Anti-discrimination Rules

VII. Key Issues: Regulation & Reform >> B. Health Care Regulation >> Health Insurance Regulation >> Anti-discrimination Rules

Topic Outline

1 Overview
2 Rehabilitation Act of 1973
3 Pregnancy Discrimination Act of 1978
4 Americans with Disabilities Act
5 Aging Discrimination
6 Genetic Discrimination
- 6.1 Resources

Overview

Anti-discrimination restrictions were developed as a means of leveling the playing field across individuals on grounds they should not be disadvantaged in the market for insurance due to factors generally beyond their control. The Duke Center for Health Policy has developed a draft working paper assessing the costs and benefits of anti-discrimination restrictions, including the topics listed below (pdf):

Rehabilitation Act of 1973
Pregnancy Discrimination Act of 1978
Americans with Disabilities Act
Child Abuse Prevention and Treatment Act

Rehabilitation Act of 1973

Sections 501 and 505 of the Rehabilitation Act of 1973. This law makes it illegal to discriminate against a qualified person with a disability in the federal government. The law also makes it illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit. The law also requires that employers reasonably accommodate the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or employee, unless doing so would impose an undue hardship on the operation of the employer’s business.

Pregnancy Discrimination Act of 1978

The Pregnancy Discrimination Act amended Title VII to make it illegal to discriminate against a woman because of pregnancy, childbirth, or a medical condition related to pregnancy or childbirth. The law also makes it illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit.

The Pregnancy Discrimination Act of 1978 (full text)
Equal Employment Opportunity Commission. The Pregnancy Discrimination Act of 1978

Americans with Disabilities Act

Title I of the Americans with Disabilities Act of 1990 (ADA). This law makes it illegal to discriminate against a qualified person with a disability in the private sector and in state and local governments. The law also makes it illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit. The law also requires that employers reasonably accommodate the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or employee, unless doing so would impose an undue hardship on the operation of the employer’s business.

Aging Discrimination

Currently there is no diagnostic test for biological aging. However, “aging-rate tests may someday be standard in annual physicals, and tracking the results over time would offer unprecedented insights on health risks. But such tests also may well raise fractious privacy and social equity issues. Insurers might demand that customers take them in order to set premiums for life and health care policies. The tests may also reveal how factors like exposure to environmental toxins and the stress of job loss accelerate aging, and by how much — fodder for lawsuits.

The Age Discrimination in Employment Act of 1967 (ADEA) protects people who are 40 or older from discrimination because of age. The law also makes it illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit.

Equal Employment Opportunity Commission. The Age Discrimination in Employment Act of 1967 includes text of the ADEA (Pub. L. 90-202) (ADEA), as amended, as it appears in volume 29 of the United States Code, beginning at section 621. The Older Workers Benefit Protection Act (Pub. L. 101-433) amended several sections of the ADEA. In addition, section 115 of the Civil Rights Act of 1991 (P.L. 102-166) amended section 7(e) of the ADEA (29 U. S.C. 626(e)). Cross references to the ADEA as enacted appear in italics following each section heading.

Genetic Discrimination

“The Genetic Information Nondiscrimination Act, effective November 21, 2009, makes it illegal to discriminate against employees or applicants because of genetic information. Genetic information includes information about an individual’s genetic tests and the genetic tests of an individual’s family members, as well as information about any disease, disorder or condition of an individual’s family members (i.e. an individual’s family medical history). The law also makes it illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit.
GINA covers family medical history, data on genetic tests and information about requests for genetic services. Employers generally are barred from:

Asking for family medical history or genetic-test results during required exams.
Probing about the illness of an employee or a family member.
Requiring workers to provide family medical histories.
Using genetic information for hiring, firing, promotion, pay, benefits, etc.

Critics argue that this limits the information that some employers have used to gauge the fitness of their workers and encourage healthier lifestyles. Asking for the information—for example, during a mandatory physical or an exam that was part of a job offer—is enough to constitute a violation. GINA also prohibits companies from using such information to hire, fire or promote employees.