febuary 14, 2007

Committee on Education and Labor ordered to be Reported (Amended) by Voice Vote

Step 6: Publication of a Written Report

March 5, 2007 March 5, 2007 at 3:47p.m.: Reported (Amended) by the Committee on Education and Labor. H. Rept. 110-28, Part I

  March 26, 2007 March 26, 2007: Reported (Amended) by the House Ways and Means. H. Rept. 110-28, Part II.

  April 19, 2007 (Amended) by the House Energy and Commerce. H. Rept. 110-28, Part III.

  April 19, 2007 Reported by the House Energy and Commerce. H. Rept. 110-28, Part IV

  March 13, 2007 Reported by the House Energy and Commerce Subcommittee on Health

Step 7: Scheduling Floor Action

  After the bill is reported back to the House of Representatives where it originated, it is placed in chronological order on the calendar. In the House different legislature calendars include the union, the house, the private, the corrections, and the calendar of motions to discharge committees.

Step 8: Debate 13 yrs (1995-2008)

When the bill reaches the floor of the House, there are rules or procedures governing the debate on legislation. These rules determine the conditions and amount of time allocated for general debate.

Step 9: Voting April 25, 2007 The bill is passed/agreed to in House by members voting: On motion to suspend the rules and agree to the resolution Agreed to by voice vote of 420-3, Yea-Nay Vote. Number: 261. Vote Result: Bill Passed

Step 10: Referral to Other Chamber

May 1, 2008 The bill is introduced in and passed by the House. The bill is referred to the other chamber, Senate. The bill is Passed/agreed to in Senate: Received in the Senate, considered, and agreed to without amendment by Unanimous Consent.

Step 11: Conference Committee Action

   Agreements are reached and a conference report is prepared descibbing the committee members’ reccomendatiopns for changes. Bothe the House and Senate approve of the conference report.

Step 12: Final Actions May 21, 2008 The bill has been approved by both the House and Senate. The bill is sent to President Bush, approved, and signed. H.R. 493, the Genetic Information Nondiscrimination Act is now a law.

Step 13: Overriding a Veto

   Not necessary for this bill due to GINA being passed.

The Legislative Process at the Federal Level Date Senate Measure Number:(S. 358)

Introduction January 22, 2007 By Sen. Olympia J. Snowe

Step 1: Referral to Committee   Bills are referred to standing committees in the Senate

  January 22, 2007 Read twice and referred to the Committee on Health, Education, Labor, and Pensions

Step 2: Committee Action March 29, 2007 Placed on Senate Legislative Calendar under General Orders. Calendar No. 97.

Step 3: Subcommittee Review    

Step 4: Mark Up    

Step 5: Committee Action to Report a Bill    

Step 6: Publication of a Written Report   April 10, 2007: By Senator Kennedy from Committee on Health, Education, Labor, and Pensions filed written report. Report No. 110-48 PDF file

Step 7: Scheduling Floor Action   After the bill is reported back to the Senate and placed on the legislative calendar.

Step 8: Debate   When the bill reaches the floor of the Senate, there are rules or procedures governing the debate on legislation. These rules determine the conditions and amount of time allocated for general debate.

Step 9: Voting April 24, 2008, 02:13 PM

Passed/agreed to in Senate: Passed Senate with an amendment by Yea-Nay Vote. 95 - 0. Record Vote Number: 113.Vote Result: Bill Passed

Step 10: Referral to Other Chamber

May 5, 2008 Resolving differences — House actions: On motion that the House agree to the Senate amendment Agreed to by the Yeas and Nays: 414 - 1 (Roll no. 234).

Step 11: Conference Committee Action

   

Step 12: Final Actions May 21, 2008 President Bush Signs H.R. 493, the Genetic Information Nondiscrimination Act of 2008

Step 13: Overriding a Veto    

Regulation ResultsProhibits:• Discrimination from insurance companies and employers• Health insurers from using a person’s genetic information to determine if

they are eligible for any insurance or to determine premiums• Genetic discrimination in the workplace• Employers from using an individual’s genetic information to make

employment decisionsEmployers are required to keep patient genetic information in separate confidential files.

RESULTS!• Still Relatively New• Insurance Fears

• Fewer people getting tested

• Some Cases• EEOC v Fabricut Inc.• EEOC v Nestle

• Need new privacy implementation• Issues with EMR/EHR ethical issues

• Might need to amend• Still hard to implement

• EVERY ONE IS AFFECTED !!!

Q & A