```

[House Report 110-28]
[From the U.S. Government Publishing Office]

110th Congress                                             Rept. 110-28
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     Part 2

======================================================================
 
           GENETIC INFORMATION NONDISCRIMINATION ACT OF 2007

                                _______
                                

                 March 26, 2007.--Ordered to be printed

                                _______
                                

    Mr. Rangel, from the Committee on Ways and Means, submitted the 
                               following

                              R E P O R T

                             together with

                            ADDITIONAL VIEWS

                        [To accompany H.R. 493]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Ways and Means, to whom was referred the 
bill (H.R. 493) to prohibit discrimination on the basis of 
genetic information with respect to health insurance and 
employment, having considered the same, report favorably 
thereon with an amendment and recommend that the bill as 
amended do pass.

  The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

  (a) Short Title.--This Act may be cited as the ``Genetic Information 
Nondiscrimination Act of 2007''.
  (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

         TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

Sec. 101. Amendments to Employee Retirement Income Security Act of 
1974.
Sec. 102. Amendments to the Public Health Service Act.
Sec. 103. Amendments to the Internal Revenue Code of 1986.
Sec. 104. Amendments to title XVIII of the Social Security Act relating 
to Medigap.
Sec. 105. Privacy and confidentiality.
Sec. 106. Assuring coordination.
Sec. 107. Regulations; effective date.

TITLE II--PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF GENETIC 
                              INFORMATION

Sec. 201. Definitions.
Sec. 202. Employer practices.
Sec. 203. Employment agency practices.
Sec. 204. Labor organization practices.
Sec. 205. Training programs.
Sec. 206. Confidentiality of genetic information.
Sec. 207. Remedies and enforcement.
Sec. 208. Disparate impact.
Sec. 209. Construction.
Sec. 210. Medical information that is not genetic information.
Sec. 211. Regulations.
Sec. 212. Authorization of appropriations.
Sec. 213. Effective date.

                   TITLE III--MISCELLANEOUS PROVISION

Sec. 301. Severability.

SEC. 2. FINDINGS.

  Congress makes the following findings:
          (1) Deciphering the sequence of the human genome and other 
        advances in genetics open major new opportunities for medical 
        progress. New knowledge about the genetic basis of illness will 
        allow for earlier detection of illnesses, often before symptoms 
        have begun. Genetic testing can allow individuals to take steps 
        to reduce the likelihood that they will contract a particular 
        disorder. New knowledge about genetics may allow for the 
        development of better therapies that are more effective against 
        disease or have fewer side effects than current treatments. 
        These advances give rise to the potential misuse of genetic 
        information to discriminate in health insurance and employment.
          (2) The early science of genetics became the basis of State 
        laws that provided for the sterilization of persons having 
        presumed genetic ``defects'' such as mental retardation, mental 
        disease, epilepsy, blindness, and hearing loss, among other 
        conditions. The first sterilization law was enacted in the 
        State of Indiana in 1907. By 1981, a majority of States adopted 
        sterilization laws to ``correct'' apparent genetic traits or 
        tendencies. Many of these State laws have since been repealed, 
        and many have been modified to include essential constitutional 
        requirements of due process and equal protection. However, the 
        current explosion in the science of genetics, and the history 
        of sterilization laws by the States based on early genetic 
        science, compels Congressional action in this area.
          (3) Although genes are facially neutral markers, many genetic 
        conditions and disorders are associated with particular racial 
        and ethnic groups and gender. Because some genetic traits are 
        most prevalent in particular groups, members of a particular 
        group may be stigmatized or discriminated against as a result 
        of that genetic information. This form of discrimination was 
        evident in the 1970s, which saw the advent of programs to 
        screen and identify carriers of sickle cell anemia, a disease 
        which afflicts African-Americans. Once again, State 
        legislatures began to enact discriminatory laws in the area, 
        and in the early 1970s began mandating genetic screening of all 
        African Americans for sickle cell anemia, leading to 
        discrimination and unnecessary fear. To alleviate some of this 
        stigma, Congress in 1972 passed the National Sickle Cell Anemia 
        Control Act, which withholds Federal funding from States unless 
        sickle cell testing is voluntary.
          (4) Congress has been informed of examples of genetic 
        discrimination in the workplace. These include the use of pre-
        employment genetic screening at Lawrence Berkeley Laboratory, 
        which led to a court decision in favor of the employees in that 
        case Norman-Bloodsaw v. Lawrence Berkeley Laboratory (135 F.3d 
        1260, 1269 (9th Cir. 1998)). Congress clearly has a compelling 
        public interest in relieving the fear of discrimination and in 
        prohibiting its actual practice in employment and health 
        insurance.
          (5) Federal law addressing genetic discrimination in health 
        insurance and employment is incomplete in both the scope and 
        depth of its protections. Moreover, while many States have 
        enacted some type of genetic non-discrimination law, these laws 
        vary widely with respect to their approach, application, and 
        level of protection. Congress has collected substantial 
        evidence that the American public and the medical community 
        find the existing patchwork of State and Federal laws to be 
        confusing and inadequate to protect them from discrimination. 
        Therefore Federal legislation establishing a national and 
        uniform basic standard is necessary to fully protect the public 
        from discrimination and allay their concerns about the 
        potential for discrimination, thereby allowing individuals to 
        take advantage of genetic testing, technologies, research, and 
        new therapies.

         TITLE I--GENETIC NONDISCRIMINATION IN HEALTH INSURANCE

SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 
                    1974.

  (a) Prohibition of Health Discrimination on the Basis of Genetic 
Information or Genetic Services.--
          (1) No enrollment restriction for genetic services.--Section 
        702(a)(1)(F) of the Employee Retirement Income Security Act of 
        1974 (29 U.S.C. 1182(a)(1)(F)) is amended by inserting before 
        the period the following: ``(including information about a 
        request for or receipt of genetic services by an individual or 
        family member of such individual)''.
          (2) No discrimination in group premiums based on genetic 
        information.--Section 702(b) of the Employee Retirement Income 
        Security Act of 1974 (29 U.S.C. 1182(b)) is amended--
                  (A) in paragraph (2)(A), by inserting before the 
                semicolon the following: ``except as provided in 
                paragraph (3)''; and
                  (B) by adding at the end the following:
          ``(3) No discrimination in group premiums based on genetic 
        information.--For purposes of this section, a group health 
        plan, or a health insurance issuer offering group health 
        insurance coverage in connection with a group health plan, 
        shall not adjust premium or contribution amounts for a group on 
        the basis of genetic information concerning an individual in 
        the group or a family member of the individual (including 
        information about a request for or receipt of genetic services 
        by an individual or family member of such individual).''.
  (b) Limitations on Genetic Testing.--Section 702 of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 1182) is amended by 
adding at the end the following:
  ``(c) Genetic Testing.--
          ``(1) Limitation on requesting or requiring genetic 
        testing.--A group health plan, or a health insurance issuer 
        offering health insurance coverage in connection with a group 
        health plan, shall not request or require an individual or a 
        family member of such individual to undergo a genetic test.
          ``(2) Rule of construction.--Nothing in this part shall be 
        construed to--
                  ``(A) limit the authority of a health care 
                professional who is providing health care services with 
                respect to an individual to request that such 
                individual or a family member of such individual 
                undergo a genetic test;
                  ``(B) limit the authority of a health care 
                professional who is employed by or affiliated with a 
                group health plan or a health insurance issuer and who 
                is providing health care services to an individual as 
                part of a bona fide wellness program to notify such 
                individual of the availability of a genetic test or to 
                provide information to such individual regarding such 
                genetic test; or
                  ``(C) authorize or permit a health care professional 
                to require that an individual undergo a genetic test.
  ``(d) Application to All Plans.--The provisions of subsections 
(a)(1)(F), (b)(3), and (c) shall apply to group health plans and health 
insurance issuers without regard to section 732(a).''.
  (c) Remedies and Enforcement.--Section 502 of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1132) is amended by adding at 
the end the following:
  ``(n) Enforcement of Genetic Nondiscrimination Requirements.--
          ``(1) Injunctive relief for irreparable harm.--With respect 
        to any violation of subsection (a)(1)(F), (b)(3), or (c) of 
        section 702, a participant or beneficiary may seek relief under 
        subsection 502(a)(1)(B) prior to the exhaustion of available 
        administrative remedies under section 503 if it is demonstrated 
        to the court, by a preponderance of the evidence, that the 
        exhaustion of such remedies would cause irreparable harm to the 
        health of the participant or beneficiary. Any determinations 
        that already have been made under section 503 in such case, or 
        that are made in such case while an action under this paragraph 
        is pending, shall be given due consideration by the court in 
        any action under this subsection in such case.
          ``(2) Equitable relief for genetic nondiscrimination.--
                  ``(A) Reinstatement of benefits where equitable 
                relief has been awarded.--The recovery of benefits by a 
                participant or beneficiary under a civil action under 
                this section may include an administrative penalty 
                under subparagraph (B) and the retroactive 
                reinstatement of coverage under the plan involved to 
                the date on which the participant or beneficiary was 
                denied eligibility for coverage if--
                          ``(i) the civil action was commenced under 
                        subsection (a)(1)(B); and
                          ``(ii) the denial of coverage on which such 
                        civil action was based constitutes a violation 
                        of subsection (a)(1)(F), (b)(3), or (c) of 
                        section 702.
                  ``(B) Administrative penalty.--
                          ``(i) In general.--An administrator who fails 
                        to comply with the requirements of subsection 
                        (a)(1)(F), (b)(3), or (c) of section 702 with 
                        respect to a participant or beneficiary may, in 
                        an action commenced under subsection (a)(1)(B), 
                        be personally liable in the discretion of the 
                        court, for a penalty in the amount not more 
                        than $100 for each day in the noncompliance 
                        period.
                          ``(ii) Noncompliance period.--For purposes of 
                        clause (i), the term `noncompliance period' 
                        means the period--
                                  ``(I) beginning on the date that a 
                                failure described in clause (i) occurs; 
                                and
                                  ``(II) ending on the date that such 
                                failure is corrected.
                          ``(iii) Payment to participant or 
                        beneficiary.--A penalty collected under this 
                        subparagraph shall be paid to the participant 
                        or beneficiary involved.
          ``(3) Secretarial enforcement authority.--
                  ``(A) General rule.--The Secretary has the authority 
                to impose a penalty on any failure of a group health 
                plan to meet the requirements of subsection (a)(1)(F), 
                (b)(3), or (c) of section 702.
                  ``(B) Amount.--
                          ``(i) In general.--The amount of the penalty 
                        imposed by subparagraph (A) shall be $100 for 
                        each day in the noncompliance period with 
                        respect to each individual to whom such failure 
                        relates.
                          ``(ii) Noncompliance period.--For purposes of 
                        this paragraph, the term `noncompliance period' 
                        means, with respect to any failure, the 
                        period--
                                  ``(I) beginning on the date such 
                                failure first occurs; and
                                  ``(II) ending on the date such 
                                failure is corrected.
                  ``(C) Minimum penalties where failure discovered.--
                Notwithstanding clauses (i) and (ii) of subparagraph 
                (D):
                          ``(i) In general.--In the case of 1 or more 
                        failures with respect to an individual--
                                  ``(I) which are not corrected before 
                                the date on which the plan receives a 
                                notice from the Secretary of such 
                                violation; and
                                  ``(II) which occurred or continued 
                                during the period involved;
                        the amount of penalty imposed by subparagraph 
                        (A) by reason of such failures with respect to 
                        such individual shall not be less than $2,500.
                          ``(ii) Higher minimum penalty where 
                        violations are more than de minimis.--To the 
                        extent violations for which any person is 
                        liable under this paragraph for any year are 
                        more than de minimis, clause (i) shall be 
                        applied by substituting `$15,000' for `$2,500' 
                        with respect to such person.
                  ``(D) Limitations.--
                          ``(i) Penalty not to apply where failure not 
                        discovered exercising reasonable diligence.--No 
                        penalty shall be imposed by subparagraph (A) on 
                        any failure during any period for which it is 
                        established to the satisfaction of the 
                        Secretary that the person otherwise liable for 
                        such penalty did not know, and exercising 
                        reasonable diligence would not have known, that 
                        such failure existed.
                          ``(ii) Penalty not to apply to failures 
                        corrected within certain periods.--No penalty 
                        shall be imposed by subparagraph (A) on any 
                        failure if--
                                  ``(I) such failure was due to 
                                reasonable cause and not to willful 
                                neglect; and
                                  ``(II) such failure is corrected 
                                during the 30-day period beginning on 
                                the first date the person otherwise 
                                liable for such penalty knew, or 
                                exercising reasonable diligence would 
                                have known, that such failure existed.
                          ``(iii) Overall limitation for unintentional 
                        failures.--In the case of failures which are 
                        due to reasonable cause and not to willful 
                        neglect, the penalty imposed by subparagraph 
                        (A) for failures shall not exceed the amount 
                        equal to the lesser of--
                                  ``(I) 10 percent of the aggregate 
                                amount paid or incurred by the employer 
                                (or predecessor employer) during the 
                                preceding taxable year for group health 
                                plans; or
                                  ``(II) $500,000.
                  ``(E) Waiver by secretary.--In the case of a failure 
                which is due to reasonable cause and not to willful 
                neglect, the Secretary may waive part or all of the 
                penalty imposed by subparagraph (A) to the extent that 
                the payment of such penalty would be excessive relative 
                to the failure involved.''.
  (d) Definitions.--Section 733(d) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1191b(d)) is amended by adding at the 
end the following:
          ``(5) Family member.--The term `family member' means with 
        respect to an individual--
                  ``(A) the spouse of the individual;
                  ``(B) a dependent child of the individual, including 
                a child who is born to or placed for adoption with the 
                individual; and
                  ``(C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
          ``(6) Genetic information.--
                  ``(A) In general.--Except as provided in subparagraph 
                (B), the term `genetic information' means information 
                about--
                          ``(i) an individual's genetic tests;
                          ``(ii) the genetic tests of family members of 
                        the individual; or
                          ``(iii) the occurrence of a disease or 
                        disorder in family members of the individual.
                  ``(B) Exclusions.--The term `genetic information' 
                shall not include information about the sex or age of 
                an individual.
          ``(7) Genetic test.--
                  ``(A) In general.--The term `genetic test' means an 
                analysis of human DNA, RNA, chromosomes, proteins, or 
                metabolites, that detects genotypes, mutations, or 
                chromosomal changes.
                  ``(B) Exceptions.--The term `genetic test' does not 
                mean--
                          ``(i) an analysis of proteins or metabolites 
                        that does not detect genotypes, mutations, or 
                        chromosomal changes; or
                          ``(ii) an analysis of proteins or metabolites 
                        that is directly related to a manifested 
                        disease, disorder, or pathological condition 
                        that could reasonably be detected by a health 
                        care professional with appropriate training and 
                        expertise in the field of medicine involved.
          ``(8) Genetic services.--The term `genetic services' means--
                  ``(A) a genetic test;
                  ``(B) genetic counseling (such as obtaining, 
                interpreting, or assessing genetic information); or
                  ``(C) genetic education.''.
  (e) Regulations and Effective Date.--
          (1) Regulations.--Not later than 1 year after the date of 
        enactment of this title, the Secretary of Labor shall issue 
        final regulations in an accessible format to carry out the 
        amendments made by this section.
          (2) Effective date.--The amendments made by this section 
        shall apply with respect to group health plans for plan years 
        beginning after the date that is 18 months after the date of 
        enactment of this title.

SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

  (a) Amendments Relating to the Group Market.--
          (1) Prohibition of health discrimination on the basis of 
        genetic information or genetic services.--
                  (A) No enrollment restriction for genetic services.--
                Section 2702(a)(1)(F) of the Public Health Service Act 
                (42 U.S.C. 300gg-1(a)(1)(F)) is amended by inserting 
                before the period the following: ``(including 
                information about a request for or receipt of genetic 
                services by an individual or family member of such 
                individual)''.
                  (B) No discrimination in group premiums based on 
                genetic information.--Section 2702(b) of the Public 
                Health Service Act (42 U.S.C. 300gg-1(b)) is amended--
                          (i) in paragraph (2)(A), by inserting before 
                        the semicolon the following: ``, except as 
                        provided in paragraph (3)''; and
                          (ii) by adding at the end the following:
          ``(3) No discrimination in group premiums based on genetic 
        information.--For purposes of this section, a group health 
        plan, or a health insurance issuer offering group health 
        insurance coverage in connection with a group health plan, 
        shall not adjust premium or contribution amounts for a group on 
        the basis of genetic information concerning an individual in 
        the group or a family member of the individual (including 
        information about a request for or receipt of genetic services 
        by an individual or family member of such individual).''.
          (2) Limitations on genetic testing.--Section 2702 of the 
        Public Health Service Act (42 U.S.C. 300gg-1) is amended by 
        adding at the end the following:
  ``(c) Genetic Testing.--
          ``(1) Limitation on requesting or requiring genetic 
        testing.--A group health plan, or a health insurance issuer 
        offering health insurance coverage in connection with a group 
        health plan, shall not request or require an individual or a 
        family member of such individual to undergo a genetic test.
          ``(2) Rule of construction.--Nothing in this part shall be 
        construed to--
                  ``(A) limit the authority of a health care 
                professional who is providing health care services with 
                respect to an individual to request that such 
                individual or a family member of such individual 
                undergo a genetic test;
                  ``(B) limit the authority of a health care 
                professional who is employed by or affiliated with a 
                group health plan or a health insurance issuer and who 
                is providing health care services to an individual as 
                part of a bona fide wellness program to notify such 
                individual of the availability of a genetic test or to 
                provide information to such individual regarding such 
                genetic test; or
                  ``(C) authorize or permit a health care professional 
                to require that an individual undergo a genetic test.
  ``(d) Application to All Plans.--The provisions of subsections 
(a)(1)(F), (b)(3), and (c) shall apply to group health plans and health 
insurance issuers without regard to section 2721(a).''.
          (3) Remedies and enforcement.--Section 2722(b) of the Public 
        Health Service Act (42 U.S.C. 300gg-22(b)) is amended by adding 
        at the end the following:
          ``(3) Enforcement authority relating to genetic 
        discrimination.--
                  ``(A) General rule.--In the cases described in 
                paragraph (1), notwithstanding the provisions of 
                paragraph (2)(C), the following provisions shall apply 
                with respect to an action under this subsection by the 
                Secretary with respect to any failure of a health 
                insurance issuer in connection with a group health 
                plan, to meet the requirements of subsection (a)(1)(F), 
                (b)(3), or (c) of section 2702.
                  ``(B) Amount.--
                          ``(i) In general.--The amount of the penalty 
                        imposed under this paragraph shall be $100 for 
                        each day in the noncompliance period with 
                        respect to each individual to whom such failure 
                        relates.
                          ``(ii) Noncompliance period.--For purposes of 
                        this paragraph, the term `noncompliance period' 
                        means, with respect to any failure, the 
                        period--
                                  ``(I) beginning on the date such 
                                failure first occurs; and
                                  ``(II) ending on the date such 
                                failure is corrected.
                  ``(C) Minimum penalties where failure discovered.--
                Notwithstanding clauses (i) and (ii) of subparagraph 
                (D):
                          ``(i) In general.--In the case of 1 or more 
                        failures with respect to an individual--
                                  ``(I) which are not corrected before 
                                the date on which the plan receives a 
                                notice from the Secretary of such 
                                violation; and
                                  ``(II) which occurred or continued 
                                during the period involved;
                        the amount of penalty imposed by subparagraph 
                        (A) by reason of such failures with respect to 
                        such individual shall not be less than $2,500.
                          ``(ii) Higher minimum penalty where 
                        violations are more than de minimis.--To the 
                        extent violations for which any person is 
                        liable under this paragraph for any year are 
                        more than de minimis, clause (i) shall be 
                        applied by substituting `$15,000' for `$2,500' 
                        with respect to such person.
                  ``(D) Limitations.--
                          ``(i) Penalty not to apply where failure not 
                        discovered exercising reasonable diligence.--No 
                        penalty shall be imposed by subparagraph (A) on 
                        any failure during any period for which it is 
                        established to the satisfaction of the 
                        Secretary that the person otherwise liable for 
                        such penalty did not know, and exercising 
                        reasonable diligence would not have known, that 
                        such failure existed.
                          ``(ii) Penalty not to apply to failures 
                        corrected within certain periods.--No penalty 
                        shall be imposed by subparagraph (A) on any 
                        failure if--
                                  ``(I) such failure was due to 
                                reasonable cause and not to willful 
                                neglect; and
                                  ``(II) such failure is corrected 
                                during the 30-day period beginning on 
                                the first date the person otherwise 
                                liable for such penalty knew, or 
                                exercising reasonable diligence would 
                                have known, that such failure existed.
                          ``(iii) Overall limitation for unintentional 
                        failures.--In the case of failures which are 
                        due to reasonable cause and not to willful 
                        neglect, the penalty imposed by subparagraph 
                        (A) for failures shall not exceed the amount 
                        equal to the lesser of--
                                  ``(I) 10 percent of the aggregate 
                                amount paid or incurred by the employer 
                                (or predecessor employer) during the 
                                preceding taxable year for group health 
                                plans; or
                                  ``(II) $500,000.
                  ``(E) Waiver by secretary.--In the case of a failure 
                which is due to reasonable cause and not to willful 
                neglect, the Secretary may waive part or all of the 
                penalty imposed by subparagraph (A) to the extent that 
                the payment of such penalty would be excessive relative 
                to the failure involved.''.
          (4) Definitions.--Section 2791(d) of the Public Health 
        Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at the 
        end the following:
          ``(15) Family member.--The term `family member' means with 
        respect to an individual--
                  ``(A) the spouse of the individual;
                  ``(B) a dependent child of the individual, including 
                a child who is born to or placed for adoption with the 
                individual; and
                  ``(C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
          ``(16) Genetic information.--
                  ``(A) In general.--Except as provided in subparagraph 
                (B), the term `genetic information' means information 
                about--
                          ``(i) an individual's genetic tests;
                          ``(ii) the genetic tests of family members of 
                        the individual; or
                          ``(iii) the occurrence of a disease or 
                        disorder in family members of the individual.
                  ``(B) Exclusions.--The term `genetic information' 
                shall not include information about the sex or age of 
                an individual.
          ``(17) Genetic test.--
                  ``(A) In general.--The term `genetic test' means an 
                analysis of human DNA, RNA, chromosomes, proteins, or 
                metabolites, that detects genotypes, mutations, or 
                chromosomal changes.
                  ``(B) Exceptions.--The term `genetic test' does not 
                mean--
                          ``(i) an analysis of proteins or metabolites 
                        that does not detect genotypes, mutations, or 
                        chromosomal changes; or
                          ``(ii) an analysis of proteins or metabolites 
                        that is directly related to a manifested 
                        disease, disorder, or pathological condition 
                        that could reasonably be detected by a health 
                        care professional with appropriate training and 
                        expertise in the field of medicine involved.
          ``(18) Genetic services.--The term `genetic services' means--
                  ``(A) a genetic test;
                  ``(B) genetic counseling (such as obtaining, 
                interpreting, or assessing genetic information); or
                  ``(C) genetic education.''.
  (b) Amendment Relating to the Individual Market.--
          (1) In general.--The first subpart 3 of part B of title XXVII 
        of the Public Health Service Act (42 U.S.C. 300gg-51 et seq.) 
        (relating to other requirements) is amended--
                  (A) by redesignating such subpart as subpart 2; and
                  (B) by adding at the end the following:

``SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS OF 
                    GENETIC INFORMATION.

  ``(a) Prohibition on Genetic Information as a Condition of 
Eligibility.--A health insurance issuer offering health insurance 
coverage in the individual market may not establish rules for the 
eligibility (including continued eligibility) of any individual to 
enroll in individual health insurance coverage based on genetic 
information (including information about a request for or receipt of 
genetic services by an individual or family member of such individual).
  ``(b) Prohibition on Genetic Information in Setting Premium Rates.--A 
health insurance issuer offering health insurance coverage in the 
individual market shall not adjust premium or contribution amounts for 
an individual on the basis of genetic information concerning the 
individual or a family member of the individual (including information 
about a request for or receipt of genetic services by an individual or 
family member of such individual).
  ``(c) Genetic Testing.--
          ``(1) Limitation on requesting or requiring genetic 
        testing.--A health insurance issuer offering health insurance 
        coverage in the individual market shall not request or require 
        an individual or a family member of such individual to undergo 
        a genetic test.
          ``(2) Rule of construction.--Nothing in this part shall be 
        construed to--
                  ``(A) limit the authority of a health care 
                professional who is providing health care services with 
                respect to an individual to request that such 
                individual or a family member of such individual 
                undergo a genetic test;
                  ``(B) limit the authority of a health care 
                professional who is employed by or affiliated with a 
                health insurance issuer and who is providing health 
                care services to an individual as part of a bona fide 
                wellness program to notify such individual of the 
                availability of a genetic test or to provide 
                information to such individual regarding such genetic 
                test; or
                  ``(C) authorize or permit a health care professional 
                to require that an individual undergo a genetic 
                test.''.
          (2) Remedies and enforcement.--Section 2761(b) of the Public 
        Health Service Act (42 U.S.C. 300gg-61(b)) is amended to read 
        as follows:
  ``(b) Secretarial Enforcement Authority.--The Secretary shall have 
the same authority in relation to enforcement of the provisions of this 
part with respect to issuers of health insurance coverage in the 
individual market in a State as the Secretary has under section 
2722(b)(2), and section 2722(b)(3) with respect to violations of 
genetic nondiscrimination provisions, in relation to the enforcement of 
the provisions of part A with respect to issuers of health insurance 
coverage in the small group market in the State.''.
  (c) Elimination of Option of Non-Federal Governmental Plans To Be 
Excepted From Requirements Concerning Genetic Information.--Section 
2721(b)(2) of the Public Health Service Act (42 U.S.C. 300gg-21(b)(2)) 
is amended--
          (1) in subparagraph (A), by striking ``If the plan sponsor'' 
        and inserting ``Except as provided in subparagraph (D), if the 
        plan sponsor''; and
          (2) by adding at the end the following:
                  ``(D) Election not applicable to requirements 
                concerning genetic information.--The election described 
                in subparagraph (A) shall not be available with respect 
                to the provisions of subsections (a)(1)(F) and (c) of 
                section 2702 and the provisions of section 2702(b) to 
                the extent that such provisions apply to genetic 
                information (or information about a request for or the 
                receipt of genetic services by an individual or a 
                family member of such individual).''.
  (d) Regulations and Effective Date.--
          (1) Regulations.--Not later than 1 year after the date of 
        enactment of this title, the Secretary of Labor and the 
        Secretary of Health and Human Services (as the case may be) 
        shall issue final regulations in an accessible format to carry 
        out the amendments made by this section.
          (2) Effective date.--The amendments made by this section 
        shall apply--
                  (A) with respect to group health plans, and health 
                insurance coverage offered in connection with group 
                health plans, for plan years beginning after the date 
                that is 18 months after the date of enactment of this 
                title; and
                  (B) with respect to health insurance coverage 
                offered, sold, issued, renewed, in effect, or operated 
                in the individual market after the date that is 18 
                months after the date of enactment of this title.

SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986.

  (a) No Discrimination in Group Premiums Based on Genetic 
Information.--Subsection (b) of section 9802 of the Internal Revenue 
Code of 1986 is amended--
          (1) in paragraph (2)(A), by inserting before the semicolon 
        the following: ``except as provided in paragraph (3)''; and
          (2) by adding at the end the following:
          ``(3) No group-based discrimination on basis of genetic 
        information.--For purposes of this section, a group health plan 
        may not adjust premium or contribution amounts for the group 
        covered under such plan on the basis of genetic information.''.
  (b) Limitations on Genetic Testing and Collection of Genetic 
Information.--Section 9802 of such Code is amended by redesignating 
subsection (c) as subsection (f) and by inserting after subsection (b) 
the following new subsections:
  ``(c) Genetic Testing.--
          ``(1) Limitation on requesting or requiring genetic 
        testing.--A group health plan may not request or require an 
        individual or a family member of such individual to undergo a 
        genetic test.
          ``(2) Exception for health care professionals.--Paragraph (1) 
        shall not be construed to limit the authority of a health care 
        professional who is providing health care services to an 
        individual to request that such individual undergo a genetic 
        test.
          ``(3) Provision of information not prohibited.--Paragraph (1) 
        shall not be construed to limit the authority of a group health 
        plan--
                  ``(A) to provide information generally about the 
                availability of genetic tests, or
                  ``(B) to provide information about genetic tests to a 
                health care professional with respect to the treatment 
                of an individual to whom such professional is providing 
                health care services.
  ``(d) Prohibition on Collection of Genetic Information.--
          ``(1) In general.--A group health plan shall not request, 
        require, or purchase genetic information for purposes of 
        underwriting (as defined in section 9832).
          ``(2) Prohibition on collection of genetic information prior 
        to enrollment.--A group health plan shall not request, require, 
        or purchase genetic information with respect to any individual 
        prior to such individual's enrollment under the plan or in 
        connection with such enrollment.
          ``(3) Incidental collection.--If a group health plan obtains 
        genetic information incidental to the requesting, requiring, or 
        purchasing of other information concerning any individual, such 
        request, requirement, or purchase shall not be considered a 
        violation of paragraph (2) if such request, requirement, or 
        purchase is not in violation of paragraph (1).
  ``(e) Application to All Plans.--The provisions of subsections 
(a)(1)(F), (b)(3), (c), and (d) shall apply to group health plans 
without regard to section 9831(a).''.
  (c) Definitions.--Subsection (d) of section 9832 of such Code is 
amended by adding at the end the following:
          ``(6) Family member.--The term `family member' means, with 
        respect to any individual--
                  ``(A) a dependent (as such term is used for purposes 
                of section 9801(f)(2)) of such individual, and
                  ``(B) any other individual who is a first-degree, 
                second-degree, third-degree, or fourth-degree relative 
                of such individual or of an individual described in 
                subparagraph (A).
          ``(7) Genetic information.--
                  ``(A) In general.--The term `genetic information' 
                means, with respect to any individual, information 
                about--
                          ``(i) such individual's genetic tests,
                          ``(ii) the genetic tests of family members of 
                        such individual, and
                          ``(iii) the occurrence of a disease or 
                        disorder in family members of such individual.
                  ``(B) Inclusion of genetic services and participation 
                in genetic research.--Such term includes, with respect 
                to any individual, any request for genetic services, 
                receipt of genetic services, or participation in any 
                clinical research, or any other program, which includes 
                genetic services, by such individual or any family 
                member of such individual.
                  ``(C) Exclusions.--The term `genetic information' 
                shall not include information about the sex or age of 
                any individual.
                  ``(D) Application to family members covered under 
                same plan.--Information described in clause (iii) of 
                subparagraph (A) shall not be treated as genetic 
                information to the extent that such information is 
                taken into account only with respect to the individual 
                in which such disease or disorder occurs and not as 
                genetic information with respect to any other 
                individual.
          ``(8) Genetic test.--
                  ``(A) In general.--The term `genetic test' means an 
                analysis of human DNA, RNA, chromosomes, proteins, or 
                metabolites, that detects genotypes, mutations, or 
                chromosomal changes.
                  ``(B) Exceptions.--The term `genetic test' does not 
                mean--
                          ``(i) an analysis of proteins or metabolites 
                        that does not detect genotypes, mutations, or 
                        chromosomal changes, or
                          ``(ii) an analysis of proteins or metabolites 
                        that is directly related to a manifested 
                        disease, disorder, or pathological condition 
                        that could reasonably be detected by a health 
                        care professional with appropriate training and 
                        expertise in the field of medicine involved.
          ``(9) Genetic services.--The term `genetic services' means--
                  ``(A) a genetic test,
                  ``(B) genetic counseling (such as obtaining, 
                interpreting, or assessing genetic information), and
                  ``(C) genetic education.
          ``(10) Underwriting.--The term `underwriting' means, with 
        respect to any group health plan--
                  ``(A) rules for eligibility (including enrollment and 
                continued eligibility) for, or determination of, 
                benefits under the plan,
                  ``(B) the computation of premium or contribution 
                amounts under the plan,
                  ``(C) the application of any pre-existing condition 
                exclusion under the plan, and
                  ``(D) other activities related to the creation, 
                renewal, or replacement of a contract of health 
                insurance or health benefits.''.
  (d) Enforcement.--
          (1) In general.--Subchapter C of chapter 100 of the Internal 
        Revenue Code of 1986 (relating to general provisions) is 
        amended by adding at the end the following new section:

``SEC. 9834. ENFORCEMENT.

  ``For the imposition of tax on any failure of a group health plan to 
meet the requirements of this chapter, see section 4980D.''.
          (2) Conforming amendment.--The table of sections for 
        subchapter C of chapter 100 of such Code is amended by adding 
        at the end the following new item:

``Sec. 9834. Enforcement.''.
  (e) Regulations and Effective Date.--
          (1) Regulations.--The Secretary of the Treasury shall issue 
        regulations or other guidance not later than 1 year after the 
        date of the enactment of this Act to carry out the amendments 
        made by this section.
          (2) Effective date.--The amendments made by this section 
        shall apply with respect to group health plans for plan years 
        beginning after the date that is 18 months after the date of 
        the enactment of this Act.

SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY ACT RELATING 
                    TO MEDIGAP.

  (a) Nondiscrimination.--Section 1882(s)(2) of the Social Security Act 
(42 U.S.C. 1395ss(s)(2)) is amended by adding at the end the following:
  ``(E) An issuer of a medicare supplemental policy shall not deny or 
condition the issuance or effectiveness of the policy (including the 
imposition of any exclusion of benefits under the policy based on a 
pre-existing condition) and shall not discriminate in the pricing of 
the policy (including the adjustment of premium rates) of an individual 
on the basis of the genetic information with respect to such 
individual.''.
  (b) Limitations on Genetic Testing and Collection of Genetic 
Information.--
          (1) In general.--Section 1882 of the Social Security Act (42 
        U.S.C. 1395ss) is amended by adding at the end the following:
  ``(x) Limitations on Genetic Testing and Collection of Genetic 
Information.--
          ``(1) Genetic testing.--
                  ``(A) Limitation on requesting or requiring genetic 
                testing.--An issuer of a medicare supplemental policy 
                shall not request or require an individual or a family 
                member of such individual to undergo a genetic test.
                  ``(B) Exception for health care professionals.--
                Subparagraph (A) shall not be construed to limit the 
                authority of a health care professional who is 
                providing health care services to an individual to 
                request that such individual undergo a genetic test.
                  ``(C) Provision of information not prohibited.--
                Subparagraph (A) shall not be construed to limit the 
                authority of an issuer of a medicare supplemental 
                policy--
                          ``(i) to provide information generally about 
                        the availability of genetic tests, or
                          ``(ii) to provide information about genetic 
                        tests to a health care professional with 
                        respect to the treatment of an individual to 
                        whom such professional is providing health care 
                        services.
          ``(2) Prohibition on collection of genetic information.--
                  ``(A) In general.--An issuer of a medicare 
                supplemental policy shall not request, require, or 
                purchase genetic information for purposes of 
                underwriting.
                  ``(B) Limitation relating to the collection of 
                genetic information prior to enrollment.--An issuer of 
                a medicare supplemental policy shall not request, 
                require, or purchase genetic information concerning any 
                individual prior to such individual's enrollment under 
                the policy or in connection with such enrollment.
                  ``(C) Incidental collection.--Where an issuer of a 
                medicare supplemental policy obtains genetic 
                information incidental to the requesting, requiring, or 
                purchasing of other information concerning an enrollee, 
                such request, requirement, or purchase shall not be 
                considered a violation of this paragraph if such 
                request, requirement, or purchase is not in violation 
                of subparagraph (A).
          ``(3) Definitions.--In this subsection and subsection 
        (s)(2)(E):
                  ``(A) Family member.--The term `family member' means, 
                with respect to any individual, any individual who is a 
                first-degree, second-degree, third-degree, or fourth-
                degree relative of such individual.
                  ``(B) Genetic information.--
                          ``(i) In general.--The term `genetic 
                        information' means, with respect to any 
                        individual, information about--
                                  ``(I) such individual's genetic 
                                tests;
                                  ``(II) the genetic tests of family 
                                members of such individual; and
                                  ``(III) the occurrence of a disease 
                                or disorder in family members of such 
                                individual.
                          ``(ii) Inclusion of genetic services and 
                        participation in genetic research.--Such term 
                        includes, with respect to any individual, any 
                        request for genetic services, receipt of 
                        genetic services, or participation in any 
                        clinical research, or any other program, which 
                        includes genetic services, by such individual 
                        or any family member of such individual.
                          ``(iii) Exclusions.--The term `genetic 
                        information' shall not include information 
                        about the sex or age of an individual.
                  ``(C) Genetic test.--
                          ``(i) In general.--The term `genetic test' 
                        means an analysis of human DNA, RNA, 
                        chromosomes, proteins, or metabolites, that 
                        detects genotypes, mutations, or chromosomal 
                        changes.
                          ``(ii) Exceptions.--The term `genetic test' 
                        does not mean--
                                  ``(I) an analysis of proteins or 
                                metabolites that does not detect 
                                genotypes, mutations, or chromosomal 
                                changes; or
                                  ``(II) an analysis of proteins or 
                                metabolites that is directly related to 
                                a manifested disease, disorder, or 
                                pathological condition that could 
                                reasonably be detected by a health care 
                                professional with appropriate training 
                                and expertise in the field of medicine 
                                involved.
                  ``(D) Genetic services.--The term `genetic services' 
                means--
                          ``(i) a genetic test;
                          ``(ii) genetic counseling (such as obtaining, 
                        interpreting, or assessing genetic 
                        information); and
                          ``(iii) genetic education.
                  ``(E) Underwriting.--The term `underwriting' means, 
                with respect to a medicare supplemental policy--
                          ``(i) rules for eligibility (including 
                        enrollment and continued eligibility) for, or 
                        determination of, benefits under the policy;
                          ``(ii) the computation of premium or 
                        contribution amounts under the policy;
                          ``(iii) the application of any pre-existing 
                        condition exclusion under the policy; and
                          ``(iv) other activities related to the 
                        creation, renewal, or replacement of a contract 
                        of health insurance or health benefits.
                  ``(F) Issuer of a medicare supplemental policy.--The 
                term `issuer of a medicare supplemental policy' 
                includes a third-party administrator or other person 
                acting for or on behalf of such issuer.''.
          (2) Conforming amendment.--Section 1882(o) of such Act (42 
        U.S.C. 1395ss(o)) is amended by adding at the end the 
        following:
          ``(4) The issuer of the medicare supplemental policy (as 
        defined in subsection (x)) complies with subsection (s)(2)(E) 
        and subsection (x).''.
  (c) Effective Date.--The amendments made by this section shall apply 
with respect to an issuer of a medicare supplemental policy for policy 
years beginning on or after the date that is 18 months after the date 
of enactment of this Act.
  (d) Transition Provisions.--
          (1) In general.--If the Secretary of Health and Human 
        Services identifies a State as requiring a change to its 
        statutes or regulations to conform its regulatory program to 
        the changes made by this section, the State regulatory program 
        shall not be considered to be out of compliance with the 
        requirements of section 1882 of the Social Security Act due 
        solely to failure to make such change until the date specified 
        in paragraph (4).
          (2) NAIC standards.--If, not later than June 30, 2008, the 
        National Association of Insurance Commissioners (in this 
        subsection referred to as the ``NAIC'') modifies its NAIC Model 
        Regulation relating to section 1882 of the Social Security Act 
        (referred to in such section as the 1991 NAIC Model Regulation, 
        as subsequently modified) to conform to the amendments made by 
        this section, such revised regulation incorporating the 
        modifications shall be considered to be the applicable NAIC 
        model regulation (including the revised NAIC model regulation 
        and the 1991 NAIC Model Regulation) for the purposes of such 
        section.
          (3) Secretary standards.--If the NAIC does not make the 
        modifications described in paragraph (2) within the period 
        specified in such paragraph, the Secretary of Health and Human 
        Services shall, not later than October 1, 2008, make the 
        modifications described in such paragraph and such revised 
        regulation incorporating the modifications shall be considered 
        to be the appropriate regulation for the purposes of such 
        section.
          (4) Date specified.--
                  (A) In general.--Subject to subparagraph (B), the 
                date specified in this paragraph for a State is the 
                earlier of--
                          (i) the date the State changes its statutes 
                        or regulations to conform its regulatory 
                        program to the changes made by this section, or
                          (ii) October 1, 2008.
                  (B) Additional legislative action required.--In the 
                case of a State which the Secretary identifies as--
                          (i) requiring State legislation (other than 
                        legislation appropriating funds) to conform its 
                        regulatory program to the changes made in this 
                        section, but
                          (ii) having a legislature which is not 
                        scheduled to meet in 2008 in a legislative 
                        session in which such legislation may be 
                        considered, the date specified in this 
                        paragraph is the first day of the first 
                        calendar quarter beginning after the close of 
                        the first legislative session of the State 
                        legislature that begins on or after July 1, 
                        2008. For purposes of the previous sentence, in 
                        the case of a State that has a 2-year 
                        legislative session, each year of such session 
                        shall be deemed to be a separate regular 
                        session of the State legislature.

SEC. 105. PRIVACY AND CONFIDENTIALITY.

  Part C of title XI of the Social Security Act is amended by adding at 
the end the following new section:
       ``application of hipaa regulations to genetic information
  ``Sec. 1180.  (a) In General.--The Secretary of Health and Human 
Services shall revise the HIPAA privacy regulation (as defined in 
subsection (b)) so it is consistent with the following:
          ``(1) Genetic information shall be treated as health 
        information described in section 1171(4)(B).
          ``(2) The use or disclosure by a covered entity that is a 
        group health plan, health insurance issuer that issues health 
        insurance coverage, or issuer of a medicare supplemental policy 
        of protected health information that is genetic information 
        about an individual for underwriting purposes under the plan, 
        coverage, or policy shall not be a permitted use or disclosure.
  ``(b) Definitions.--For purposes of this section:
          ``(1) Genetic information; genetic test; family member.--The 
        terms `genetic information', `genetic test', and `family 
        member' have the meanings given such terms in section 2791 of 
        the Public Health Service Act (42 U.S.C. 300gg-91), as amended 
        by the Genetic Information Nondiscrimination Act of 2007.
          ``(2) Group health plan; health insurance coverage; medicare 
        supplemental policy.--The terms `group health plan' and `health 
        insurance coverage' have the meanings given such terms under 
        section 2791 of the Public Health Service Act (42 U.S.C. 300gg-
        91), and the term `medicare supplemental policy' has the 
        meaning given such term in section 1882(g).
          ``(3) HIPAA privacy regulation.--The term `HIPAA privacy 
        regulation' means the regulations promulgated by the Secretary 
        under this part and section 264 of the Health Insurance 
        Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 
        note).
          ``(4) Underwriting purposes.--The term `underwriting 
        purposes' means, with respect to a group health plan, health 
        insurance coverage, or a medicare supplemental policy--
                  ``(A) rules for eligibility (including enrollment and 
                continued eligibility) for, or determination of, 
                benefits under the plan, coverage, or policy;
                  ``(B) the computation of premium or contribution 
                amounts under the plan, coverage, or policy;
                  ``(C) the application of any pre-existing condition 
                exclusion under the plan, coverage, or policy; and
                  ``(D) other activities related to the creation, 
                renewal, or replacement of a contract of health 
                insurance or health benefits.
  ``(c) Procedure.--The revisions under subsection (a) shall be made by 
notice in the Federal Register published not later than 60 days after 
the date of the enactment of this section and shall be effective upon 
publication, without opportunity for any prior public comment, but may 
be revised, consistent with this section, after opportunity for public 
comment.''.

SEC. 106. ASSURING COORDINATION.

  (a) In General.--Except as provided in subsection (b), the Secretary 
of the Treasury, the Secretary of Health and Human Services, and the 
Secretary of Labor shall ensure, through the execution of an 
interagency memorandum of understanding among such Secretaries, that--
          (1) regulations, rulings, and interpretations issued by such 
        Secretaries relating to the same matter over which two or more 
        such Secretaries have responsibility under this title (and the 
        amendments made by this title) are administered so as to have 
        the same effect at all times; and
          (2) coordination of policies relating to enforcing the same 
        requirements through such Secretaries in order to have a 
        coordinated enforcement strategy that avoids duplication of 
        enforcement efforts and assigns priorities in enforcement.
  (b) Authority of the Secretary.--The Secretary of Health and Human 
Services has the sole authority to promulgate regulations to implement 
the amendment made by section 104.

SEC. 107. REGULATIONS; EFFECTIVE DATE.

  (a) Regulations.--Not later than 1 year after the date of enactment 
of this title, the Secretary of Labor, the Secretary of Health and 
Human Services, and the Secretary of the Treasury shall issue final 
regulations in an accessible format to carry out this title.
  (b) Effective Date.--Except as provided in section 103, the 
amendments made by this title shall take effect on the date that is 18 
months after the date of enactment of this Act.

TITLE II--PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF GENETIC 
                              INFORMATION

SEC. 201. DEFINITIONS.

  In this title:
          (1) Commission.--The term ``Commission'' means the Equal 
        Employment Opportunity Commission as created by section 705 of 
        the Civil Rights Act of 1964 (42 U.S.C. 2000e-4).
          (2) Employee; employer; employment agency; labor 
        organization; member.--
                  (A) In general.--The term ``employee'' means--
                          (i) an employee (including an applicant), as 
                        defined in section 701(f) of the Civil Rights 
                        Act of 1964 (42 U.S.C. 2000e(f));
                          (ii) a State employee (including an 
                        applicant) described in section 304(a) of the 
                        Government Employee Rights Act of 1991 (42 
                        U.S.C. 2000e-16c(a));
                          (iii) a covered employee (including an 
                        applicant), as defined in section 101 of the 
                        Congressional Accountability Act of 1995 (2 
                        U.S.C. 1301);
                          (iv) a covered employee (including an 
                        applicant), as defined in section 411(c) of 
                        title 3, United States Code; or
                          (v) an employee or applicant to which section 
                        717(a) of the Civil Rights Act of 1964 (42 
                        U.S.C. 2000e-16(a)) applies.
                  (B) Employer.--The term ``employer'' means--
                          (i) an employer (as defined in section 701(b) 
                        of the Civil Rights Act of 1964 (42 U.S.C. 
                        2000e(b));
                          (ii) an entity employing a State employee 
                        described in section 304(a) of the Government 
                        Employee Rights Act of 1991;
                          (iii) an employing office, as defined in 
                        section 101 of the Congressional Accountability 
                        Act of 1995;
                          (iv) an employing office, as defined in 
                        section 411(c) of title 3, United States Code; 
                        or
                          (v) an entity to which section 717(a) of the 
                        Civil Rights Act of 1964 applies.
                  (C) Employment agency; labor organization.--The terms 
                ``employment agency'' and ``labor organization'' have 
                the meanings given the terms in section 701 of the 
                Civil Rights Act of 1964 (42 U.S.C. 2000e).
                  (D) Member.--The term ``member'', with respect to a 
                labor organization, includes an applicant for 
                membership in a labor organization.
          (3) Family member.--The term ``family member'' means with 
        respect to an individual--
                  (A) the spouse of the individual;
                  (B) a dependent child of the individual, including a 
                child who is born to or placed for adoption with the 
                individual; and
                  (C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
          (4) Genetic information.--
                  (A) In general.--Except as provided in subparagraph 
                (B), the term ``genetic information'' means information 
                about--
                          (i) an individual's genetic tests;
                          (ii) the genetic tests of family members of 
                        the individual; or
                          (iii) the occurrence of a disease or disorder 
                        in family members of the individual.
                  (B) Exceptions.--The term ``genetic information'' 
                shall not include information about the sex or age of 
                an individual.
          (5) Genetic monitoring.--The term ``genetic monitoring'' 
        means the periodic examination of employees to evaluate 
        acquired modifications to their genetic material, such as 
        chromosomal damage or evidence of increased occurrence of 
        mutations, that may have developed in the course of employment 
        due to exposure to toxic substances in the workplace, in order 
        to identify, evaluate, and respond to the effects of or control 
        adverse environmental exposures in the workplace.
          (6) Genetic services.--The term ``genetic services'' means--
                  (A) a genetic test;
                  (B) genetic counseling (such as obtaining, 
                interpreting or assessing genetic information); or
                  (C) genetic education.
          (7) Genetic test.--
                  (A) In general.--The term ``genetic test'' means the 
                analysis of human DNA, RNA, chromosomes, proteins, or 
                metabolites, that detects genotypes, mutations, or 
                chromosomal changes.
                  (B) Exception.--The term ``genetic test'' does not 
                mean an analysis of proteins or metabolites that does 
                not detect genotypes, mutations, or chromosomal 
                changes.

SEC. 202. EMPLOYER PRACTICES.

  (a) Use of Genetic Information.--It shall be an unlawful employment 
practice for an employer--
          (1) to fail or refuse to hire or to discharge any employee, 
        or otherwise to discriminate against any employee with respect 
        to the compensation, terms, conditions, or privileges of 
        employment of the employee, because of genetic information with 
        respect to the employee (or information about a request for or 
        the receipt of genetic services by such employee or family 
        member of such employee); or
          (2) to limit, segregate, or classify the employees of the 
        employer in any way that would deprive or tend to deprive any 
        employee of employment opportunities or otherwise adversely 
        affect the status of the employee as an employee, because of 
        genetic information with respect to the employee (or 
        information about a request for or the receipt of genetic 
        services by such employee or family member of such employee).
  (b) Acquisition of Genetic Information.--It shall be an unlawful 
employment practice for an employer to request, require, or purchase 
genetic information with respect to an employee or a family member of 
the employee (or information about a request for the receipt of genetic 
services by such employee or a family member of such employee) except--
          (1) where an employer inadvertently requests or requires 
        family medical history of the employee or family member of the 
        employee;
          (2) where--
                  (A) health or genetic services are offered by the 
                employer, including such services offered as part of a 
                bona fide wellness program;
                  (B) the employee provides prior, knowing, voluntary, 
                and written authorization;
                  (C) only the employee (or family member if the family 
                member is receiving genetic services) and the licensed 
                health care professional or board certified genetic 
                counselor involved in providing such services receive 
                individually identifiable information concerning the 
                results of such services; and
                  (D) any individually identifiable genetic information 
                provided under subparagraph (C) in connection with the 
                services provided under subparagraph (A) is only 
                available for purposes of such services and shall not 
                be disclosed to the employer except in aggregate terms 
                that do not disclose the identity of specific 
                employees;
          (3) where an employer requests or requires family medical 
        history from the employee to comply with the certification 
        provisions of section 103 of the Family and Medical Leave Act 
        of 1993 (29 U.S.C. 2613) or such requirements under State 
        family and medical leave laws;
          (4) where an employer purchases documents that are 
        commercially and publicly available (including newspapers, 
        magazines, periodicals, and books, but not including medical 
        databases or court records) that include family medical 
        history; or
          (5) where the information involved is to be used for genetic 
        monitoring of the biological effects of toxic substances in the 
        workplace, but only if--
                  (A) the employer provides written notice of the 
                genetic monitoring to the employee;
                  (B)(i) the employee provides prior, knowing, 
                voluntary, and written authorization; or
                  (ii) the genetic monitoring is required by Federal or 
                State law;
                  (C) the employee is informed of individual monitoring 
                results;
                  (D) the monitoring is in compliance with--
                          (i) any Federal genetic monitoring 
                        regulations, including any such regulations 
                        that may be promulgated by the Secretary of 
                        Labor pursuant to the Occupational Safety and 
                        Health Act of 1970 (29 U.S.C. 651 et seq.), the 
                        Federal Mine Safety and Health Act of 1977 (30 
                        U.S.C. 801 et seq.), or the Atomic Energy Act 
                        of 1954 (42 U.S.C. 2011 et seq.); or
                          (ii) State genetic monitoring regulations, in 
                        the case of a State that is implementing 
                        genetic monitoring regulations under the 
                        authority of the Occupational Safety and Health 
                        Act of 1970 (29 U.S.C. 651 et seq.); and
                  (E) the employer, excluding any licensed health care 
                professional or board certified genetic counselor that 
                is involved in the genetic monitoring program, receives 
                the results of the monitoring only in aggregate terms 
                that do not disclose the identity of specific 
                employees;
  (c) Preservation of Protections.--In the case of information to which 
any of paragraphs (1) through (5) of subsection (b) applies, such 
information may not be used in violation of paragraph (1) or (2) of 
subsection (a) or treated or disclosed in a manner that violates 
section 206.

SEC. 203. EMPLOYMENT AGENCY PRACTICES.

  (a) Use of Genetic Information.--It shall be an unlawful employment 
practice for an employment agency--
          (1) to fail or refuse to refer for employment, or otherwise 
        to discriminate against, any individual because of genetic 
        information with respect to the individual (or information 
        about a request for or the receipt of genetic services by such 
        individual or family member of such individual);
          (2) to limit, segregate, or classify individuals or fail or 
        refuse to refer for employment any individual in any way that 
        would deprive or tend to deprive any individual of employment 
        opportunities, or otherwise adversely affect the status of the 
        individual as an employee, because of genetic information with 
        respect to the individual (or information about a request for 
        or the receipt of genetic services by such individual or family 
        member of such individual); or
          (3) to cause or attempt to cause an employer to discriminate 
        against an individual in violation of this title.
  (b) Acquisition of Genetic Information.--It shall be an unlawful 
employment practice for an employment agency to request, require, or 
purchase genetic information with respect to an individual or a family 
member of the individual (or information about a request for the 
receipt of genetic services by such individual or a family member of 
such individual) except--
          (1) where an employment agency inadvertently requests or 
        requires family medical history of the individual or family 
        member of the individual;
          (2) where--
                  (A) health or genetic services are offered by the 
                employment agency, including such services offered as 
                part of a bona fide wellness program;
                  (B) the individual provides prior, knowing, 
                voluntary, and written authorization;
                  (C) only the individual (or family member if the 
                family member is receiving genetic services) and the 
                licensed health care professional or board certified 
                genetic counselor involved in providing such services 
                receive individually identifiable information 
                concerning the results of such services; and
                  (D) any individually identifiable genetic information 
                provided under subparagraph (C) in connection with the 
                services provided under subparagraph (A) is only 
                available for purposes of such services and shall not 
                be disclosed to the employment agency except in 
                aggregate terms that do not disclose the identity of 
                specific individuals;
          (3) where an employment agency requests or requires family 
        medical history from the individual to comply with the 
        certification provisions of section 103 of the Family and 
        Medical Leave Act of 1993 (29 U.S.C. 2613) or such requirements 
        under State family and medical leave laws;
          (4) where an employment agency purchases documents that are 
        commercially and publicly available (including newspapers, 
        magazines, periodicals, and books, but not including medical 
        databases or court records) that include family medical 
        history; or
          (5) where the information involved is to be used for genetic 
        monitoring of the biological effects of toxic substances in the 
        workplace, but only if--
                  (A) the employment agency provides written notice of 
                the genetic monitoring to the individual;
                  (B)(i) the individual provides prior, knowing, 
                voluntary, and written authorization; or
                  (ii) the genetic monitoring is required by Federal or 
                State law;
                  (C) the individual is informed of individual 
                monitoring results;
                  (D) the monitoring is in compliance with--
                          (i) any Federal genetic monitoring 
                        regulations, including any such regulations 
                        that may be promulgated by the Secretary of 
                        Labor pursuant to the Occupational Safety and 
                        Health Act of 1970 (29 U.S.C. 651 et seq.), the 
                        Federal Mine Safety and Health Act of 1977 (30 
                        U.S.C. 801 et seq.), or the Atomic Energy Act 
                        of 1954 (42 U.S.C. 2011 et seq.); or
                          (ii) State genetic monitoring regulations, in 
                        the case of a State that is implementing 
                        genetic monitoring regulations under the 
                        authority of the Occupational Safety and Health 
                        Act of 1970 (29 U.S.C. 651 et seq.); and
                  (E) the employment agency, excluding any licensed 
                health care professional or board certified genetic 
                counselor that is involved in the genetic monitoring 
                program, receives the results of the monitoring only in 
                aggregate terms that do not disclose the identity of 
                specific individuals;
  (c) Preservation of Protections.--In the case of information to which 
any of paragraphs (1) through (5) of subsection (b) applies, such 
information may not be used in violation of paragraph (1) or (2) of 
subsection (a) or treated or disclosed in a manner that violates 
section 206.

SEC. 204. LABOR ORGANIZATION PRACTICES.

  (a) Use of Genetic Information.--It shall be an unlawful employment 
practice for a labor organization--
          (1) to exclude or to expel from the membership of the 
        organization, or otherwise to discriminate against, any member 
        because of genetic information with respect to the member (or 
        information about a request for or the receipt of genetic 
        services by such member or family member of such member);
          (2) to limit, segregate, or classify the members of the 
        organization, or fail or refuse to refer for employment any 
        member, in any way that would deprive or tend to deprive any 
        member of employment opportunities, or otherwise adversely 
        affect the status of the member as an employee, because of 
        genetic information with respect to the member (or information 
        about a request for or the receipt of genetic services by such 
        member or family member of such member); or
          (3) to cause or attempt to cause an employer to discriminate 
        against a member in violation of this title.
  (b) Acquisition of Genetic Information.--It shall be an unlawful 
employment practice for a labor organization to request, require, or 
purchase genetic information with respect to a member or a family 
member of the member (or information about a request for the receipt of 
genetic services by such member or a family member of such member) 
except--
          (1) where a labor organization inadvertently requests or 
        requires family medical history of the member or family member 
        of the member;
          (2) where--
                  (A) health or genetic services are offered by the 
                labor organization, including such services offered as 
                part of a bona fide wellness program;
                  (B) the member provides prior, knowing, voluntary, 
                and written authorization;
                  (C) only the member (or family member if the family 
                member is receiving genetic services) and the licensed 
                health care professional or board certified genetic 
                counselor involved in providing such services receive 
                individually identifiable information concerning the 
                results of such services; and
                  (D) any individually identifiable genetic information 
                provided under subparagraph (C) in connection with the 
                services provided under subparagraph (A) is only 
                available for purposes of such services and shall not 
                be disclosed to the labor organization except in 
                aggregate terms that do not disclose the identity of 
                specific members;
          (3) where a labor organization requests or requires family 
        medical history from the members to comply with the 
        certification provisions of section 103 of the Family and 
        Medical Leave Act of 1993 (29 U.S.C. 2613) or such requirements 
        under State family and medical leave laws;
          (4) where a labor organization purchases documents that are 
        commercially and publicly available (including newspapers, 
        magazines, periodicals, and books, but not including medical 
        databases or court records) that include family medical 
        history; or
          (5) where the information involved is to be used for genetic 
        monitoring of the biological effects of toxic substances in the 
        workplace, but only if--
                  (A) the labor organization provides written notice of 
                the genetic monitoring to the member;
                  (B)(i) the member provides prior, knowing, voluntary, 
                and written authorization; or
                  (ii) the genetic monitoring is required by Federal or 
                State law;
                  (C) the member is informed of individual monitoring 
                results;
                  (D) the monitoring is in compliance with--
                          (i) any Federal genetic monitoring 
                        regulations, including any such regulations 
                        that may be promulgated by the Secretary of 
                        Labor pursuant to the Occupational Safety and 
                        Health Act of 1970 (29 U.S.C. 651 et seq.), the 
                        Federal Mine Safety and Health Act of 1977 (30 
                        U.S.C. 801 et seq.), or the Atomic Energy Act 
                        of 1954 (42 U.S.C. 2011 et seq.); or
                          (ii) State genetic monitoring regulations, in 
                        the case of a State that is implementing 
                        genetic monitoring regulations under the 
                        authority of the Occupational Safety and Health 
                        Act of 1970 (29 U.S.C. 651 et seq.); and
                  (E) the labor organization, excluding any licensed 
                health care professional or board certified genetic 
                counselor that is involved in the genetic monitoring 
                program, receives the results of the monitoring only in 
                aggregate terms that do not disclose the identity of 
                specific members;
  (c) Preservation of Protections.--In the case of information to which 
any of paragraphs (1) through (5) of subsection (b) applies, such 
information may not be used in violation of paragraph (1) or (2) of 
subsection (a) or treated or disclosed in a manner that violates 
section 206.

SEC. 205. TRAINING PROGRAMS.

  (a) Use of Genetic Information.--It shall be an unlawful employment 
practice for any employer, labor organization, or joint labor-
management committee controlling apprenticeship or other training or 
retraining, including on-the-job training programs--
          (1) to discriminate against any individual because of genetic 
        information with respect to the individual (or information 
        about a request for or the receipt of genetic services by such 
        individual or a family member of such individual) in admission 
        to, or employment in, any program established to provide 
        apprenticeship or other training or retraining;
          (2) to limit, segregate, or classify the applicants for or 
        participants in such apprenticeship or other training or 
        retraining, or fail or refuse to refer for employment any 
        individual, in any way that would deprive or tend to deprive 
        any individual of employment opportunities, or otherwise 
        adversely affect the status of the individual as an employee, 
        because of genetic information with respect to the individual 
        (or information about a request for or receipt of genetic 
        services by such individual or family member of such 
        individual); or
          (3) to cause or attempt to cause an employer to discriminate 
        against an applicant for or a participant in such 
        apprenticeship or other training or retraining in violation of 
        this title.
  (b) Acquisition of Genetic Information.--It shall be an unlawful 
employment practice for an employer, labor organization, or joint 
labor-management committee described in subsection (a) to request, 
require, or purchase genetic information with respect to an individual 
or a family member of the individual (or information about a request 
for the receipt of genetic services by such individual or a family 
member of such individual) except--
          (1) where the employer, labor organization, or joint labor-
        management committee inadvertently requests or requires family 
        medical history of the individual or family member of the 
        individual;
          (2) where--
                  (A) health or genetic services are offered by the 
                employer, labor organization, or joint labor-management 
                committee, including such services offered as part of a 
                bona fide wellness program;
                  (B) the individual provides prior, knowing, 
                voluntary, and written authorization;
                  (C) only the individual (or family member if the 
                family member is receiving genetic services) and the 
                licensed health care professional or board certified 
                genetic counselor involved in providing such services 
                receive individually identifiable information 
                concerning the results of such services;
                  (D) any individually identifiable genetic information 
                provided under subparagraph (C) in connection with the 
                services provided under subparagraph (A) is only 
                available for purposes of such services and shall not 
                be disclosed to the employer, labor organization, or 
                joint labor-management committee except in aggregate 
                terms that do not disclose the identity of specific 
                individuals;
          (3) where the employer, labor organization, or joint labor-
        management committee requests or requires family medical 
        history from the individual to comply with the certification 
        provisions of section 103 of the Family and Medical Leave Act 
        of 1993 (29 U.S.C. 2613) or such requirements under State 
        family and medical leave laws;
          (4) where the employer, labor organization, or joint labor-
        management committee purchases documents that are commercially 
        and publicly available (including newspapers, magazines, 
        periodicals, and books, but not including medical databases or 
        court records) that include family medical history; or
          (5) where the information involved is to be used for genetic 
        monitoring of the biological effects of toxic substances in the 
        workplace, but only if--
                  (A) the employer, labor organization, or joint labor-
                management committee provides written notice of the 
                genetic monitoring to the individual;
                  (B)(i) the individual provides prior, knowing, 
                voluntary, and written authorization; or
                  (ii) the genetic monitoring is required by Federal or 
                State law;
                  (C) the individual is informed of individual 
                monitoring results;
                  (D) the monitoring is in compliance with--
                          (i) any Federal genetic monitoring 
                        regulations, including any such regulations 
                        that may be promulgated by the Secretary of 
                        Labor pursuant to the Occupational Safety and 
                        Health Act of 1970 (29 U.S.C. 651 et seq.), the 
                        Federal Mine Safety and Health Act of 1977 (30 
                        U.S.C. 801 et seq.), or the Atomic Energy Act 
                        of 1954 (42 U.S.C. 2011 et seq.); or
                          (ii) State genetic monitoring regulations, in 
                        the case of a State that is implementing 
                        genetic monitoring regulations under the 
                        authority of the Occupational Safety and Health 
                        Act of 1970 (29 U.S.C. 651 et seq.); and
                  (E) the employer, labor organization, or joint labor-
                management committee, excluding any licensed health 
                care professional or board certified genetic counselor 
                that is involved in the genetic monitoring program, 
                receives the results of the monitoring only in 
                aggregate terms that do not disclose the identity of 
                specific individuals;
  (c) Preservation of Protections.--In the case of information to which 
any of paragraphs (1) through (5) of subsection (b) applies, such 
information may not be used in violation of paragraph (1) or (2) of 
subsection (a) or treated or disclosed in a manner that violates 
section 206.

SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION.

  (a) Treatment of Information as Part of Confidential Medical 
Record.--If an employer, employment agency, labor organization, or 
joint labor-management committee possesses genetic information about an 
employee or member (or information about a request for or receipt of 
genetic services by such employee or member or family member of such 
employee or member), such information shall be maintained on separate 
forms and in separate medical files and be treated as a confidential 
medical record of the employee or member.
  (b) Limitation on Disclosure.--An employer, employment agency, labor 
organization, or joint labor-management committee shall not disclose 
genetic information concerning an employee or member (or information 
about a request for or receipt of genetic services by such employee or 
member or family member of such employee or member) except--
          (1) to the employee (or family member if the family member is 
        receiving the genetic services) or member of a labor 
        organization at the request of the employee or member of such 
        organization;
          (2) to an occupational or other health researcher if the 
        research is conducted in compliance with the regulations and 
        protections provided for under part 46 of title 45, Code of 
        Federal Regulations;
          (3) in response to an order of a court, except that--
                  (A) the employer, employment agency, labor 
                organization, or joint labor-management committee may 
                disclose only the genetic information expressly 
                authorized by such order; and
                  (B) if the court order was secured without the 
                knowledge of the employee or member to whom the 
                information refers, the employer, employment agency, 
                labor organization, or joint labor-management committee 
                shall provide the employee or member with adequate 
                notice to challenge the court order;
          (4) to government officials who are investigating compliance 
        with this title if the information is relevant to the 
        investigation; or
          (5) to the extent that such disclosure is made in connection 
        with the employee's compliance with the certification 
        provisions of section 103 of the Family and Medical Leave Act 
        of 1993 (29 U.S.C. 2613) or such requirements under State 
        family and medical leave laws.

SEC. 207. REMEDIES AND ENFORCEMENT.

  (a) Employees Covered by Title VII of the Civil Rights Act of 1964.--
          (1) In general.--The powers, remedies, and procedures 
        provided in sections 705, 706, 707, 709, 710, and 711 of the 
        Civil Rights Act of 1964 (42 U.S.C. 2000e-4 et seq.) to the 
        Commission, the Attorney General, or any person, alleging a 
        violation of title VII of that Act (42 U.S.C. 2000e et seq.) 
        shall be the powers, remedies, and procedures this title 
        provides to the Commission, the Attorney General, or any 
        person, respectively, alleging an unlawful employment practice 
        in violation of this title against an employee described in 
        section 201(2)(A)(i), except as provided in paragraphs (2) and 
        (3).
          (2) Costs and fees.--The powers, remedies, and procedures 
        provided in subsections (b) and (c) of section 722 of the 
        Revised Statutes (42 U.S.C. 1988), shall be powers, remedies, 
        and procedures this title provides to the Commission, the 
        Attorney General, or any person, alleging such a practice.
          (3) Damages.--The powers, remedies, and procedures provided 
        in section 1977A of the Revised Statutes (42 U.S.C. 1981a), 
        including the limitations contained in subsection (b)(3) of 
        such section 1977A, shall be powers, remedies, and procedures 
        this title provides to the Commission, the Attorney General, or 
        any person, alleging such a practice (not an employment 
        practice specifically excluded from coverage under section 
        1977A(a)(1) of the Revised Statutes).
  (b) Employees Covered by Government Employee Rights Act of 1991.--
          (1) In general.--The powers, remedies, and procedures 
        provided in sections 302 and 304 of the Government Employee 
        Rights Act of 1991 (42 U.S.C. 2000e-16b, 2000e-16c) to the 
        Commission, or any person, alleging a violation of section 
        302(a)(1) of that Act (42 U.S.C. 2000e-16b(a)(1)) shall be the 
        powers, remedies, and procedures this title provides to the 
        Commission, or any person, respectively, alleging an unlawful 
        employment practice in violation of this title against an 
        employee described in section 201(2)(A)(ii), except as provided 
        in paragraphs (2) and (3).
          (2) Costs and fees.--The powers, remedies, and procedures 
        provided in subsections (b) and (c) of section 722 of the 
        Revised Statutes (42 U.S.C. 1988), shall be powers, remedies, 
        and procedures this title provides to the Commission, or any 
        person, alleging such a practice.
          (3) Damages.--The powers, remedies, and procedures provided 
        in section 1977A of the Revised Statutes (42 U.S.C. 1981a), 
        including the limitations contained in subsection (b)(3) of 
        such section 1977A, shall be powers, remedies, and procedures 
        this title provides to the Commission, or any person, alleging 
        such a practice (not an employment practice specifically 
        excluded from coverage under section 1977A(a)(1) of the Revised 
        Statutes).
  (c) Employees Covered by Congressional Accountability Act of 1995.--
          (1) In general.--The powers, remedies, and procedures 
        provided in the Congressional Accountability Act of 1995 (2 
        U.S.C. 1301 et seq.) to the Board (as defined in section 101 of 
        that Act (2 U.S.C. 1301)), or any person, alleging a violation 
        of section 201(a)(1) of that Act (42 U.S.C. 1311(a)(1)) shall 
        be the powers, remedies, and procedures this title provides to 
        that Board, or any person, alleging an unlawful employment 
        practice in violation of this title against an employee 
        described in section 201(2)(A)(iii), except as provided in 
        paragraphs (2) and (3).
          (2) Costs and fees.--The powers, remedies, and procedures 
        provided in subsections (b) and (c) of section 722 of the 
        Revised Statutes (42 U.S.C. 1988), shall be powers, remedies, 
        and procedures this title provides to that Board, or any 
        person, alleging such a practice.
          (3) Damages.--The powers, remedies, and procedures provided 
        in section 1977A of the Revised Statutes (42 U.S.C. 1981a), 
        including the limitations contained in subsection (b)(3) of 
        such section 1977A, shall be powers, remedies, and procedures 
        this title provides to that Board, or any person, alleging such 
        a practice (not an employment practice specifically excluded 
        from coverage under section 1977A(a)(1) of the Revised 
        Statutes).
          (4) Other applicable provisions.--With respect to a claim 
        alleging a practice described in paragraph (1), title III of 
        the Congressional Accountability Act of 1995 (2 U.S.C. 1381 et 
        seq.) shall apply in the same manner as such title applies with 
        respect to a claim alleging a violation of section 201(a)(1) of 
        such Act (2 U.S.C. 1311(a)(1)).
  (d) Employees Covered by Chapter 5 of Title 3, United States Code.--
          (1) In general.--The powers, remedies, and procedures 
        provided in chapter 5 of title 3, United States Code, to the 
        President, the Commission, the Merit Systems Protection Board, 
        or any person, alleging a violation of section 411(a)(1) of 
        that title, shall be the powers, remedies, and procedures this 
        title provides to the President, the Commission, such Board, or 
        any person, respectively, alleging an unlawful employment 
        practice in violation of this title against an employee 
        described in section 201(2)(A)(iv), except as provided in 
        paragraphs (2) and (3).
          (2) Costs and fees.--The powers, remedies, and procedures 
        provided in subsections (b) and (c) of section 722 of the 
        Revised Statutes (42 U.S.C. 1988), shall be powers, remedies, 
        and procedures this title provides to the President, the 
        Commission, such Board, or any person, alleging such a 
        practice.
          (3) Damages.--The powers, remedies, and procedures provided 
        in section 1977A of the Revised Statutes (42 U.S.C. 1981a), 
        including the limitations contained in subsection (b)(3) of 
        such section 1977A, shall be powers, remedies, and procedures 
        this title provides to the President, the Commission, such 
        Board, or any person, alleging such a practice (not an 
        employment practice specifically excluded from coverage under 
        section 1977A(a)(1) of the Revised Statutes).
  (e) Employees Covered by Section 717 of the Civil Rights Act of 
1964.--
          (1) In general.--The powers, remedies, and procedures 
        provided in section 717 of the Civil Rights Act of 1964 (42 
        U.S.C. 2000e-16) to the Commission, the Attorney General, the 
        Librarian of Congress, or any person, alleging a violation of 
        that section shall be the powers, remedies, and procedures this 
        title provides to the Commission, the Attorney General, the 
        Librarian of Congress, or any person, respectively, alleging an 
        unlawful employment practice in violation of this title against 
        an employee or applicant described in section 201(2)(A)(v), 
        except as provided in paragraphs (2) and (3).
          (2) Costs and fees.--The powers, remedies, and procedures 
        provided in subsections (b) and (c) of section 722 of the 
        Revised Statutes (42 U.S.C. 1988), shall be powers, remedies, 
        and procedures this title provides to the Commission, the 
        Attorney General, the Librarian of Congress, or any person, 
        alleging such a practice.
          (3) Damages.--The powers, remedies, and procedures provided 
        in section 1977A of the Revised Statutes (42 U.S.C. 1981a), 
        including the limitations contained in subsection (b)(3) of 
        such section 1977A, shall be powers, remedies, and procedures 
        this title provides to the Commission, the Attorney General, 
        the Librarian of Congress, or any person, alleging such a 
        practice (not an employment practice specifically excluded from 
        coverage under section 1977A(a)(1) of the Revised Statutes).
  (f) Definition.--In this section, the term ``Commission'' means the 
Equal Employment Opportunity Commission.

SEC. 208. DISPARATE IMPACT.

  (a) General Rule.--Notwithstanding any other provision of this Act, 
``disparate impact'', as that term is used in section 703(k) of the 
Civil Rights Act of 1964 (42 U.S.C. 2000e-2(k)), on the basis of 
genetic information does not establish a cause of action under this 
Act.
  (b) Commission.--On the date that is 6 years after the date of 
enactment of this Act, there shall be established a commission, to be 
known as the Genetic Nondiscrimination Study Commission (referred to in 
this section as the ``Commission'') to review the developing science of 
genetics and to make recommendations to Congress regarding whether to 
provide a disparate impact cause of action under this Act.
  (c) Membership.--
          (1) In general.--The Commission shall be composed of 8 
        members, of which--
                  (A) 1 member shall be appointed by the Majority 
                Leader of the Senate;
                  (B) 1 member shall be appointed by the Minority 
                Leader of the Senate;
                  (C) 1 member shall be appointed by the Chairman of 
                the Committee on Health, Education, Labor, and Pensions 
                of the Senate;
                  (D) 1 member shall be appointed by the ranking 
                minority member of the Committee on Health, Education, 
                Labor, and Pensions of the Senate;
                  (E) 1 member shall be appointed by the Speaker of the 
                House of Representatives;
                  (F) 1 member shall be appointed by the Minority 
                Leader of the House of Representatives;
                  (G) 1 member shall be appointed by the Chairman of 
                the Committee on Education and the Workforce of the 
                House of Representatives; and
                  (H) 1 member shall be appointed by the ranking 
                minority member of the Committee on Education and the 
                Workforce of the House of Representatives.
          (2) Compensation and expenses.--The members of the Commission 
        shall not receive compensation for the performance of services 
        for the Commission, but shall be allowed travel expenses, 
        including per diem in lieu of subsistence, at rates authorized 
        for employees of agencies under subchapter I of chapter 57 of 
        title 5, United States Code, while away from their homes or 
        regular places of business in the performance of services for 
        the Commission.
  (d) Administrative Provisions.--
          (1) Location.--The Commission shall be located in a facility 
        maintained by the Equal Employment Opportunity Commission.
          (2) Detail of government employees.--Any Federal Government 
        employee may be detailed to the Commission without 
        reimbursement, and such detail shall be without interruption or 
        loss of civil service status or privilege.
          (3) Information from federal agencies.--The Commission may 
        secure directly from any Federal department or agency such 
        information as the Commission considers necessary to carry out 
        the provisions of this section. Upon request of the Commission, 
        the head of such department or agency shall furnish such 
        information to the Commission.
          (4) Hearings.--The Commission may hold such hearings, sit and 
        act at such times and places, take such testimony, and receive 
        such evidence as the Commission considers advisable to carry 
        out the objectives of this section, except that, to the extent 
        possible, the Commission shall use existing data and research.
          (5) Postal services.--The Commission may use the United 
        States mails in the same manner and under the same conditions 
        as other departments and agencies of the Federal Government.
  (e) Report.--Not later than 1 year after all of the members are 
appointed to the Commission under subsection (c)(1), the Commission 
shall submit to Congress a report that summarizes the findings of the 
Commission and makes such recommendations for legislation as are 
consistent with this Act.
  (f) Authorization of Appropriations.--There are authorized to be 
appropriated to the Equal Employment Opportunity Commission such sums 
as may be necessary to carry out this section.

SEC. 209. CONSTRUCTION.

  Nothing in this title shall be construed to--
          (1) limit the rights or protections of an individual under 
        the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et 
        seq.), including coverage afforded to individuals under section 
        102 of such Act (42 U.S.C. 12112), or under the Rehabilitation 
        Act of 1973 (29 U.S.C. 701 et seq.);
          (2)(A) limit the rights or protections of an individual to 
        bring an action under this title against an employer, 
        employment agency, labor organization, or joint labor-
        management committee for a violation of this title; or
          (B) establish a violation under this title for an employer, 
        employment agency, labor organization, or joint labor-
        management committee of a provision of the amendments made by 
        title I;
          (3) limit the rights or protections of an individual under 
        any other Federal or State statute that provides equal or 
        greater protection to an individual than the rights or 
        protections provided for under this title;
          (4) apply to the Armed Forces Repository of Specimen Samples 
        for the Identification of Remains;
          (5) limit or expand the protections, rights, or obligations 
        of employees or employers under applicable workers' 
        compensation laws;
          (6) limit the authority of a Federal department or agency to 
        conduct or sponsor occupational or other health research that 
        is conducted in compliance with the regulations contained in 
        part 46 of title 45, Code of Federal Regulations (or any 
        corresponding or similar regulation or rule); and
          (7) limit the statutory or regulatory authority of the 
        Occupational Safety and Health Administration or the Mine 
        Safety and Health Administration to promulgate or enforce 
        workplace safety and health laws and regulations.

SEC. 210. MEDICAL INFORMATION THAT IS NOT GENETIC INFORMATION.

  An employer, employment agency, labor organization, or joint labor-
management committee shall not be considered to be in violation of this 
title based on the use, acquisition, or disclosure of medical 
information that is not genetic information about a manifested disease, 
disorder, or pathological condition of an employee or member, including 
a manifested disease, disorder, or pathological condition that has or 
may have a genetic basis.

SEC. 211. REGULATIONS.

  Not later than 1 year after the date of enactment of this title, the 
Commission shall issue final regulations in an accessible format to 
carry out this title.

SEC. 212. AUTHORIZATION OF APPROPRIATIONS.

  There are authorized to be appropriated such sums as may be necessary 
to carry out this title (except for section 208).

SEC. 213. EFFECTIVE DATE.

  This title takes effect on the date that is 18 months after the date 
of enactment of this Act.

                   TITLE III--MISCELLANEOUS PROVISION

SEC. 301. SEVERABILITY.

  If any provision of this Act, an amendment made by this Act, or the 
application of such provision or amendment to any person or 
circumstance is held to be unconstitutional, the remainder of this Act, 
the amendments made by this Act, and the application of such provisions 
to any person or circumstance shall not be affected thereby.

                       I. SUMMARY AND BACKGROUND

                         A. Purpose and Summary

                                PURPOSE

    The bill adopts national, uniform standards of protection 
against discrimination in health insurance and employment based 
on genetic information. Establishing these standards will allay 
concerns about the potential for discrimination and encourage 
individuals to participate in genetic research and to take 
advantage of genetic testing and new therapies. The standards 
will provide substantive protections to those individuals who 
may suffer from actual genetic discrimination now and in the 
future. The adoption of the standards is essential to 
fulfilling the promise of the human genome project and 
improving the health and longevity of the American people.

                                SUMMARY

    The provisions of the bill, H.R. 493, as adopted by the 
Committee, are as follows:
           Section 103 prohibits a group health plan 
        from adjusting premiums or contribution amounts for the 
        group on the basis of genetic information and from 
        requesting or requiring genetic testing. Section 103 
        also restricts a group health plan's collection of 
        genetic information. The Committee bill enforces these 
        prohibitions through the use of an excise tax on group 
        health plans that fail to comply with these rules. This 
        same enforcement mechanism is used under present law 
        with respect to similar health care provisions, 
        including provisions relating to mental heath parity, 
        limitations on pre-existing condition exclusions, the 
        prohibition on discrimination based on health status, 
        and the rules relating to benefits for mothers and 
        newborns.
           Section 104 prohibits an issuer of a 
        Medicare supplemental policy from denying or 
        conditioning the issuance of a policy, discriminating 
        in the price of the policy, or applying pre-existing 
        condition exclusions to the policy on the basis of 
        genetic information. Section 104 also prohibits an 
        issuer of a Medicare supplemental policy from 
        requesting or requiring genetic testing and restricts 
        an issuer's collection of genetic information.
           Section 105 directs the Secretary of Health 
        and Human Services to conform our nation's privacy laws 
        governing health information to the provisions in this 
        bill.
           Sections 106 and 107 require that the 
        Secretary of the Treasury, the Secretary of Health and 
        Human Services, and the Secretary of Labor coordinate 
        administration and enforcement and issue regulations 
        with respect to the standards protecting against 
        genetic discrimination.

                 B. Background and Need for Legislation

    Advances in the science of genetics open major new 
opportunities for medical progress, including earlier detection 
of illnesses. These developments can provide individuals with 
the opportunity to take steps to reduce the likelihood that 
they will contract a particular disorder. These developments 
also facilitate more advanced treatments. These advances will 
also give rise to the potential for the misuse of genetic 
information to discriminate in the areas of health insurance 
and employment. Past experience with sterilization laws, as 
well as examples of current genetic discrimination, have 
created the need to protect against the misuse of genetic 
information.

                         C. Legislative History

                               BACKGROUND

    H.R. 493 was introduced in the House of Representatives on 
January 16, 2007, and was referred to the Committee on 
Education and Labor, the Committee on Energy and Commerce, and 
the Committee on Ways and Means for a period to be determined 
by the Speaker of the House, in each case for consideration of 
such provisions as fall within the jurisdiction of the 
Committee concerned. The bill, as amended, was favorably 
reported by the Committee on Education and Labor on March 5, 
2007, H. Rept. No. 110-28.

                           COMMITTEE HEARINGS

    The Subcommittee on Health of the Committee on Ways and 
Means conducted a hearing on the bill on March 14, 2007.

                            COMMITTEE ACTION

    The Committee on Ways and Means marked up the bill on March 
21, 2007, and ordered the bill, as amended, favorably reported.

                      II. EXPLANATION OF THE BILL

 A. Prohibition of Discrimination Based on Genetic Testing (Secs. 103, 
    106, and 107 of the Bill and Sec. 9802 and New Sec. 9834 of the 
                         Internal Revenue Code)

                              PRESENT LAW

    The Health Insurance Portability and Accountability Act of 
1996 (``HIPAA'') imposes a number of requirements with respect 
to group health coverage that are designed to provide 
protections to health plan participants. The requirements are 
enforced through the Internal Revenue Code of 1986, as amended 
(the ``Code''), the Employee Retirement Income Security Act of 
1974 (``ERISA''), and the Public Health Service Act (``PHSA'').
    Under present law, HIPAA provides certain protections 
against genetic discrimination. Among other things, HIPAA 
provides that a group health plan may not establish rules for 
eligibility of any individual to enroll under the plan based on 
genetic information.\1\ Under final regulations issued by the 
Department of Treasury pursuant to HIPAA, any restriction on 
benefits provided under a group health plan must apply 
uniformly to all similarly situated individuals and must not be 
directed at individual participants or beneficiaries based on 
genetic information of the participants or beneficiaries.\2\ A 
group health plan also may not require an individual to pay a 
premium or contribution which is greater than such premium or 
contribution for a similarly situated individual enrolled in 
the plan on the basis of genetic information of the individual 
or of a dependent enrolled under the plan.\3\
---------------------------------------------------------------------------
    \1\ Code sec. 9802(a).
    \2\ Treas. Reg. sec. 54.9802-1(b)(2)(i)(B).
    \3\ Code sec. 9802(b).
---------------------------------------------------------------------------
    In addition, HIPAA generally provides that a pre-existing 
condition exclusion may be imposed with respect to a 
participant or beneficiary only if: (1) the exclusion relates 
to a condition (whether physical or mental), regardless of the 
cause of the condition, for which medical advice, diagnosis, 
care, or treatment was recommended or received within the 6-
month period ending on the enrollment date; (2) the exclusion 
extends for a period of not more than 12 months after the 
enrollment date; and (3) the period of any pre-existing 
condition exclusion is reduced by the length of the aggregate 
of the periods of creditable coverage (if any) applicable to 
the participant as of the enrollment date. The limitation on 
preexisting condition exclusions applies to exclusions on the 
basis of genetic information.\4\
---------------------------------------------------------------------------
    \4\ Code sec. 9801.
---------------------------------------------------------------------------
    Under final regulations issued by the Department of 
Treasury, genetic information is defined as information about 
genes, gene products, and inherited characteristics that may 
derive from the individual or a family member. This includes 
information regarding carrier status and information derived 
from laboratory tests that identify mutations in specific genes 
or chromosomes, physical medical examinations, family 
histories, and direct analysis of genes or chromosomes.\5\
---------------------------------------------------------------------------
    \5\ Treas. Reg. sec. 54.9801-2.
---------------------------------------------------------------------------
    The requirements do not apply to any governmental plan or 
any group health plan that has less than two participants who 
are current employees. A group health plan is defined as a plan 
(including a self-insured plan) of, or contributed to by, an 
employer (including a self-employed person) or employee 
organization to provide health care (directly or otherwise) to 
the employees, former employees, the employer, others 
associated or formerly associated with the employer in a 
business relationship, or their families.
    The Code imposes an excise tax on group health plans which 
fail to meet these requirements.\6\ The excise tax is equal to 
$100 per day during the period of noncompliance and is 
generally imposed on the employer sponsoring the plan if the 
plan fails to meet the requirements. The maximum tax that can 
be imposed during a taxable year cannot exceed the lesser of: 
(1) 10 percent of the employer's group health plan expenses for 
the prior year; or (2) $500,000. No tax is imposed if the 
Secretary of the Treasury determines that the employer did not 
know, and in exercising reasonable diligence would not have 
known, that the failure existed.
---------------------------------------------------------------------------
    \6\ Code sec. 4980D.
---------------------------------------------------------------------------

                           REASONS FOR CHANGE

    The advances in genetics open up many opportunities for 
medical progress with respect to the prevention, detection, and 
treatment of disease. However, this information also presents 
the possibility for misuse. The Committee is aware of examples 
of genetic discrimination in the workforce and with respect to 
insurance. In some cases, genetic conditions and disorders are 
associated with particular racial and ethnic groups and gender. 
Because some genetic traits are most prevalent in particular 
groups, members of a particular group may be stigmatized or 
discriminated against as a result of genetic information. The 
Committee is concerned that the possibility of discrimination 
on the basis of genetic information may prohibit individuals 
from taking full advantage of the information that may be 
available. Thus, some individuals may not be receiving the best 
possible medical care. The Committee bill therefore adopts a 
uniform, national standard that prohibits discrimination based 
on genetic information. The Committee bill assures that the 
full array of enforcement mechanisms applicable to group health 
plans under the Code is available with respect to the 
prohibition on genetic discrimination under this provision.

                        EXPLANATION OF PROVISION

    The provision modifies the group health plan requirements 
under the Code.
    Under the provision, a group health plan may not adjust 
premium or contribution amounts for the group covered under 
such plan on the basis of genetic information. In the case of 
family members who are covered under the same group health 
plan, the group health plan is permitted to adjust premium or 
contribution amounts for the group on the basis of the 
occurrence of diseases or disorders in family members in the 
group, provided that such information is taken into account 
only with respect to the individual in which the disease or 
disorder occurs and not as genetic information with respect to 
family members in which the disease or disorder has not 
occurred.
    The provision also requires that a group health plan may 
not request or require an individual or family member of such 
individual to undergo a genetic test. The provision does not 
limit the authority of a health care professional who is 
providing health care services to an individual to request that 
such individual undergo a genetic test. The provision also does 
not limit the authority of a group health plan to provide 
information generally about the availability of genetic tests, 
for example, in the case of a summary plan description, or to 
provide information about genetic tests to a health care 
professional with respect to the treatment of an individual to 
whom such professional is providing health care services, for 
example, during a quality assurance review.
    The provision contains two rules with respect to a group 
health plan's collection of genetic information. First, a group 
health plan is prohibited from requesting, requiring, or 
purchasing genetic information for purposes of underwriting. 
Second, a group health plan is prohibited from requesting, 
requiring, or purchasing genetic information with respect to 
any individual prior to such individual's enrollment under the 
plan or in connection with such enrollment. The second 
prohibition is not violated where the collection of genetic 
information is incidental to the requesting, requiring, or 
purchasing of other information concerning the individual 
provided that such request, requirement or purchase is not for 
purposes of underwriting.
    The term underwriting, with respect to any group health 
plan, means: (1) rules for determining eligibility for, or 
determination of, benefits under the plan; (2) the computation 
of premium or contribution amounts under the plan; (3) the 
application of any pre-existing condition exclusion under the 
plan; and (4) other activities related to the creation, 
renewal, or replacement of a contract of health insurance or 
health benefits.
    Under the provision, the current law requirement that a 
group health plan may not establish rules for eligibility based 
on genetic information is extended to governmental plans and 
group health plans with less than two participants who are 
current employees. The provisions requiring (1) that group 
premiums or contribution amounts may not be adjusted on the 
basis of genetic information of an individual in the group, (2) 
that a group health plan may not request or require an 
individual or family member of such individual undergo a 
genetic test, and (3) that group health plans not collect 
genetic information for purposes of underwriting or in 
connection with enrollment also apply to all group health 
plans.
    Genetic information means, with respect to any individual, 
information about: (1) such individual's genetic tests; (2) the 
genetic tests of family members of such individual; and (3) the 
occurrence of a disease or disorder in family members of such 
individual. The term genetic information also includes, with 
respect to any individual, any request for genetic services, 
receipt of genetic services, or participation in any clinical 
research, or any other program, which includes genetic 
services, by such individual or any family member of such 
individual. The term genetic information does not include the 
occurrence of a disease or disorder in family members of an 
individual to the extent that such information is taken into 
account only with respect to the individual in which such 
disease or disorder occurs and not as genetic information with 
respect to any other individual.
    A genetic test is defined as an analysis of human DNA, RNA, 
chromosomes, proteins, or metabolites, that detects genotypes, 
mutations, or chromosomal changes. The term genetic test does 
not include (1) an analysis of proteins or metabolites that 
does not detect genotypes, mutations, or chromosomal changes, 
or (2) an analysis of proteins or metabolites that is directly 
related to a manifested disease, disorder, or pathological 
condition that could reasonably be detected by a health care 
professional with appropriate training and expertise in the 
field of medicine involved.
    Genetic services are defined as a genetic test, genetic 
counseling (such as obtaining, interpreting, or assessing 
genetic information), and genetic education.
    A family member means, with respect to an individual: (1) 
the spouse of the individual; (2) a child of such individual 
(by birth, adoption, or placement for adoption); and (3) any 
other individual who is a first-degree, second-degree, third-
degree, or fourth-degree relative of such individual or of an 
individual described in (1) or (2). In general, it is intended 
that the term ``family member'' be interpreted broadly so as to 
provide the maximum protection against discrimination.
    Under the provision, the Secretary of the Treasury is 
directed to issue regulations or other guidance to carry out 
the provision no later than one year after date of enactment. 
The Secretary of the Treasury is to coordinate administration 
and enforcement with the Secretary of Health and Human Services 
and the Secretary of Labor so that provisions over which two or 
more such Secretaries have jurisdiction are administered in the 
same manner and so as to avoid duplication of enforcement 
efforts.

                             EFFECTIVE DATE

    The provision is effective with respect to group health 
plans for plan years beginning after the date that is 18 months 
after the date of enactment.

  B. Medigap Provisions (Sec. 104 of the Bill and Section 1882 of the 
                         Social Security Act )

                              PRESENT LAW

    Under the Medicare statute, all insurers offering Medigap 
policies are required to offer open enrollment for six months 
from the date on which the individual is 65 years of age or 
older and is enrolled for benefits under Part B. During this 
time an insurer cannot deny the issuance, or discriminate in 
the pricing of a policy because of an individual's ``health 
status, claims experience, receipt of health care, or medical 
condition.'' However, the issuer may apply pre-existing 
condition exclusions for the policy during its first 6 months, 
based on a pre-existing condition for which the policy holder 
had received treatment or was otherwise diagnosed during the 6 
month period before the policy became effective. If an 
individual applies for a Medigap policy after the open 
enrollment period, the company is permitted to use medical 
underwriting. This means that the company can use an 
individual's medical history to decide whether or not to accept 
the application and how much to charge for the policy.
    The law also guarantees issuance of specified Medigap 
policies (without an exclusion based on a pre-existing 
condition) for certain persons whose previous supplementary 
coverage was terminated. Again, the insurer cannot deny the 
issuance, or discriminate in the pricing of a policy because of 
an individual's ``health status, claims experience, receipt of 
health care, or medical condition.'' This right must be 
exercised within 63 days of termination of other enrollment.
    The law states that no Medigap policy may be issued in a 
state unless: (1) the state's regulatory program has been 
approved by the Secretary as providing for the application and 
enforcement of the National Association of Insurance 
Commissioners' (NAIC's) Model Standards; or (2) (if the state's 
program has not been approved), the policy has been approved by 
the Secretary as meeting the standards. CMS published a Notice 
in the Federal Register on March 25, 2005, which recognized the 
latest version (with clarifications) adopted by the NAIC on 
September 8, 2004.

                        EXPLANATION OF PROVISION

    The bill would prohibit an issuer of a Medigap policy from: 
(1) denying or conditioning the issuance or effectiveness of a 
policy; (2) discriminating in the pricing of a policy; or (3) 
applying pre-existing condition exclusions based on an 
individual's genetic information (as defined in the bill). In 
addition, the rules and definitions of section 103 of the bill 
(relating to genetic nondiscrimination standards applicable to 
group health plans) generally apply to the issuer of a Medigap 
policy, except that the definition of the term family member 
does not include the individual's spouse or dependent child 
(except to the extent that the child is a first, second, third, 
or fourth-degree relative of the individual).
    A state identified by the Secretary as requiring a change 
in its statutes or regulations to conform its regulatory 
program to the requirements of this section would have until 
October 1, 2008, to make such a change before being considered 
out of compliance. States requiring a statutory change that do 
not meet in legislative session in 2008 would be given 
additional time to come into compliance. The bill would give 
NAIC until June 30, 2008, to modify its model regulation to 
conform to the requirements of this section. If NAIC failed to 
meet that deadline, the Secretary would have until October 1, 
2008, to make the modifications.

                             EFFECTIVE DATE

    The provision is effective with respect to an issuer of a 
Medigap policy for policy years beginning on or after the date 
that is 18 months after the date of enactment.

C. Provisions Relating to Privacy and Confidentiality (Sec. 105 of the 
         Bill and New Section 1180 of the Social Security Act)

                              PRESENT LAW

    Standards to protect the privacy of health information were 
issued pursuant to HIPAA's Administrative Simplification 
provisions. The HIPAA privacy rule (45 CFR Parts 160, 164) 
applies to individually identifiable health (including genetic) 
information that is created or received by individual and group 
health plans (the term encompasses both private and government 
plans, and HMOs) and health care providers. The rule, which 
took effect in April 2003, gives patients the right of access 
to their medical information and places certain limitations on 
when and how plans and providers may use and disclose medical 
information. Generally, plans and providers may use and 
disclose health information for treatment, payment, and health 
care operations (broadly defined) without the individual's 
authorization and with few restrictions. Thus, the privacy rule 
permits a health plan to use or disclose health (including 
genetic) information for underwriting, premium rating, and 
other activities related to the creation, renewal, or 
replacement of a contract of health insurance or health 
benefits.

                        EXPLANATION OF PROVISION

    The bill would require the Secretary, by rulemaking, to 
revise the HIPAA privacy rule as follows. First, genetic 
information (as defined in the bill) would be treated as health 
information under the privacy rule. This is already the case, 
but it is not made explicit in the rule. Second, the use and 
disclosure of genetic information by a group health plan, 
health insurance issuer, or issuer of a Medigap policy for 
underwriting and other activities related to the creation, 
renewal, or replacement of a contract of health insurance or 
health benefits would be prohibited.

                             EFFECTIVE DATE

    The bill would require the Secretary to publish a revision 
to the privacy rule in the Federal Register, not later than 60 
days after enactment. The revision would take effect upon 
publication, but may be further modified, after opportunity for 
public comment.

                      III. VOTES OF THE COMMITTEE

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the following statement is made 
concerning the votes of the Committee on Ways and Means in its 
consideration of the bill, H.R. 493, the Genetic 
Nondiscrimination Act of 2007.
    The bill, HR. 493, as amended, was ordered favorably 
reported by voice vote (with a quorum being present).

                     IV. BUDGET EFFECTS OF THE BILL

               A. Committee Estimate of Budgetary Effects

    In compliance with clause 3(d)(2) of rule XIII of the Rules 
of the House of Representatives, the following statement is 
made concerning the effects on the budget of the revenue 
provisions of the bill, H.R. 493 as reported.
    The effects of the bill on Federal budget receipts is 
presented in the cost estimate provided by the Congressional 
Budget Office (see below).

B. Statement Regarding New Budget Authority and Tax Expenditures Budget 
                               Authority

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee states that the 
bill involves no new or increased budget authority.

      C. Cost Estimate Prepared by the Congressional Budget Office

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, requiring a cost estimate 
prepared by the CBO, the following statement by CBO is 
provided.

H.R. 493--Genetic Information Nondiscrimination Act of 2007

    H.R. 493 would amend the Employee Retirement Income 
Security Act of 1974 (ERISA), the Public Health Service Act, 
Title XVIII of the Social Security Act, and the Internal 
Revenue Code of 1986 to prohibit the use of genetic information 
(including results of genetic tests and family history of 
disease) by employers in employment decisions and by health 
insurers and health plans in making enrollment determinations 
and setting insurance premiums.
    CBO estimates that enacting the bill would increase the 
number of individuals who obtain health insurance by about 600 
people per year, nearly all of whom would obtain insurance in 
the individual market. The bill would affect federal revenues 
because the premiums paid by some of those newly insured 
individuals would be tax-deductible.
    CBO estimates that enacting H.R. 493 would reduce revenues 
by less than $500,000 in each year from 2008 through 2017, by 
$1 million over the 2008-2012 period, and by $2 million over 
the 2008-2017 period. (These estimates include reductions in 
off-budget receipts from Social Security payroll taxes of less 
than $500,000 over the 2008-2012 period, and slightly less than 
$1 million over the 2008-2017 period.) The bill's requirements 
would apply to Medicare supplemental insurance, which could 
affect direct spending for Medicare. However, we estimate that 
the bill would have no significant effect on direct spending.
    The bill would require the Secretaries of Health and Human 
Services (HHS), Labor, and the Treasury to issue regulations to 
carry out the provisions of this bill, and would require the 
Secretaries of HHS and Labor to enforce those provisions. In 
addition, six years after enactment, the bill would establish a 
commission to review the science of genetics and to make 
recommendations to the Congress on the need to establish a 
disparate impact standard for genetic discrimination. The bill 
would authorize the appropriation of such sums as necessary to 
establish the commission and to carry out the other provisions 
of the bill. Assuming the availability of appropriated funds, 
CBO estimates that implementing H.R. 493 would incur 
discretionary costs of less than $500,000 in 2008 and $2 
million over the 2008-2017 period.
    Because H.R. 493 would limit state and local employment 
practices and broaden an existing preemption of state law, it 
contains intergovernmental mandates as defined in the Unfunded 
Mandates Reform Act (UMRA). The bill would restrict how state 
and local governments use genetic information in employment 
practices and in the provision of health care to employees. It 
also would broaden the scope of federal regulations that govern 
the confidentiality of health information to include genetic 
information, and in so doing, it would preempt state laws that 
apply to such information. There is little indication that 
state, local, or tribal governments currently engage in or are 
likely to engage in the activities that would be prohibited by 
the bill. Consequently, CBO estimates that the costs of the 
mandates would not be significant and would not exceed the 
threshold established in UMRA ($66 million in 2007, adjusted 
annually for inflation).
    The bill also contains private-sector mandates on health 
insurers, health plans, employers, labor unions, and other 
organizations by restricting how those entities use genetic 
information in employment practices and in the provision of 
health care to employees. CBO estimates that the direct cost of 
those requirements would not exceed the annual threshold 
specified in UMRA ($131 million in 2007, adjusted annually for 
inflation) in any of the first five years the mandates would be 
effective.
    On March 2, 2007, CBO transmitted a cost estimate for H.R. 
493, the Genetic Information Nondiscrimination Act of 2007, as 
ordered reported by the House Committee on Education and Labor 
on February 14, 2007. The Ways and Means Committee's version of 
H.R. 493 differs from the previous version in that it would 
also make conforming modifications to the Internal Revenue 
Code. CBO and the Joint Committee on Taxation estimate those 
conforming modifications would have no incremental budgetary 
effect. Thus, CBO's estimates for the two versions of the 
legislation are identical.
    The CBO staff contacts for this estimate are Shinobu Suzuki 
(for federal costs), Leo Lex (for the state and local impact), 
and David Auerbach (for the private-sector impact). This 
estimate was approved by Peter H. Fontaine, Deputy Assistant 
Director for Budget Analysis.

                    D. Macroeconomic Impact Analysis

    In compliance with clause 3(h)(2) of rule XIII of the Rules 
of the House of Representatives, the following statement is 
made by the Joint Committee on Taxation with respect to the 
provisions of the bill amending the Internal Revenue Code of 
1986: the effects of the bill on economic activity are so small 
as to be incalculable within the context of a model of the 
aggregate economy.

                             E. PAY-GO Rule

    In compliance with clause 10 of rule XXI of the Rules of 
the House of Representatives, the following statement is made 
concerning the effects on the budget of the revenue provisions 
of the bill, H.R. 493, as reported: the provisions of the bill 
affecting revenues have the following net effect on the deficit 
or surplus: (1) the bill would not increase the deficit or 
reduce the surplus in fiscal year 2007; (2) the bill would 
increase the deficit or reduce the surplus by $1 million over 
the fiscal year 2008-2012 period; and (2) the bill would 
increase the deficit or reduce the surplus by $2 million over 
the fiscal year 2008-2017 period.

     V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE

          A. Committee Oversight Findings and Recommendations

    With respect to clause 3(c)(1) of rule XIII of the Rules of 
the House of Representatives (relating to oversight findings), 
the Committee advises that it is appropriate and timely to 
enact the provisions included in the bill as reported.

        B. Statement of General Performance Goals and Objectives

    With respect to clause 3(c)(4) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
bill contains no measure that authorizes funding, so no 
statement of general performance goals and objectives for which 
any measure authorizes funding is required.

                 C. Constitutional Authority Statement

    With respect to clause 3(d)(1) of rule XIII of the Rules of 
the House of Representatives (relating to Constitutional 
Authority), the Committee states that the Committee's action in 
reporting this bill is derived from Article I of the 
Constitution, Section 8 (``The Congress shall have Power To lay 
and collect Taxes, Duties, Imposts and Excises . . .''), and 
from the 16th Amendment to the Constitution.

              D. Information Relating to Unfunded Mandates

    This information is provided in accordance with section 423 
of the Unfunded Mandates Act of 1995 (Pub. L. No. 104-4).
    The Committee has determined that the revenue provisions of 
the bill contain no Federal private sector mandates or Federal 
intergovernmental mandates on State, local, or tribal 
governments within the meaning of the Unfunded Mandates Act.

                E. Applicability of House Rule XXI 5(b)

    Clause 5 of rule XXI of the Rules of the House of 
Representatives provides, in part, that ``A bill or joint 
resolution, amendment, or conference report carrying a Federal 
income tax rate increase may not be considered as passed or 
agreed to unless so determined by a vote of not less than 
three-fifths of the Members voting, a quorum being present.'' 
The Committee has carefully reviewed the provisions of the 
bill, and states that the provisions of the bill do not involve 
any Federal income tax rate increases within the meaning of the 
rule.

                       F. Tax Complexity Analysis

    Section 4022(b) of the Internal Revenue Service Reform and 
Restructuring Act of 1998 (the ``IRS Reform Act'') requires the 
Joint Committee on Taxation (in consultation with the Internal 
Revenue Service and the Department of the Treasury) to provide 
a tax complexity analysis. The complexity analysis is required 
for all legislation reported by the Senate Committee on 
Finance, the House Committee on Ways and Means, or any 
committee of conference if the legislation includes a provision 
that directly or indirectly amends the Internal Revenue Code 
and has widespread applicability to individuals or small 
businesses.
    The staff of the Joint Committee on Taxation has determined 
that a complexity analysis is not required under section 
4022(b) of the IRS Reform Act because the bill contains no 
provisions that amend the Code and that have ``widespread 
applicability'' to individuals or small businesses.

                        G. Limited Tax Benefits

    Pursuant to clause 9 of rule XXI of the Rules of the House 
of Representatives, the Ways and Means Committee has determined 
that the bill as reported contains no congressional earmarks, 
limited tax benefits, or limited tariff benefits within the 
meaning of that Rule.

       VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974

           *       *       *       *       *       *       *

TITLE I--PROTECTION OF EMPLOYEE BENEFIT RIGHTS

           *       *       *       *       *       *       *

Subtitle B--Regulatory Provisions 

           *       *       *       *       *       *       *

Part 5--Administration and Enforcement

           *       *       *       *       *       *       *

                           CIVIL ENFORCEMENT

  Sec. 502. (a) * * *

           *       *       *       *       *       *       *

  (n) Enforcement of Genetic Nondiscrimination Requirements.--
          (1) Injunctive relief for irreparable harm.--With 
        respect to any violation of subsection (a)(1)(F), 
        (b)(3), or (c) of section 702, a participant or 
        beneficiary may seek relief under subsection 
        502(a)(1)(B) prior to the exhaustion of available 
        administrative remedies under section 503 if it is 
        demonstrated to the court, by a preponderance of the 
        evidence, that the exhaustion of such remedies would 
        cause irreparable harm to the health of the participant 
        or beneficiary. Any determinations that already have 
        been made under section 503 in such case, or that are 
        made in such case while an action under this paragraph 
        is pending, shall be given due consideration by the 
        court in any action under this subsection in such case.
          (2) Equitable relief for genetic nondiscrimination.--
                  (A) Reinstatement of benefits where equitable 
                relief has been awarded.--The recovery of 
                benefits by a participant or beneficiary under 
                a civil action under this section may include 
                an administrative penalty under subparagraph 
                (B) and the retroactive reinstatement of 
                coverage under the plan involved to the date on 
                which the participant or beneficiary was denied 
                eligibility for coverage if--
                          (i) the civil action was commenced 
                        under subsection (a)(1)(B); and
                          (ii) the denial of coverage on which 
                        such civil action was based constitutes 
                        a violation of subsection (a)(1)(F), 
                        (b)(3), or (c) of section 702.
                  (B) Administrative penalty.--
                          (i) In general.--An administrator who 
                        fails to comply with the requirements 
                        of subsection (a)(1)(F), (b)(3), or (c) 
                        of section 702 with respect to a 
                        participant or beneficiary may, in an 
                        action commenced under subsection 
                        (a)(1)(B), be personally liable in the 
                        discretion of the court, for a penalty 
                        in the amount not more than $100 for 
                        each day in the noncompliance period.
                          (ii) Noncompliance period.--For 
                        purposes of clause (i), the term 
                        ``noncompliance period'' means the 
                        period--
                                  (I) beginning on the date 
                                that a failure described in 
                                clause (i) occurs; and
                                  (II) ending on the date that 
                                such failure is corrected.
                          (iii) Payment to participant or 
                        beneficiary.--A penalty collected under 
                        this subparagraph shall be paid to the 
                        participant or beneficiary involved.
          (3) Secretarial enforcement authority.--
                  (A) General rule.--The Secretary has the 
                authority to impose a penalty on any failure of 
                a group health plan to meet the requirements of 
                subsection (a)(1)(F), (b)(3), or (c) of section 
                702.
                  (B) Amount.--
                          (i) In general.--The amount of the 
                        penalty imposed by subparagraph (A) 
                        shall be $100 for each day in the 
                        noncompliance period with respect to 
                        each individual to whom such failure 
                        relates.
                          (ii) Noncompliance period.--For 
                        purposes of this paragraph, the term 
                        ``noncompliance period'' means, with 
                        respect to any failure, the period--
                                  (I) beginning on the date 
                                such failure first occurs; and
                                  (II) ending on the date such 
                                failure is corrected.
                  (C) Minimum penalties where failure 
                discovered.--Notwithstanding clauses (i) and 
                (ii) of subparagraph (D):
                          (i) In general.--In the case of 1 or 
                        more failures with respect to an 
                        individual--
                                  (I) which are not corrected 
                                before the date on which the 
                                plan receives a notice from the 
                                Secretary of such violation; 
                                and
                                  (II) which occurred or 
                                continued during the period 
                                involved;
                        the amount of penalty imposed by 
                        subparagraph (A) by reason of such 
                        failures with respect to such 
                        individual shall not be less than 
                        $2,500.
                          (ii) Higher minimum penalty where 
                        violations are more than de minimis.--
                        To the extent violations for which any 
                        person is liable under this paragraph 
                        for any year are more than de minimis, 
                        clause (i) shall be applied by 
                        substituting ``$15,000'' for ``$2,500'' 
                        with respect to such person.
                  (D) Limitations.--
                          (i) Penalty not to apply where 
                        failure not discovered exercising 
                        reasonable diligence.--No penalty shall 
                        be imposed by subparagraph (A) on any 
                        failure during any period for which it 
                        is established to the satisfaction of 
                        the Secretary that the person otherwise 
                        liable for such penalty did not know, 
                        and exercising reasonable diligence 
                        would not have known, that such failure 
                        existed.
                          (ii) Penalty not to apply to failures 
                        corrected within certain periods.--No 
                        penalty shall be imposed by 
                        subparagraph (A) on any failure if--
                                  (I) such failure was due to 
                                reasonable cause and not to 
                                willful neglect; and
                                  (II) such failure is 
                                corrected during the 30-day 
                                period beginning on the first 
                                date the person otherwise 
                                liable for such penalty knew, 
                                or exercising reasonable 
                                diligence would have known, 
                                that such failure existed.
                          (iii) Overall limitation for 
                        unintentional failures.--In the case of 
                        failures which are due to reasonable 
                        cause and not to willful neglect, the 
                        penalty imposed by subparagraph (A) for 
                        failures shall not exceed the amount 
                        equal to the lesser of--
                                  (I) 10 percent of the 
                                aggregate amount paid or 
                                incurred by the employer (or 
                                predecessor employer) during 
                                the preceding taxable year for 
                                group health plans; or
                                  (II) $500,000.
                  (E) Waiver by secretary.--In the case of a 
                failure which is due to reasonable cause and 
                not to willful neglect, the Secretary may waive 
                part or all of the penalty imposed by 
                subparagraph (A) to the extent that the payment 
                of such penalty would be excessive relative to 
                the failure involved.

           *       *       *       *       *       *       *

                 Part 7--Group Health Plan Requirements

     Subpart A--Requirements Relating to Portability, Access, and 
Renewability

           *       *       *       *       *       *       *

SEC. 702. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL PARTICIPANTS 
                    AND BENEFICIARIES BASED ON HEALTH STATUS.

  (a) In Eligibility To Enroll.--
          (1) In general.--Subject to paragraph (2), a group 
        health plan, and a health insurance issuer offering 
        group health insurance coverage in connection with a 
        group health plan, may not establish rules for 
        eligibility (including continued eligibility) of any 
        individual to enroll under the terms of the plan based 
        on any of the following health status-related factors 
        in relation to the individual or a dependent of the 
        individual:
                  (A) * * *

           *       *       *       *       *       *       *

                  (F) Genetic information (including 
                information about a request for or receipt of 
                genetic services by an individual or family 
                member of such individual).

           *       *       *       *       *       *       *

  (b) In Premium Contributions.--
          (1) * * *
          (2) Construction.--Nothing in paragraph (1) shall be 
        construed--
                  (A) to restrict the amount that an employer 
                may be charged for coverage under a group 
                health plan except as provided in paragraph 
                (3); or

           *       *       *       *       *       *       *

          (3) No discrimination in group premiums based on 
        genetic information.--For purposes of this section, a 
        group health plan, or a health insurance issuer 
        offering group health insurance coverage in connection 
        with a group health plan, shall not adjust premium or 
        contribution amounts for a group on the basis of 
        genetic information concerning an individual in the 
        group or a family member of the individual (including 
        information about a request for or receipt of genetic 
        services by an individual or family member of such 
        individual).
  (c) Genetic Testing.--
          (1) Limitation on requesting or requiring genetic 
        testing.--A group health plan, or a health insurance 
        issuer offering health insurance coverage in connection 
        with a group health plan, shall not request or require 
        an individual or a family member of such individual to 
        undergo a genetic test.
          (2) Rule of construction.--Nothing in this part shall 
        be construed to--
                  (A) limit the authority of a health care 
                professional who is providing health care 
                services with respect to an individual to 
                request that such individual or a family member 
                of such individual undergo a genetic test;
                  (B) limit the authority of a health care 
                professional who is employed by or affiliated 
                with a group health plan or a health insurance 
                issuer and who is providing health care 
                services to an individual as part of a bona 
                fide wellness program to notify such individual 
                of the availability of a genetic test or to 
                provide information to such individual 
                regarding such genetic test; or
                  (C) authorize or permit a health care 
                professional to require that an individual 
                undergo a genetic test.
  (d) Application to All Plans.--The provisions of subsections 
(a)(1)(F), (b)(3), and (c) shall apply to group health plans 
and health insurance issuers without regard to section 732(a).

           *       *       *       *       *       *       *

Subpart C--General Provisions

           *       *       *       *       *       *       *

SEC. 733. DEFINITIONS.

  (a) * * *

           *       *       *       *       *       *       *

  (d) Other Definitions.--For purposes of this part--
          (1) * * *

           *       *       *       *       *       *       *

          (5) Family member.--The term ``family member'' means 
        with respect to an individual--
                  (A) the spouse of the individual;
                  (B) a dependent child of the individual, 
                including a child who is born to or placed for 
                adoption with the individual; and
                  (C) all other individuals related by blood to 
                the individual or the spouse or child described 
                in subparagraph (A) or (B).
          (6) Genetic information.--
                  (A) In general.--Except as provided in 
                subparagraph (B), the term ``genetic 
                information'' means information about--
                          (i) an individual's genetic tests;
                          (ii) the genetic tests of family 
                        members of the individual; or
                          (iii) the occurrence of a disease or 
                        disorder in family members of the 
                        individual.
                  (B) Exclusions.--The term ``genetic 
                information'' shall not include information 
                about the sex or age of an individual.
          (7) Genetic test.--
                  (A) In general.--The term ``genetic test'' 
                means an analysis of human DNA, RNA, 
                chromosomes, proteins, or metabolites, that 
                detects genotypes, mutations, or chromosomal 
                changes.
                  (B) Exceptions.--The term ``genetic test'' 
                does not mean--
                          (i) an analysis of proteins or 
                        metabolites that does not detect 
                        genotypes, mutations, or chromosomal 
                        changes; or
                          (ii) an analysis of proteins or 
                        metabolites that is directly related to 
                        a manifested disease, disorder, or 
                        pathological condition that could 
                        reasonably be detected by a health care 
                        professional with appropriate training 
                        and expertise in the field of medicine 
                        involved.
          (8) Genetic services.--The term ``genetic services'' 
        means--
                  (A) a genetic test;
                  (B) genetic counseling (such as obtaining, 
                interpreting, or assessing genetic 
                information); or
                  (C) genetic education.

           *       *       *       *       *       *       *

                              ----------                              

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *

    TITLE XXVII--REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

                      Part A--Group Market Reforms

Subpart 1--Portability, Access, and Renewability Requirements

           *       *       *       *       *       *       *

SEC. 2702. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL PARTICIPANTS 
                    AND BENEFICIARIES BASED ON HEALTH STATUS.

  (a) In Eligibility To Enroll.--
          (1) In general.--Subject to paragraph (2), a group 
        health plan, and a health insurance issuer offering 
        group health insurance coverage in connection with a 
        group health plan, may not establish rules for 
        eligibility (including continued eligibility) of any 
        individual to enroll under the terms of the plan based 
        on any of the following health status-related factors 
        in relation to the individual or a dependent of the 
        individual:
                  (A) * * *
          * * * * * * *
                  (F) Genetic information (including 
                information about a request for or receipt of 
                genetic services by an individual or family 
                member of such individual).
          * * * * * * *
  (b) In Premium Contributions.--
          (1) * * *
          (2) Construction.--Nothing in paragraph (1) shall be 
        construed--
                  (A) to restrict the amount that an employer 
                may be charged for coverage under a group 
                health plan, except as provided in paragraph 
                (3); or
          * * * * * * *
          (3) No discrimination in group premiums based on 
        genetic information.--For purposes of this section, a 
        group health plan, or a health insurance issuer 
        offering group health insurance coverage in connection 
        with a group health plan, shall not adjust premium or 
        contribution amounts for a group on the basis of 
        genetic information concerning an individual in the 
        group or a family member of the individual (including 
        information about a request for or receipt of genetic 
        services by an individual or family member of such 
        individual).
  (c) Genetic Testing.--
          (1) Limitation on requesting or requiring genetic 
        testing.--A group health plan, or a health insurance 
        issuer offering health insurance coverage in connection 
        with a group health plan, shall not request or require 
        an individual or a family member of such individual to 
        undergo a genetic test.
          (2) Rule of construction.--Nothing in this part shall 
        be construed to--
                  (A) limit the authority of a health care 
                professional who is providing health care 
                services with respect to an individual to 
                request that such individual or a family member 
                of such individual undergo a genetic test;
                  (B) limit the authority of a health care 
                professional who is employed by or affiliated 
                with a group health plan or a health insurance 
                issuer and who is providing health care 
                services to an individual as part of a bona 
                fide wellness program to notify such individual 
                of the availability of a genetic test or to 
                provide information to such individual 
                regarding such genetic test; or
                  (C) authorize or permit a health care 
                professional to require that an individual 
                undergo a genetic test.
  (d) Application to All Plans.--The provisions of subsections 
(a)(1)(F), (b)(3), and (c) shall apply to group health plans 
and health insurance issuers without regard to section 2721(a).

           *       *       *       *       *       *       *

         Subpart 4--Exclusion of Plans; Enforcement; Preemption

SEC. 2721. EXCLUSION OF CERTAIN PLANS.

  (a) * * *
  (b) Limitation on Application of Provisions Relating to Group 
Health Plans.--
          (1) * * *
          (2) Treatment of nonfederal governmental plans.--
                  (A) Election to be excluded.--[If the plan 
                sponsor] Except as provided in subparagraph 
                (D), if the plan sponsor of a nonfederal 
                governmental plan which is a group health plan 
                to which the provisions of subparts 1 through 3 
                otherwise apply makes an election under this 
                subparagraph (in such form and manner as the 
                Secretary may by regulations prescribe), then 
                the requirements of such subparts insofar as 
                they apply directly to group health plans (and 
                not merely to group health insurance coverage) 
                shall not apply to such governmental plans for 
                such period except as provided in this 
                paragraph.

           *       *       *       *       *       *       *

                  (D) Election not applicable to requirements 
                concerning genetic information.--The election 
                described in subparagraph (A) shall not be 
                available with respect to the provisions of 
                subsections (a)(1)(F) and (c) of section 2702 
                and the provisions of section 2702(b) to the 
                extent that such provisions apply to genetic 
                information (or information about a request for 
                or the receipt of genetic services by an 
                individual or a family member of such 
                individual).

SEC. 2722. ENFORCEMENT.

  (a) * * *
  (b) Secretarial Enforcement Authority.--
          (1) * * *

           *       *       *       *       *       *       *

          (3) Enforcement authority relating to genetic 
        discrimination.--
                  (A) General rule.--In the cases described in 
                paragraph (1), notwithstanding the provisions 
                of paragraph (2)(C), the following provisions 
                shall apply with respect to an action under 
                this subsection by the Secretary with respect 
                to any failure of a health insurance issuer in 
                connection with a group health plan, to meet 
                the requirements of subsection (a)(1)(F), 
                (b)(3), or (c) of section 2702.
                  (B) Amount.--
                          (i) In general.--The amount of the 
                        penalty imposed under this paragraph 
                        shall be $100 for each day in the 
                        noncompliance period with respect to 
                        each individual to whom such failure 
                        relates.
                          (ii) Noncompliance period.--For 
                        purposes of this paragraph, the term 
                        ``noncompliance period'' means, with 
                        respect to any failure, the period--
                                  (I) beginning on the date 
                                such failure first occurs; and
                                  (II) ending on the date such 
                                failure is corrected.
                  (C) Minimum penalties where failure 
                discovered.--Notwithstanding clauses (i) and 
                (ii) of subparagraph (D):
                          (i) In general.--In the case of 1 or 
                        more failures with respect to an 
                        individual--
                                  (I) which are not corrected 
                                before the date on which the 
                                plan receives a notice from the 
                                Secretary of such violation; 
                                and
                                  (II) which occurred or 
                                continued during the period 
                                involved;
                        the amount of penalty imposed by 
                        subparagraph (A) by reason of such 
                        failures with respect to such 
                        individual shall not be less than 
                        $2,500.
                          (ii) Higher minimum penalty where 
                        violations are more than de minimis.--
                        To the extent violations for which any 
                        person is liable under this paragraph 
                        for any year are more than de minimis, 
                        clause (i) shall be applied by 
                        substituting ``$15,000'' for ``$2,500'' 
                        with respect to such person.
                  (D) Limitations.--
                          (i) Penalty not to apply where 
                        failure not discovered exercising 
                        reasonable diligence.--No penalty shall 
                        be imposed by subparagraph (A) on any 
                        failure during any period for which it 
                        is established to the satisfaction of 
                        the Secretary that the person otherwise 
                        liable for such penalty did not know, 
                        and exercising reasonable diligence 
                        would not have known, that such failure 
                        existed.
                          (ii) Penalty not to apply to failures 
                        corrected within certain periods.--No 
                        penalty shall be imposed by 
                        subparagraph (A) on any failure if--
                                  (I) such failure was due to 
                                reasonable cause and not to 
                                willful neglect; and
                                  (II) such failure is 
                                corrected during the 30-day 
                                period beginning on the first 
                                date the person otherwise 
                                liable for such penalty knew, 
                                or exercising reasonable 
                                diligence would have known, 
                                that such failure existed.
                          (iii) Overall limitation for 
                        unintentional failures.--In the case of 
                        failures which are due to reasonable 
                        cause and not to willful neglect, the 
                        penalty imposed by subparagraph (A) for 
                        failures shall not exceed the amount 
                        equal to the lesser of--
                                  (I) 10 percent of the 
                                aggregate amount paid or 
                                incurred by the employer (or 
                                predecessor employer) during 
                                the preceding taxable year for 
                                group health plans; or
                                  (II) $500,000.
                  (E) Waiver by secretary.--In the case of a 
                failure which is due to reasonable cause and 
                not to willful neglect, the Secretary may waive 
                part or all of the penalty imposed by 
                subparagraph (A) to the extent that the payment 
                of such penalty would be excessive relative to 
                the failure involved.

           *       *       *       *       *       *       *

Part B--Individual Market Rules

           *       *       *       *       *       *       *

Subpart [3] 2--Other Requirements

           *       *       *       *       *       *       *

SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS OF GENETIC 
                    INFORMATION.

  (a) Prohibition on Genetic Information as a Condition of 
Eligibility.--A health insurance issuer offering health 
insurance coverage in the individual market may not establish 
rules for the eligibility (including continued eligibility) of 
any individual to enroll in individual health insurance 
coverage based on genetic information (including information 
about a request for or receipt of genetic services by an 
individual or family member of such individual).
  (b) Prohibition on Genetic Information in Setting Premium 
Rates.--A health insurance issuer offering health insurance 
coverage in the individual market shall not adjust premium or 
contribution amounts for an individual on the basis of genetic 
information concerning the individual or a family member of the 
individual (including information about a request for or 
receipt of genetic services by an individual or family member 
of such individual).
  (c) Genetic Testing.--
          (1) Limitation on requesting or requiring genetic 
        testing.--A health insurance issuer offering health 
        insurance coverage in the individual market shall not 
        request or require an individual or a family member of 
        such individual to undergo a genetic test.
          (2) Rule of construction.--Nothing in this part shall 
        be construed to--
                  (A) limit the authority of a health care 
                professional who is providing health care 
                services with respect to an individual to 
                request that such individual or a family member 
                of such individual undergo a genetic test;
                  (B) limit the authority of a health care 
                professional who is employed by or affiliated 
                with a health insurance issuer and who is 
                providing health care services to an individual 
                as part of a bona fide wellness program to 
                notify such individual of the availability of a 
                genetic test or to provide information to such 
                individual regarding such genetic test; or
                  (C) authorize or permit a health care 
                professional to require that an individual 
                undergo a genetic test.

                     Subpart 3--General Provisions

SEC. 2761. ENFORCEMENT.

  (a) * * *
  [(b) Secretarial Enforcement Authority.--The Secretary shall 
have the same authority in relation to enforcement of the 
provisions of this part with respect to issuers of health 
insurance coverage in the individual market in a State as the 
Secretary has under section 2722(b)(2) in relation to the 
enforcement of the provisions of part A with respect to issuers 
of health insurance coverage in the small group market in the 
State.]
  (b) Secretarial Enforcement Authority.--The Secretary shall 
have the same authority in relation to enforcement of the 
provisions of this part with respect to issuers of health 
insurance coverage in the individual market in a State as the 
Secretary has under section 2722(b)(2), and section 2722(b)(3) 
with respect to violations of genetic nondiscrimination 
provisions, in relation to the enforcement of the provisions of 
part A with respect to issuers of health insurance coverage in 
the small group market in the State.

           *       *       *       *       *       *       *

             Part C--Definitions; Miscellaneous Provisions

SEC. 2791. DEFINITIONS.

  (a) * * *

           *       *       *       *       *       *       *

  (d) Other Definitions.--
          (1) * * *

           *       *       *       *       *       *       *

          (15) Family member.--The term ``family member'' means 
        with respect to an individual--
                  (A) the spouse of the individual;
                  (B) a dependent child of the individual, 
                including a child who is born to or placed for 
                adoption with the individual; and
                  (C) all other individuals related by blood to 
                the individual or the spouse or child described 
                in subparagraph (A) or (B).
          (16) Genetic information.--
                  (A) In general.--Except as provided in 
                subparagraph (B), the term ``genetic 
                information'' means information about--
                          (i) an individual's genetic tests;
                          (ii) the genetic tests of family 
                        members of the individual; or
                          (iii) the occurrence of a disease or 
                        disorder in family members of the 
                        individual.
                  (B) Exclusions.--The term ``genetic 
                information'' shall not include information 
                about the sex or age of an individual.
          (17) Genetic test.--
                  (A) In general.--The term ``genetic test'' 
                means an analysis of human DNA, RNA, 
                chromosomes, proteins, or metabolites, that 
                detects genotypes, mutations, or chromosomal 
                changes.
                  (B) Exceptions.--The term ``genetic test'' 
                does not mean--
                          (i) an analysis of proteins or 
                        metabolites that does not detect 
                        genotypes, mutations, or chromosomal 
                        changes; or
                          (ii) an analysis of proteins or 
                        metabolites that is directly related to 
                        a manifested disease, disorder, or 
                        pathological condition that could 
                        reasonably be detected by a health care 
                        professional with appropriate training 
                        and expertise in the field of medicine 
                        involved.
          (18) Genetic services.--The term ``genetic services'' 
        means--
                  (A) a genetic test;
                  (B) genetic counseling (such as obtaining, 
                interpreting, or assessing genetic 
                information); or
                  (C) genetic education.

           *       *       *       *       *       *       *

                              ----------                              

INTERNAL REVENUE CODE OF 1986

           *       *       *       *       *       *       *

Subtitle K--Group Health Plan Requirements

           *       *       *       *       *       *       *

CHAPTER 100--GROUP HEALTH PLAN REQUIREMENTS

           *       *       *       *       *       *       *

    Subchapter A--Requirements Relating to Portability, Access, and 
Renewability

           *       *       *       *       *       *       *

SEC. 9802. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL PARTICIPANTS 
                    AND BENEFICIARIES BASED ON HEALTH STATUS.

  (a) * * *
  (b) In Premium Contributions.--
          (1) * * *
          (2) Construction.--Nothing in paragraph (1) shall be 
        construed
                  (A) to restrict the amount that an employer 
                may be charged for coverage under a group 
                health plan except as provided in paragraph 
                (3); or

           *       *       *       *       *       *       *

          (3) No group-based discrimination on basis of genetic 
        information.--For purposes of this section, a group 
        health plan may not adjust premium or contribution 
        amounts for the group covered under such plan on the 
        basis of genetic information.
  (c) Genetic Testing.--
          (1) Limitation on requesting or requiring genetic 
        testing.--A group health plan may not request or 
        require an individual or a family member of such 
        individual to undergo a genetic test.
          (2) Exception for health care professionals.--
        Paragraph (1) shall not be construed to limit the 
        authority of a health care professional who is 
        providing health care services to an individual to 
        request that such individual undergo a genetic test.
          (3) Provision of information not prohibited.--
        Paragraph (1) shall not be construed to limit the 
        authority of a group health plan--
                  (A) to provide information generally about 
                the availability of genetic tests, or
                  (B) to provide information about genetic 
                tests to a health care professional with 
                respect to the treatment of an individual to 
                whom such professional is providing health care 
                services.
  (d) Prohibition on Collection of Genetic Information.--
          (1) In general.--A group health plan shall not 
        request, require, or purchase genetic information for 
        purposes of underwriting (as defined in section 9832).
          (2) Prohibition on collection of genetic information 
        prior to enrollment.--A group health plan shall not 
        request, require, or purchase genetic information with 
        respect to any individual prior to such individual's 
        enrollment under the plan or in connection with such 
        enrollment.
          (3) Incidental collection.--If a group health plan 
        obtains genetic information incidental to the 
        requesting, requiring, or purchasing of other 
        information concerning any individual, such request, 
        requirement, or purchase shall not be considered a 
        violation of paragraph (2) if such request, 
        requirement, or purchase is not in violation of 
        paragraph (1).
  (e) Application to All Plans.--The provisions of subsections 
(a)(1)(F), (b)(3), (c), and (d) shall apply to group health 
plans without regard to section 9831(a).
  [(c)] (f) Special rules for church plans.--A church plan (as 
defined in section 414(e)) shall not be treated as failing to 
meet the requirements of this section solely because such plan 
requires evidence of good health for coverage of--
          (1) * * *

           *       *       *       *       *       *       *

                    Subchapter C--General Provisions

Sec.  9831.  General exceptions.
     * * * * * * *
Sec.  9834.  Enforcement.

           *       *       *       *       *       *       *

SEC. 9832. DEFINITIONS.

  (a) * * *

           *       *       *       *       *       *       *

  (d) Other definitions.--For purposes of this chapter--
          (1) * * *

           *       *       *       *       *       *       *

          (6) Family member.--The term ``family member'' means, 
        with respect to any individual--
                  (A) a dependent (as such term is used for 
                purposes of section 9801(f)(2)) of such 
                individual, and
                  (B) any other individual who is a first-
                degree, second-degree, third-degree, or fourth-
                degree relative of such individual or of an 
                individual described in subparagraph (A).
          (7) Genetic information.--
                  (A) In general.--The term ``genetic 
                information'' means, with respect to any 
                individual, information about--
                          (i) such individual's genetic tests,
                          (ii) the genetic tests of family 
                        members of such individual, and
                          (iii) the occurrence of a disease or 
                        disorder in family members of such 
                        individual.
                  (B) Inclusion of genetic services and 
                participation in genetic research.--Such term 
                includes, with respect to any individual, any 
                request for genetic services, receipt of 
                genetic services, or participation in any 
                clinical research, or any other program, which 
                includes genetic services, by such individual 
                or any family member of such individual.
                  (C) Exclusions.--The term ``genetic 
                information'' shall not include information 
                about the sex or age of any individual.
                  (D) Application to family members covered 
                under same plan.--Information described in 
                clause (iii) of subparagraph (A) shall not be 
                treated as genetic information to the extent 
                that such information is taken into account 
                only with respect to the individual in which 
                such disease or disorder occurs and not as 
                genetic information with respect to any other 
                individual.
          (8) Genetic test.--
                  (A) In general.--The term ``genetic test'' 
                means an analysis of human DNA, RNA, 
                chromosomes, proteins, or metabolites, that 
                detects genotypes, mutations, or chromosomal 
                changes.
                  (B) Exceptions.--The term ``genetic test'' 
                does not mean--
                          (i) an analysis of proteins or 
                        metabolites that does not detect 
                        genotypes, mutations, or chromosomal 
                        changes, or
                          (ii) an analysis of proteins or 
                        metabolites that is directly related to 
                        a manifested disease, disorder, or 
                        pathological condition that could 
                        reasonably be detected by a health care 
                        professional with appropriate training 
                        and expertise in the field of medicine 
                        involved.
          (9) Genetic services.--The term ``genetic services'' 
        means--
                  (A) a genetic test,
                  (B) genetic counseling (such as obtaining, 
                interpreting, or assessing genetic 
                information), and
                  (C) genetic education.
          (10) Underwriting.--The term ``underwriting'' means, 
        with respect to any group health plan--
                  (A) rules for eligibility (including 
                enrollment and continued eligibility) for, or 
                determination of, benefits under the plan,
                  (B) the computation of premium or 
                contribution amounts under the plan,
                  (C) the application of any pre-existing 
                condition exclusion under the plan, and
                  (D) other activities related to the creation, 
                renewal, or replacement of a contract of health 
                insurance or health benefits.

SEC. 9834. ENFORCEMENT.

  For the imposition of tax on any failure of a group health 
plan to meet the requirements of this chapter, see section 
4980D.

           *       *       *       *       *       *       *

                              ----------                              

SOCIAL SECURITY ACT

           *       *       *       *       *       *       *

     TITLE XI--GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE 
SIMPLIFICATION

           *       *       *       *       *       *       *

Part C--Administrative Simplification

           *       *       *       *       *       *       *

        APPLICATION OF HIPAA REGULATIONS TO GENETIC INFORMATION

  Sec. 1180.  (a) In General.--The Secretary of Health and 
Human Services shall revise the HIPAA privacy regulation (as 
defined in subsection (b)) so it is consistent with the 
following:
          (1) Genetic information shall be treated as health 
        information described in section 1171(4)(B).
          (2) The use or disclosure by a covered entity that is 
        a group health plan, health insurance issuer that 
        issues health insurance coverage, or issuer of a 
        medicare supplemental policy of protected health 
        information that is genetic information about an 
        individual for underwriting purposes under the plan, 
        coverage, or policy shall not be a permitted use or 
        disclosure.
  (b) Definitions.--For purposes of this section:
          (1) Genetic information; genetic test; family 
        member.--The terms ``genetic information'', ``genetic 
        test'', and ``family member'' have the meanings given 
        such terms in section 2791 of the Public Health Service 
        Act (42 U.S.C. 300gg-91), as amended by the Genetic 
        Information Nondiscrimination Act of 2007.
          (2) Group health plan; health insurance coverage; 
        medicare supplemental policy.--The terms ``group health 
        plan'' and ``health insurance coverage'' have the 
        meanings given such terms under section 2791 of the 
        Public Health Service Act (42 U.S.C. 300gg-91), and the 
        term ``medicare supplemental policy'' has the meaning 
        given such term in section 1882(g).
          (3) HIPAA privacy regulation.--The term ``HIPAA 
        privacy regulation'' means the regulations promulgated 
        by the Secretary under this part and section 264 of the 
        Health Insurance Portability and Accountability Act of 
        1996 (42 U.S.C. 1320d-2 note).
          (4) Underwriting purposes.--The term ``underwriting 
        purposes'' means, with respect to a group health plan, 
        health insurance coverage, or a medicare supplemental 
        policy--
                  (A) rules for eligibility (including 
                enrollment and continued eligibility) for, or 
                determination of, benefits under the plan, 
                coverage, or policy;
                  (B) the computation of premium or 
                contribution amounts under the plan, coverage, 
                or policy;
                  (C) the application of any pre-existing 
                condition exclusion under the plan, coverage, 
                or policy; and
                  (D) other activities related to the creation, 
                renewal, or replacement of a contract of health 
                insurance or health benefits.
  (c) Procedure.--The revisions under subsection (a) shall be 
made by notice in the Federal Register published not later than 
60 days after the date of the enactment of this section and 
shall be effective upon publication, without opportunity for 
any prior public comment, but may be revised, consistent with 
this section, after opportunity for public comment.

           *       *       *       *       *       *       *

                 TITLE XVIII OF THE SOCIAL SECURITY ACT

Part E--Miscellaneous Provisions

           *       *       *       *       *       *       *

    CERTIFICATION OF MEDICARE SUPPLEMENTAL HEALTH INSURANCE POLICIES

  Sec. 1882. (a)  * * *

           *       *       *       *       *       *       *

  (o) The requirements of this subsection are as follows:
          (1) * * *

           *       *       *       *       *       *       *

          (4) The issuer of the medicare supplemental policy 
        (as defined in subsection (x)) complies with subsection 
        (s)(2)(E) and subsection (x).

           *       *       *       *       *       *       *

  (s)(1) * * *
  (2)(A) * * *

           *       *       *       *       *       *       *

  (E) An issuer of a medicare supplemental policy shall not 
deny or condition the issuance or effectiveness of the policy 
(including the imposition of any exclusion of benefits under 
the policy based on a pre-existing condition) and shall not 
discriminate in the pricing of the policy (including the 
adjustment of premium rates) of an individual on the basis of 
the genetic information with respect to such individual.

           *       *       *       *       *       *       *

  (x) Limitations on Genetic Testing and Collection of Genetic 
Information.--
          (1) Genetic testing.--
                  (A) Limitation on requesting or requiring 
                genetic testing.--An issuer of a medicare 
                supplemental policy shall not request or 
                require an individual or a family member of 
                such individual to undergo a genetic test.
                  (B) Exception for health care 
                professionals.--Subparagraph (A) shall not be 
                construed to limit the authority of a health 
                care professional who is providing health care 
                services to an individual to request that such 
                individual undergo a genetic test.
                  (C) Provision of information not 
                prohibited.--Subparagraph (A) shall not be 
                construed to limit the authority of an issuer 
                of a medicare supplemental policy--
                          (i) to provide information generally 
                        about the availability of genetic 
                        tests, or
                          (ii) to provide information about 
                        genetic tests to a health care 
                        professional with respect to the 
                        treatment of an individual to whom such 
                        professional is providing health care 
                        services.
          (2) Prohibition on collection of genetic 
        information.--
                  (A) In general.--An issuer of a medicare 
                supplemental policy shall not request, require, 
                or purchase genetic information for purposes of 
                underwriting.
                  (B) Limitation relating to the collection of 
                genetic information prior to enrollment.--An 
                issuer of a medicare supplemental policy shall 
                not request, require, or purchase genetic 
                information concerning any individual prior to 
                such individual's enrollment under the policy 
                or in connection with such enrollment.
                  (C) Incidental collection.--Where an issuer 
                of a medicare supplemental policy obtains 
                genetic information incidental to the 
                requesting, requiring, or purchasing of other 
                information concerning an enrollee, such 
                request, requirement, or purchase shall not be 
                considered a violation of this paragraph if 
                such request, requirement, or purchase is not 
                in violation of subparagraph (A).
          (3) Definitions.--In this subsection and subsection 
        (s)(2)(E):
                  (A) Family member.--The term ``family 
                member'' means, with respect to any individual, 
                any individual who is a first-degree, second-
                degree, third-degree, or fourth-degree relative 
                of such individual.
                  (B) Genetic information.--
                          (i) In general.--The term ``genetic 
                        information'' means, with respect to 
                        any individual, information about--
                                  (I) such individual's genetic 
                                tests;
                                  (II) the genetic tests of 
                                family members of such 
                                individual; and
                                  (III) the occurrence of a 
                                disease or disorder in family 
                                members of such individual.
                          (ii) Inclusion of genetic services 
                        and participation in genetic 
                        research.--Such term includes, with 
                        respect to any individual, any request 
                        for genetic services, receipt of 
                        genetic services, or participation in 
                        any clinical research, or any other 
                        program, which includes genetic 
                        services, by such individual or any 
                        family member of such individual.
                          (iii) Exclusions.--The term ``genetic 
                        information'' shall not include 
                        information about the sex or age of an 
                        individual.
                  (C) Genetic test.--
                          (i) In general.--The term ``genetic 
                        test'' means an analysis of human DNA, 
                        RNA, chromosomes, proteins, or 
                        metabolites, that detects genotypes, 
                        mutations, or chromosomal changes.
                          (ii) Exceptions.--The term ``genetic 
                        test'' does not mean--
                                  (I) an analysis of proteins 
                                or metabolites that does not 
                                detect genotypes, mutations, or 
                                chromosomal changes; or
                                  (II) an analysis of proteins 
                                or metabolites that is directly 
                                related to a manifested 
                                disease, disorder, or 
                                pathological condition that 
                                could reasonably be detected by 
                                a health care professional with 
                                appropriate training and 
                                expertise in the field of 
                                medicine involved.
                  (D) Genetic services.--The term ``genetic 
                services'' means--
                          (i) a genetic test;
                          (ii) genetic counseling (such as 
                        obtaining, interpreting, or assessing 
                        genetic information); and
                          (iii) genetic education.
                  (E) Underwriting.--The term ``underwriting'' 
                means, with respect to a medicare supplemental 
                policy--
                          (i) rules for eligibility (including 
                        enrollment and continued eligibility) 
                        for, or determination of, benefits 
                        under the policy;
                          (ii) the computation of premium or 
                        contribution amounts under the policy;
                          (iii) the application of any pre-
                        existing condition exclusion under the 
                        policy; and
                          (iv) other activities related to the 
                        creation, renewal, or replacement of a 
                        contract of health insurance or health 
                        benefits.
                  (F) Issuer of a medicare supplemental 
                policy.--The term ``issuer of a medicare 
                supplemental policy'' includes a third-party 
                administrator or other person acting for or on 
                behalf of such issuer.

           *       *       *       *       *       *       *

                         VII. ADDITIONAL VIEWS

    At the time of the Ways and Means Committee markup, a 
bipartisan compromise was being developed by the House Energy 
and Commerce Committee to extend protections to genetic 
information of a fetus or embryo. However, an agreement had not 
yet been reached. The Energy and Commerce Committee has since 
reached an agreement and adopted an amendment to extend these 
protections. We request that the changes brought about by this 
bipartisan compromise be incorporated into all relevant 
sections before the bill moves to the House floor.
                                   Jim McCrery.
                                   Wally Herger.
                                   Ron Lewis.
                                   Dave Camp.
                                   Sam Johnson.

                                  
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