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Republicans Draw Line in Sand on Genetic Nondiscrimination

While legislation that would prevent employers and insurers from denying coverage or charging more to people with a genetic predisposition to diseases passed through a subcommittee markup yesterday, Republican lawmakers made clear that several issues that must be resolved in the full committee.

The Genetic Information Nondiscrimination Act of 2007 (H.R. 493) passed by a voice vote Tuesday, but not before Republicans on the House Energy and Commerce health subcommittee presented several amendments for debate. Republicans later voluntarily withdrew the amendments, but the fact that they offered them sent a message that these issues must be addressed before the bill goes to the House floor.

In turn, Democrats, led by subcommittee Chairman Frank Pallone (N.J.), pledged to work to reach a consensus.

“This is very close to the finish line,” Pallone said. “There’s no reason” why it shouldn’t pass.

Republicans agreed that there was room for compromise on the bill. These problems are “resolvable,” Rep. Joe Barton (R-Texas), the full committee’s ranking member, said.

Rep. Nathan Deal (R-Ga.), the subcommittee’s ranking member, was the sponsor of several amendments, including one provision that would define what types of tests are covered by the law.

Republicans have complained that the legislation is written too broadly, leaving it “ripe with unintended consequences,” Deal said. The lawmakers are concerned that the legislation could apply to organ donor tests, genotype testing for new drugs, forensic DNA and other uses.

The amendment would define these tests as “an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, for the purpose of detecting genotypes, mutations, or chromosomal changes which are classified by the Secretary [of Health and Human Services] as predictive markers for an inheritable genetic disease, disorder, or pathological condition in an asymptomic individual.” The amendment also would exempt analysis related to diagnosis or evaluation of a patient’s current health or an existing disease, disorder or pathological condition.

While this issue has been debated for some time now, a new controversy arose during markup: whether long-term care insurance should be subjected to the nondiscrimination law.

Pallone sought inclusion of the Republican amendment as part of a deal to get an amendment of his own included, but he faced considerable opposition from colleagues on his side of the aisle, including from Reps. Al Green (Texas), Diana DeGette (Colo.), Lois Capps (Calif.) and Anna Eshoo (Calif.).

While Pallone attempted to distinguish this type of insurance as more of an investment tool than actual health coverage, other Democrats were not persuaded.

“Insurance protections are insurance protections,” Eshoo said. Democrats made clear that this is an issue they wanted to resolve before the bill goes to the full committee.

Meanwhile, Pallone’s amendment prohibiting genetic information from being used as a pre-existing condition to deny insurance coverage later passed by a voice vote.

Other Republican amendments gave the secretary of the Department of Health and Human Services the authority to determine when federal nondiscrimination standards would preempt state law and would allow genetic data to be shared as part of health counseling, education and treatment.

The Republicans later withdrew their amendments, with an eye toward negotiating these points over the next few days. “Hopefully we stimulated your interest” in these issues, Deal told Pallone. H.R. 493 passed by a voice vote.

Pallone expects the bill to go to the full committee next week. The bill has the full support of Energy and Commerce Chairman John Dingell (D-Mich.), who commented that he would ensure the bill moves speedily to the floor.

The subcommittee also passed several other bills by a voice vote. These bills included H.R. 477, which would amend the Public Health Service Act to strengthen education, prevention, and treatment programs relating to stroke and H.R. 545, that would make Indian tribes eligible to receive grants to address methamphetamine addiction. Also passing by a voice vote were H.R. 1132, providing grants for preventative measures related to breast and cervical cancers, and H.R. 727, funding trauma care.

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